Non-communicable Diseases in Nepal: A Big Hurdle for Achieving SDGs

Abstract

Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors. NCDs are the leading causes of ill health in the world and it accounts for 70% of premature deaths globally [1]. NCDs, including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for most of the premature deaths worldwide. Almost three quarters of all NCD deaths, and 82% of the 16 million people who died prematurely, or before reaching 70 years of age, occur in lowand middle-income countries [2]. NCDs claim lives at a younger age in SEA Region compared to rest of the world. The proportion of deaths due to NCDs below the age of 60 years was 34% in SEA region, compared to 23% in rest of the world[3]. NCDs have been receiving an increased attention within global governing bodies since the first United Nations’ high‐level meeting on NCDs in 2011 [4]. Millenium Development Goals (MDGs) were replaced after the formulation of the SDGs in September 2015. The vision of inclusive growth across the globe has paved way for formation of Sustainable Development Goals (SDGs) by the UN General Assembly [5]. NCDs are included in SDG-3 as “to ensure healthy lives and promote well‐being for all at all ages” [6] Specifically, SDG target 3.4 aims to “reduce by one‐third premature mortality from NCDs through prevention and treatment and promote mental health and well‐being.” Three of the nine health targets focus on NCD‐related issues which reflects the importance given to NCDs in SDGs. NCDs are estimated to account for 66% of all deaths in Nepal [7]. Depicting the scenario of rest of the developing countries, NCDs account for more than 44 % of deaths and 80 % of outpatient visits. Nearly one third of the population are with hypertension [8] and 15 % are with diabetes [9]. The most common NCDs among outpatients are chronic obstructive pulmonary diseases (COPD) i.e., 43 % followed by cardiovascular diseases (CVDs) 40 %, diabetes mellitus 12 % and cancer5 % [10]. Nepal has seen shift in disease pattern from high to low burden of infectious disease and increasing burden of NCDs [11]. Rapid urbanization, change in dietary patterns, behavioural factors and major improvements in prevention of maternal and child health to raise life expectancy are all factors contributing to shift disease patterns in Nepal [12]. The countrywide STEPS survey of NCDs risk factors which was carried out in 2019 showed a remarkably high prevalence of less than five servings of fruit and/or vegetable, tobacco use, overweight/obese and raised blood pressure as 96.7%, %, 28.9%, 24.3%, 24.5% respectively [13].