NCDs, a beatable beast
By Ahmed Khedr
It was a Friday night when they told me that my cousin was unconscious and he had his final exam the next day. My family asked me to check on him being a medical student and I checked his blood sugar level. It was a shock to find it over 700. It was a shock for me that my cousin is just 16 years old and has diabetes type 1. A few months later my grandfather died of untreated hypertension. Then I know that non-Communicable Diseases (NCDs) are silent killers and people are not aware of their dangers. NCDs are considered one of the leading causes of premature deaths globally and are a huge burden economically because of treatment costs on the one hand. On the other hand, NCDs deprive communities of resources due to less productivity of affected people, especially in low-income countries.
When it comes to numbers, in 2015, 70% of global deaths were caused by NCDs. The four main NCDs are cardiovascular diseases, cancers, diabetes and chronic lung diseases. The burden of these diseases is rising disproportionately among lower income countries and populations. In 2015, over three quarters of NCD deaths — 30.7 million — occurred in low- and middle-income countries with about 48% of deaths occurring before the age of 70 in these countries. Which rings a bell to stand along together and fight NCDs.
I strongly believe that NCD related issues are like a tree whose roots lead to complications and consequences in the leaves, therefore we have to figure out the root causes of NCDs and work on those. NCDs’ roots are not just health related, however, they are a combination of factors such as poverty, illiteracy and poor access to equal and good medication especially in low-income countries as well as sedentary life style and the dominance of junk food, alcohol and tobacco companies especially in high income countries. Obesity is more prevalent in high income countries due to fast paced lifestyle which is a huge risk factor for NCDs as well as high tobacco and alcohol consumption. In my part of the world, we do suffer more from NCDs, but due to unawareness of NCDs most of the patients only seek medical help when they have complications of NCDs and then comes the challenge of inadequate and unequal medical treatment. Therefore, treatment and prevention programs are dealing with the symptom leaves of the NCD tree and not addressing the roots, which is why the problem keeps re-growing. I do believe there is a huge gap between what is being discussed at global levels and what is being achieved on the national level due to many reasons including inadequate evaluation and monitoring systems tracking globally adopted strategies. In addition to non-cooperation of governments and absence of youth empowerment especially in low-income countries due to high benefits and profits between governments and food, tobacco, alcohol entities. For example, in Egypt we do not have a well-planned national strategy for NCDs as they focus more on hepatitis C. However, NCDs causes much morbidity and mortality, and I strongly believe that the lack of strategy is due to lack of publicity, research and advocacy to attract decision makers, sponsors and governments to form national, sustainable and inclusive NCDs program. However, when I was at the Global NCD Alliance Forum in the United Arab Emirates I met health workers from Kuwait who told me that they do not tax tobacco as they do not need the money. Obviously, it is not about money, but about decreasing consumption and using this tax for health purposes.
I have been working in the public health field since 2013 and focused on NCDs, emphasizing their burden and danger. I believe that my biggest achievement is to sustain our work on NCDs through building a secondary line of young leaders to continue my work. When I was a public health officer at IFMSA Egypt (International Federation of Medical Student Association), I formed a local team of new members as project coordinators and coordinator assistants and integrated them into public health work early. During my last term, I organized an initiative called “Checkup” about estimating the NCDs risk factors such as obesity among my university students at Menoufia University and the correlation to study curricula and regular exercise. The initiative was published as an abstract in conferences in Macedonia and Bangladesh, and I had project team of four new members as my assistant, project coordinator and two coordinator assistants who got promoted to be national public health officer assistant and public health officers respectively and continued their passion to recruit more public health activists to work on NCDs.
I expect NCDs to be much more visible with regards to their magnitude and hazards. I also hope that NCD responses will be first priority among SDGs in the future, especially as they are so connected to other targets. I also expect much more funds to be directed towards global health systems and health insurances, especially in low-income countries to support treatment and prevention of NCDs. I hope to have multinational health-related entities to limit the spread of fast food, alcohol and tobacco companies as well as many more restrictions for their usage especially for adolescents and teens.
I have always been keen on fundraising my campaigns. Living in a low-income country with limited resources, I therefore used some innovative ways such as building partnership with bio-medical labs to provide total lipid profiles for obese and overweight subjects. Small pharmaceutical companies were very helpful partners by providing us with all equipment and tools needed such as sugar measuring devices and for financing logistics. Sports clubs are major sponsors by letting us use their pitches and facilities for sport competitions and marathons including media coverage with simple registration fees which is used to fund the rest of the campaigns. Food firms especially dairy producers were our sponsor for the “Build Your Body” project about good nutrition for adolescents and kids. NCDs are a beast which is easy to beat by the three P´s: planning, patience and proper evaluation and monitoring.
Originally published at medium.com on March 30, 2018.
