Study examines non-communicable disease burden in Pakistan
Non-communicable diseases like cardiovascular diseases, cancers, diabetes and injuries have become the major causes of disability and death in Pakistan, according to a report by a group of researchers that included Johns Hopkins Bloomberg School of Public Health professor, Adnan A. Hyder. Furthermore, while rates of death and disability from non-communicable diseases are expected to continue to increase, Pakistan's health care system is unprepared to handle the rising burden. The report suggests that if current trends continue, nearly 4 million people between the ages of 30-69 will die from cardiovascular disease, cancers and chronic respiratory disease by 2025.
The study, "Non-Communicable Diseases and Injuries in Pakistan: Strategic Priorities," published as part of The Lancet series on Health Transitions in Pakistan, also examined the prevalence of non-communicable diseases such as road traffic injuries, noting that enforcement of traffic safety laws is weak. Both seat belt and speeding laws are enforced poorly, as is the helmet law for bicycle and motorcycle riders, where hospital-based surveillance data indicates that more than 90 percent of riders do not wear helmets. No legislation exists for vehicle standards, road safety audits or promotion of safer transportation systems.
"Pakistan is the sixth most populous country in the world. The recognition of injuries as a key component of the national disease burden is an important first step. This issue needs some serious attention from policy makers," said Hyder, director of the Health Systems program in the Bloomberg School's Department of International Health and head of the Johns Hopkins International Injury Research Unit.
According to the report, Pakistan was one of the first developing countries to implement an integrated national action plan for non-communicable diseases, but the high-level, government buy-in the plan had initially was withdrawn. The report goes on to explain that the economic effect of non-communicable diseases and injuries is devastating, estimating a cumulative production loss at approximately $3.47 billion.
Hyder and his colleagues recommend several strategies for preventing non-communicable diseases, which include implementing policy, legislation and programs to support and promote healthy diet and physical activity; directing generated revenue from the increased excise tax on cigarette sales toward prevention initiatives, thereby mitigating the cost of the suggested measures; and re-prioritizing of funds from international donor agencies to fund non-communicable diseases and injuries. The target goal is to reduce the number of premature deaths due to cancers and cardiovascular and respiratory diseases by 20 percent in 2025. The researchers also stress that efforts must also be directed toward prevention of injuries and mental disorders.
The report was published as part of four papers in the Lancet Series which examine the transitions in Pakistan's health system and focus on the country's past and present performance in health, specifically after the 18th amendment to the Constitution abolished the federal Ministry of Health. The series also calls for a unified vision for universal and equitable health access across the nation. Other papers in the Series focus on reproductive and maternal health, non-communicable diseases and injuries, and recommendations for future health reforms.