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Tobacco legislation, salt reduction among best ways to fight NCDs say experts

The way forward is clear: tobacco legislation, salt reduction and Package of Essential NCD Services (PEN) are the best buy opportunities for the two Samoas’ fight against Non Communicable Diseases.

This was the message from World Health Organization representative, Dr. Yang Baoping, for American Samoa, Samoa, Cook Islands, Niue and Tokelau, during his presentation at the NCD conference held in the territory last week.

Dr Baoping spoke at the third annual bilateral two day summit, on the fight against Non Communicable Diseases. The two-day summit consisted of presentations and sharing of information from several local government agencies and some 30 delegates from Samoa, Tonga and Fiji.

NCDs, sometimes referred to as “lifestyle diseases” because they are brought about by the way you live, include heart diseases, hypertension and stroke, diabetes, cancer and chronic respiratory diseases.

Dr. Baoping noted in his presentation that 80% of early death in the Pacific is none other than NCDs. A particular concern is the fact that the children are increasingly becoming obese and vulnerable to NCDs later in life and people with NCDs are less productive — they have more sick leave, and add costs to the health care system. He stated that the growing burden of NCDs slows down economic growth and prosperity.

“One day we will all die from something, however the NCD crisis in the Pacific is contributing to a growing number of people dying prematurely,” he said.

“It is likely that NCD related disability in the Pacific will increase over the years to come and put even more pressure on the health sector.  The commonly caused NCD related disabilities are amputations due to diabetes, stroke paralysis, blindness and different physical limitations.”

Dr. Baoping said Samoa is following a Pacific trend of about 40% prevalence of high blood pressure and about 22% prevalence of raised blood glucose, which is a risk for developing diabetes, and compared with the international prevalence rates, the Pacific is very high.

He noted that for diabetes, the Western Pacific Region is one of the regions with the lowest prevalence of diabetes, However in the Pacific, the trend is quite different when focusing on specific countries, within the region, where the trend is alarming with some countries having diabetes prevalence rates of more than 25%.

Prevalence in American Samoa is 29.6% while Prevalence in Samoa is 21%, he said.

Regarding obesity, Dr. Baoping said, the Western Pacific Region has very low levels of obesity but when the Pacific is separated from Asia, the trend is concerning. Obesity rate in American Samoa is 74.6% while Samoa’s is 57.0% , however both countries exceed the average for Pacific island countries.

He added that the main four NCD risk factors are tobacco use, physical inactivity, overweight and obesity, and the prevalence rates for both Samoas are alarming.

Dr. Baoping noted that he attended a Pacific Island Forums Leaders meeting in Auckland where the Pacific leaders declared NCDs a health and development crisis for the region.

As a result there was Political Declaration on prevention and control of NCDs.

The Declaration also urges the WHO to take the lead in coordinating NCD prevention and control programs, to develop a global implementation plan and global monitoring framework including sets of voluntary targets and indicators and scare up technical assistance.

Dr. Baoping said, it is important that countries identify specific areas and or activities that they are able to focus on, and give the appropriate attention. He believes that for the two Samoa’s this may be tobacco control term, tobacco legislations, taxation and establishment of tobacco free settings.

“Increased taxes on tobacco are one of the other intervention that can give more revenue to the government and at the same time improve health outcomes.

“Also reduction of population-based salt intake is another and evidence shows that reducing salt intake from levels 5-6gram per person the rates of stroke and coronary heart diseases can decrease by 24% and 18%”.

He added that packaging of essential NCD (PEN) is another set of intervention.

The PEN is a conceptual framework for strengthening equity and efficiency of primary health care in low-resource settings; it identifies core technologies, medicines and risk prediction tools; discusses protocols required for implementation of a set of essential NCD interventions; develops technical and operational outline for integration of essential NCD interventions into primary care and for evaluation of impact.

“Each of us has a choice whether to continue with the status quo or to take up the challenge and invest now in chronic disease prevention."

“The knowledge of how to prevent these diseases is available now; the way forward is clear...i t’s our turn to take action” he said.