Non Communicable Diseases in Seychelles Overview Bharathi Viswanathan

Non Communicable Diseases in Seychelles Overview Bharathi Viswanathan Program Manager, UPCCD Ministry of Health, Seychelles

The Seychelles · Archipelago : 115 islands ·Total · population : 85, 000 90% population on 1 island Predominantly African descent · · Tourism, tuna · GNP/cap : $ 6, 000/cap/yr School: 2 yrs crèche and 10 grades prim. & sec obligatory, free, ~100% ·

Number of deaths due to CVD, cancer and other causes, Seychelles by age 250 No of deaths per year 200 Men Women Other Cancer CVD 150 100 50 0 0 -34 35 -64 65+ Age category

Current “baby bonanza” but expected large increase in DM & CVD in next 20 years irrespective of interventions 55 Age

Prevalence of main risk factors in the general population aged 35 -64 of Seychelles in 1989 and 2004 (Seychelles Heart Study)

Trends in prevalence of overweight and obesity in children aged 5 -18, 1998 -2006 • Criteria of International Obesity Task Force (IOTF) for overweight and obesity • Prevalence of overweight increased by 50% : 9% to 14% in boys; 12% to 19% in girls • Prevalence of obesity doubled: 2% to 5% in boys; 3% to 6% in girls

Development of Programs for NCD prevention n Set up of the Unit for Prevention and control of CVD in 1989, NCD section 2005. Surveys/surveillance n n n Population based adults surveys (WHO STEP wise) in 1989, 1994 & 2004 School based surveys targeting children (GYTS 2002 & 2007, GSHS 2007) Systematic ongoing collection of health indicators (overweight, BMI, HBP, etc) in children aged 5, 9, 12, & 15 attending schools since 1998 Population based : n Several awareness campaigns targeting the general population through media (national radio and TV since the early 1990 s) yearly n High-profile activities for WNTD, WHD and WDD, including Minister’s message n ‘Give Me 5’ campaign to promote the consumption of fruit and vegetables n National Campaign to Promote healthy lifestyles (6 key messages) in 2009 n Promotion of smoke free ‘Jeux Des Iles’ in August 2011

Development of Programs for NCD prevention Individual based: n Screening in individuals including HBP and diabetes in public and workplaces. Other: n Specialized ‘NCD nurses’ in prominent role in the prevention of NCD’s n NCD-related school curriculum, with components for both teachers and students, has been worked out with the Ministry of Education. n Free Health care to all Seychellois and resident clients at the point of service, as provided for by the Constitution of Seychelles.

Development of NCD related Policy & Achievements Tobacco Control: FCTC: n First country to ratify the FCTC in the African region in 2003. n Active participation in all FCTC meetings Tobacco Control Act: n National Committee for Tobacco Control was established in 2001 to develop a comprehensive legislation for tobacco control. n Tobacco Control Act was enacted in August 2009 n Act includes, among various provisions; total ban on smoking in enclosed public places and workplaces, total ban on tobacco advertising, promotion and sponsorship, display of health warnings on tobacco packages, set up of a tobacco control board and many others n Taxes on tobacco are as high as 60– 70% of the retail price

Development of NCD related Policy & Achievements National School nutrition policy includes; n Integration of the dietary guidelines within the school curriculum since 2007 n Ban on sugar-sweetened soft drinks in all schools n Restricts the sale of other foods of low nutritional value. Health promotion policy: n Includes several measures that enables the adoption of healthy behaviors n Expected to be presented to the cabinet and the NA soon

Policy for tobacco control in Seychelles: a success story In 2000, students of all schools handed over pledge signed by 14’ 385 to VP at State House. WHO award given to MOH, 2004 Adoption of FCTC at WHA,

Launching of the Healthy lifestyle Campaign by Health Minister Display of banners promoting smoke free Jeux des Iles in August 2011

Dietary Guidelines & Seychelles Food Guide

Challenges & lessons learnt n Good use of surveillance mechanisms supplemented by focused research; generating broad interest and consensus n Mobilizing leadership and commitment at all levels n Involving local and international experts; building on existing efforts n Seeking integrated, multidisciplinary and multi-sector approaches

Next Steps Tobacco Act: n Preparation and implementation of various guidelines related to Tobacco Control Act including; Health Warnings display on Tobacco Packages NCD Policy: n Preparation of a comprehensive National Action Plan for NCD Prevention & Control n Advocate with the Ministry of Finance for the removal of trade tax on some healthy foods n Advocate health-promoting actions e. g. establishing cycling lanes and rethinking the transportation system to encourage walking Inter-sectoral Committee: n Strengthen the multi-sectoral framework for the prevention of NCDs n Networking with other agencies in the prevention of NCD’s

Thank You