THIRD MEETING OF THE GLOBAL FORUM ON NCD PREVENTION AND CONTROLRio de Janeiro, 9-12 November 2003: THIRD MEETING OF THE GLOBAL FORUM ON NCD PREVENTION AND CONTROL Rio de Janeiro, 9-12 November 2003 PROGRESS REPORT OF THE REGIONAL NETWORK WHO SOUTH-EAST ASIA REGION Dr Jerzy Leowski, RA NCS, WHO SEARO


Estimated Share of NCDs in Deaths & Disease Burden SEAR – 2001: Estimated Share of NCDs in Deaths andamp; Disease Burden SEAR – 2001 Source: World Health Report 2002


Attributable mortality in SEAR by risk factor : Attributable mortality in SEAR by risk factor The above risk factors contribute to 85% of all NCD related and 42.5% of all deaths in SEAR Source: World Health Report 2002


Slide4: Noncommunicable diseases (NCD) are assuming high proportions and becoming the leading causes of mortality, morbidity and disability in WHO South-East Asia Region (SEAR). This situation is due to the demographic and socioeconomic transformation taking place in the Region which, in turn, has resulted in profound lifestyle changes. The observed increase in NCD has not resulted in the adoption of appropriate public health measures. This is reflected in in the meager resources allocated and the limited interest of the governments in identifying and addressing priorities related to NCD prevention and control.


Recent Developments : Recent Developments Regional NCD Surveillance Network Regional Strategy for NCD Surveillance Eight SEAR countries supported in conducting standardized NCD risk factor survey and Global Youth Tobacco Survey (GYTS) Regional NCD Risk Factor InfoBase and Profile Regional mechanisms facilitating surveillance activities Community-based NCD prevention projects National networks for NCD Prevention and Control Regional guidelines for management of major NCD at PHC


Regional NCD Surveillance Network: Regional NCD Surveillance Network Established in October 2002 Participating countries: Bangladesh, India, Indonesia, Nepal, Sri Lanka, Thailand Coordinated by WHO SEARO Objective – to facilitate inter country collaboration so as to enhance regional capacity to conduct NCD surveillance and appropriate utilization of information


Regional Strategy for NCD Surveillance: Regional Strategy for NCD Surveillance Developed in 2003 Aimed at supporting countries in developing strategic plan of action and strengthen capacity for NCD surveillance Regional targets and strategies for 2003-2010 proposed Selected targets: Collection of standardized data on NCD risk factors surveillance to be incorporated into existing health information systems Sustainable data-bases for NCD and their risk factors to be established


Regional NCD Risk Factor InfoBase: Regional NCD Risk Factor InfoBase Regional site within WHO Global NCD InfoBase Covers eight common NCD risk factors Variety of data sources retrieved Entry point in establishing national NCD info bases in SEAR countries Risk Factors for Chronic Diseases in SEAR – A Profile


NCD Risk Factor Surveys using WHO STEPS approach implemented in SEAR: NCD Risk Factor Surveys using WHO STEPS approach implemented in SEAR SN – Sub National; N – National; HH – House Hold


Regional Facilitating Mechanisms: Regional Facilitating Mechanisms Training National Focal Points trained in implementing standardized risk factor surveys at 2 regional and 1 extra regional workshops National planning workshops conducted prior to surveys Regional Statistical Support Group Established in 2003 Regional expert advisory body supporting NCD surveillance in SEAR; experts from 4 countries involved Provides assistance and technical advice on sampling plan and other statistical issues for NCD and risk factor surveillance activities Developing guidelines on different aspects of NCD surveillance Regional Pool of Equipment Basic equipment (for physical measurements) for NCD risk factor surveys acquired by the Regional Office Loaned to Principal Investigators conducting surveys Better comparability of collected data across countries Reduced cost of surveys


COMMUNITY-BASED NCD PREVENTION PROJECTS : COMMUNITY-BASED NCD PREVENTION PROJECTS October 2000 - ICP pilot projects launched in 3 mega countries (Bangladesh, India, Indonesia) in order to facilitate capacity building for community-based NCD prevention May 2001 - baseline surveys completed August 2002 – pilot projects completed and reports submitted December 2002 – proposals for extension received and funds obligated January 2003 – issues related to implementation of extended demonstration projects discussed by inter country consultation


Slide12: India - sentinel surveillance system for CVD in 10 industrial populations linked to intervention (work site and family based programmes) for enhancing knowledge, motivation and skills as relevant to healthy lifestyle practices Proposals for CBI developed in Maldives and Sri Lanka COMMUNITY-BASED NCD PREVENTION PROJECTS


Informal Consultation on Integrated Community-Based Prevention of Major NCDs in SEAR, January 2003: Informal Consultation on Integrated Community-Based Prevention of Major NCDs in SEAR, January 2003 OBJECTIVES To share experiences of implementation of pilot projects on community-based integrated prevention of major NCDs completed in Bangladesh, India, Indonesia and other NCD prevention activities held in SEAR; To discuss technical issues related to strengthening of the above-mentioned projects; and To initiate discussions on establishing regional network for NCD prevention in SEAR.


Informal Consultation on Integrated Community-Based Prevention of Major NCDs in SEAR, January 2003: Informal Consultation on Integrated Community-Based Prevention of Major NCDs in SEAR, January 2003 CONCLUSIONS ON PILOT PROJECTS Community-based approach for prevention of NCD is feasible and appropriate for implementation in the countries of SEAR Valuable lessons on design and implementation were learnt and should be incorporated in the proposed extension of projects The framework provided by WHO STEPS is suitable for estimating the level of risk factors in the areas where community-based intervention is applied


Slide15: Major components at national level: Political commitment to strengthen NCD prevention National NCD Surveillance Network National Health Promotion Programme/Network Integrated NCD Prevention and Control Programmes Community based intervention projects Multisectoral coordination Other Regional co-ordination, technical support, exchange of experience, sharing resources etc. (WHO SEARO) Regional NCD Prevention Network


Regional NCD Prevention Network: Regional NCD Prevention Network National Networks for Prevention and Control of Major NCD being established in Indonesia, Maldives, Sri Lanka, and Thailand First meeting of Indonesian network held in August 2003 Sri Lanka will hold national meeting in Nov-Dec 2003 SEAR Network to be formally launched in March 2004


Conclusions: Conclusions Multiple activities are being initiated by WHO SEARO to establish a critical mass of action for prevention of NCD in the region There is a considerable interest and commitment in NCD surveillance and community-based prevention programmes Selected countries are being supported in launching national NCD prevention and control networks Regional network still to be initiated – its sustainability is a matter of concern