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 Table of Contents  
EDITORIAL
Year : 2017  |  Volume : 2  |  Issue : 1  |  Page : 1-2

Evolution of noncommunicable diseases: Past, present, and future


1 Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
2 School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
3 Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Date of Web Publication11-Apr-2017

Correspondence Address:
Arun Chockalingam
University of Toronto, Toronto
Canada
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jncd.jncd_13_17

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How to cite this article:
Chockalingam A, Thakur JS, Varma S. Evolution of noncommunicable diseases: Past, present, and future. Int J Non-Commun Dis 2017;2:1-2

How to cite this URL:
Chockalingam A, Thakur JS, Varma S. Evolution of noncommunicable diseases: Past, present, and future. Int J Non-Commun Dis [serial online] 2017 [cited 2017 Dec 16];2:1-2. Available from: http://www.ijncd.org/text.asp?2017/2/1/1/204356

“Two-thirds of the global mortality (about 36 million) is due to noncommunicable diseases (NCDs) and the WHO calls for urgent action as NCDs prematurely take 16 million lives annually.”

In 1971, Omran postulated that “epidemiological transition” accounts for the replacement of infectious diseases by chronic diseases over time due to expanded public health and sanitation.[1] As the world turns into globalization, the epidemiological transition occurs as a country undergoes the process of modernization from developing nation to developed nation status. Such developments of modern healthcare and medicine, such as antibiotics, drastically reduce infant mortality rates and extend average life expectancy, which are fraught with increasing to chronic and degenerative diseases which were more important causes of death today.

Since the first Global Burden of Diseases Study, the WHO and International Classification of Diseases categorized the diseases into three groups, the obvious ones are infectious diseases (Group I), and injuries in all forms – including both road traffic accidents and family violence (Group II). For lack of a better notation and for ease of expression, all the diseases which are not infectious were collectively called NCDs (Group III). The debate on the use of NCD is ongoing since the late 1980s. Several versions were tried as chronic diseases, noninfectious diseases, and chronic NCDs, for example. At the turn of the millennium when the Millennium Development Goals (MDG) was postulated, the NCD prevention was not identified as one of the eight MDGs.[2] Subsequently, in the dawn of the millennium, WHO and others [3],[4] dwelled on the need to get a grip on escalating NCDs. A group of world leaders in 2007 using Delphi method identified four major diseases, namely, cardiovascular diseases (CVDs) including stroke, diabetes mellitus (DM), cancer (in all its forms), and the chronic obstructive pulmonary diseases (COPDs) as key NCDs. The reason for choosing these four over other chronic diseases was the common risk factors shared by all of these, namely, tobacco, physical inactivity, diet (particularly high in saturated fat and higher salt intake), and abnormal intake of alcohol.

After several consultations with many experts around the world, the WHO reached a working document for the consideration of the Health Ministers of all countries around the world. After a series of regional meetings and further elaborations, a political declaration was developed to the agreement of all 192 countries of the world and was released at the landmark United Nation's High-Level Meeting on NCD Prevention and Control in New York on September 20, 2011.

The Political Declaration called for whole-of-government and whole-of-society approach to address the four major NCDs (CVD, DM, cancer, and COPD) through reduction of four common risk factors (tobacco, diet, physical activity, and alcohol). The countries collectively resolved in 2011 to implement strategies to prevent and control NCDs. Following the UN High-Level Meeting, the WHO through expert consultations arrived at voluntary targets and indicators [5] for public, private, and voluntary sectors to adapt and implement in all regions of the world to achieve NCD reduction. By the year 2014, the WHO promoted the slogan, 25 × 25 meaning 25% reduction in NCD by the year 2025.[6]

By 2015, when the target date of MDGs arrived, the WHO and the UN realized the unfinished agenda of MDGs in many countries and to ensure that the gains made in some of the MDGs in a number of countries to be continued, arrived at Sustainable Development Goals (SDGs).[7] With 17 laudable goals, the UN SDGs emphasized the need to protect environment, natural resources, and the need for continued partnership and collaboration. Among the 17 goals, Goal # 3 on health specifically addressed the NCDs.

Although the four major NCDs gained recognition as they contribute to the major burden, other major chronic illness-mental health received traction. There are, yet, many other chronic illnesses such as chronic kidney disease, osteoarthritis, and others need to be cared for.

In spite of the proliferation of statements and rhetoric by governments and nongovernmental organization (NGOs), measurable real progress is not visible. The burden of NCDs continues to escalate in all regions of the world. To this effect, a group of dedicated volunteers primarily from the academia decided to start an action-oriented NGO called World NCD Federation (WNF) in 2015, with a clear objective to promote public health measures to prevent and control NCDs. The WNF serves as an advocacy group and strives for implementation of best practices as well as to enhance training the required public health workforce. The goals and objectives of the WNF can be seen by visiting www.worldncdfederation.org. Furthermore, the WNF initiated a new scholarly international journal to bring out the research in NCD prevention, particularly from the low- and middle-income countries (LMICs). This International Journal of NCDs (www.ijncd.org) was launch in July 2016 as a quarterly with a focus on prevention and surveillance besides disease management.

To bring the public, private, and NGO sectors consciousness on NCD control, the WNF jointly with the Postgraduate Institute of Medical Education and Research, Chandigarh, India, is hosting the very first World NCD Congress (WNC) at Chandigarh, November 3–7, 2017. The Congress objectives are to discuss the latest advances and trends in prevention, management, and surveillance of NCDs at global level; to highlight the importance of NCDs in achieving SDGs by 2030; and to discuss the global NCD agenda and to initiate policy dialogs among stakeholders and to promote multisectoral action, partnership, and advocacy for NCDs. The expected outcomes of the congress are Chandigarh Declaration on NCDs highlighting outcome of Congress, developing partnerships and coalition for achieving the goals envisaged under the SDGs by 2030. Several workshops, policy forum, women parliamentarians' discussion, youth discussion forum, and a Health Ministers' panel discussions are scheduled before and during the conference to arrive at the Chandigarh Declaration. The WNF envisions, a series of WNC, every 3 years in different parts of the world to provide a platform for experts to deliberate key issues, monitor progress and corrective actions required, especially in LMICs.

 
  References Top

1.
Omran AR. The epidemiological transition: A theory of the epidemiology of population change. Milbank Mem Fund Q 2005;49:509-38.  Back to cited text no. 1
    
2.
United Nations, the Millennium Development Goals Report 2013; 01 July, 2013. Available from: http://www.refworld.org/docid/51f8fff34.html. [Last accessed on 2017 Mar 21].  Back to cited text no. 2
    
3.
Adeyi O, Smith O, Robles S. Public Policy and the Challenge of Chronic Noncommunicable Diseases. Washington, DC: World Bank; 2007.  Back to cited text no. 3
    
4.
Daar AS, Singer PA, Persad DL, Pramming SK, Matthews DR, Beaglehole R, et al. Grand challenges in chronic non-communicable diseases. Nature 2007;450:494-6.  Back to cited text no. 4
    
5.
Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. UN General Assembly Resolution A/RES/66/2; 19 September, 2011. Available from: http://www.who.int/nmh/events/un_ncd_summit2011/political_declaration_en.pdf. [Last accessed on 2017 Mar 17].  Back to cited text no. 5
    
6.
World Health Organization. Global action plan for the prevention and control of non-communicable diseases 2013-2020. Geneva: World Health Organization; 2013.  Back to cited text no. 6
    
7.
United Nations Development Programme. From the MDGs to sustainable development for all. New York: United Nations Development Programme; 2016.  Back to cited text no. 7
    




 

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