Call to action on NCDs Challenges and Way

Call to action on NCDs: Challenges and Way Forward for Maternal and Child Health Dr. Niloufer Sultan Ali Professor, Family Medicine Aga Khan University, Karachi 1

‘Each year, millions of women & children die from preventable causes. These are not mere statistics. They are people with names & faces. Their suffering is unacceptable in the 21 st century’, Ban Ki-moon, United Nations Secretary-General 2

A neglected dimension of women’s health NCDs are the world’s number one killer • 35 million people die every year 18 million are women NCDs represent the biggest threat to women’s health worldwide 3

WHO report 2008 4

Total deaths around the world: 58 million Deaths from NCDs: 35 million Deaths from NCDs in developing countries: 28 million Countdown to 2015, Maternal Child and Newborn survival, the 2012 report 5

Urgent priority for women’s health NCDs are no longer diseases of the rich and elderly Increasingly impacting on women in developing countries during the prime of their life 6

Source: WHO Chronic Disease Report, 2005 7

Ratio of Non-Communicable/ Communicable Deaths, India, China, Other Asia-Pacific, 1990 -2020 Deaths due to NCDs are 3 times more as compared to communicable diseases in Asia Pacific Source: WHO Chronic Disease Report, 2005 8

NCD Diseases 4 Diseases, 4 Modifiable Shared Risk Factors Tobacco Use Unhealthy diets Physical Inactivity Harmful Use of Alcohol Cardiovascular Diabetes Cancer Chronic Respiratory Source: WHO Chronic Disease Report, 2005 9

NCD in Pakistan WHO report 2008 10

NCD in Pakistan…Cont WHO report 2008 11

IMPACT OF NCDs macro-economic impact Lost National Income Lost national income from premature deaths due to heart disease, stroke and diabetes 2005 2006 -2015 (cumulative) Lost national income (billions) Brazil 3 49 China 18 558 India 9 237 0. 4 8 Pakistan 1 31 Russian Federation 11 303 Tanzania 0. 1 3 Countries Nigeria Source: WHO Chronic Disease Report, 2005 12

Women & Diabetes • Currently, 143 million women are suffering from diabetes • By 2030, this number is expected to rise to 222 million • Diabetes is the ninth leading cause of death in women globally • Gestational diabetes develops in one in 25 pregnancies worldwide. Source: WHO Chronic Disease Report, 2005 Source: Countdown to 2015, Maternal Child and Newborn survival, the 2012 report 13

Women & Cancer • Over 3 million women die of cancer each year • Breast & lung cancers are the most common cancer killers of women • An estimated 1. 7 million women will be diagnosed with breast cancer in 2020—a 26% increase from current levels—mostly in the developing world Source: WHO Chronic Disease Report, 2005 14

Women & CVD • CVD is the number one killer of women worldwide • Causes 9. 1 million deaths among women annually • In 2008, CVD killed 1. 2 million women aged between (20 -59 years) the most productive years of life • Developing countries are more affected Source: WHO Chronic Disease Report, 2005 15

Offspring CVD Risk by Parental CVD Status: Framingham Study Parental CVD Risk Ratio <55 men, <65 Women 2. 5 2 2. 2 1. 5 1. 7 1 1. 0 0. 5 0 Male offspring 1. 0 Female offspring Source: International Society of Hypertension 16

NCDs in women compromises child health NCDs not only affect the health of women but also the health of their children • Being born to a malnourished mother increases the chances of the infant suffering from under-nutrition, late physical and cognitive development and NCDs in adulthood 17

Childhood Obesity • 43 million children under five years are overweight • Girls are more likely to be overweight > Restrained from regular physical activity and sport >Lack of safe and supportive environments 18

Source: The Growth Assessment and Surveillance Unit, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland. 19

Current Challenges & Barriers to Women’s Health 20

Socio-cultural Barriers Women Education & Empowerment – Young women & girls are unable to make decisions about care for themselves or for their children without the permission of their husbands – Higher rates of illiteracy among women results in less access to information about NCD risk factors, prevention & treatment 21

Health System Barriers • Women are less likely to seek medical care from male health providers due to cultural taboos • Shortage of female health care providers • Lack of NCD component in existing health systems 22

Health System In Pakistan Source: WHO, country profile 2008 23

A Way Forward 24

Fight for NCDs Reduce modifiable risk factors among individuals & populations • Tobacco use • Unhealthy diet • Physical inactivity • Harmful use of alcohol 25

A CALL FOR ACTION We need to move away from the fragmented approach to health and move towards taking a holistic view of the health of girls and women 26

A call for Action…Cont • Enhance women education and empowerment • NCD component to be integrated into existing health systems • Link information of NCDs to reproductive health programs • Involvement of women in identifying problems, solutions & implementing policies in the fight against NCDs 27

We can act TOGETHER, LET’S MAKE NCDs A PRIORITY FOR WOMEN’S HEALTH AND DEVELOPMENT 28

Act now on NCDs for girls, women and future generations 29

We all have a role to play Everyone has a critical role to play in improving the health of women and children 30

Role of Family Physicians • • • Promote healthy lifestyle Provide opportunistic care Share information regarding NCDs Address modifiable risk factors Conduct public awareness sessions Emphasize on regular check-ups 31

Thank You