countrys policies and programs on NCDs at national

country’s policies and programs on NCDs at national level. Cristina Gaberi, MOH Republic of Moldova

Introduction • Republic of Moldova faces the double burden: one mainly characteristic for developed country and the other for developing countries • NCDs: CVDs, Cancer, liver diseases, especially cirrhosis, COPD together with reemerging tuberculosis and HIV/AIDS are the main threats to Moldova • The NCDs are not only a burden for the health system but also for economic and social development of the country

Mortality ratio by main causes of death, 2011 8% 6% 14% 9% 5% 57% Tumori Bolile aparatului circulator Bolile aparatului respirator Bolile aparatului digestiv Traume si otraviri Alte cauze Sursa: Centrul Naţional de Management în Sănătate; Anuar Statistic, 2011

NCDs situation

Moldova’s Health System, under reorganization Ministry of Health Primary Health Care Hospital Health Care Specialized Health Care Urgency Health Care Pharmaceutical Service for Public Health Supervision Service Mandatory Medical Insurance was introduced since 2004

Data collection and reporting: official statistics • Morbidity and mortality data (general and disease- specific) • Metabolic risk factors (since 2011): - Blood pressure - Blood cholesterol - Blood glucose - BMI

Data collection and reporting: NCDs risk factors • Periodically held surveys on: - tobacco consumption - alcohol consumption - overweight and obesity - physical activity - breastfeeding practices and food intake

National integrated or topic-specific policies currently operational • First National Program on Tobacco Control, 2012 -2016 • Second National Program on Diabetes Control, 2011 -2015 • Third National Program on Iodine Deficiency Disorders Elimination, 2011 -2015

National strategy and programs: currently under development or approval • National Strategy on NCDs already approved by the Govn. • National Programs on: - Alcohol Control - Cancer Control - Cardiovascular Diseases Control - Iron and Folic Acid Deficiency Reduction • National Action Plan for Food and Nutrition

Conclusions/lessons learnt • NCDs accounts for more than two thirds of the total deaths • The main common risk factors for NCDs are tobacco and alcohol consumption, low consumption of fruits and vegetable, physical inactivity, high blood pressure and high cholesterol • The major problems in NCDs surveillance and control are: - Development of an integrated intra- and multisectoral data collection, reporting and analysis system - Strengthening of the multi-sectoral cooperation - Development and enforcement of an adequate legislative and normative support for the NCDs and their risk factors surveillance and control - Training of the staff involved in the NCDs and their risk factors control

Next steps • Evaluation of all NCDs documents • Developing an action plan for the strategy of prevention and control of NCDs strategy. • Change the priority from treatment to prevention.