Launch of Strategic Plan 2013-2020: Integrated Prevention and Control of Non-Communicable Diseases (NCDs) in Guyana

PAHO/WHO in collaboration with the Ministry of Health launched the Integrated Prevention and Control of Non-Communicable Diseases (NCDs) in Guyana Strategic Plan 2013-2020 on

2 December, 2013, at the Duke Lodge, Georgetown.  Eng Vlugman, PAHO/WHO Representative (a.i) in his remarks mentioned that he was very pleased that Minister Bheri Ramsaran’s chose 2 December 2013, PAHO’s 111th birthday, as the day to launch the Strategic Plan.

Eng. Vlugman stated that it takes concerted and orchestrated efforts of collaboration among a variety of stakeholders, government and non-government organizations, public and private sectors to address the complex issues of diseases and the achievement of health. This Strategic Plan is such collaboration between the Ministry of Health PAHO/WHO CO.

The plan acknowledges the current status of non-communicable diseases in Guyana and provides a road map for reversing the epidemic by strengthening national monitoring and surveillance, scaling up the implementation of evidence-based measures to reduce risk factors like tobacco use, unhealthy diet, physical inactivity and harmful alcohol use.

The main causes of death in the Americas for both men and women are Cardio-vascular diseases, cancers, and diabetes, these are Non-Communicable Diseases or NCDs.  Every year 4½ million people die from NCDs of which 37% are people under the age of 70.  More than an estimated 200 million people live with an NCD and nearly 80% of NCD deaths occur in low-and middle-income countries.

The increasing burden of chronic NCDs globally threatens to overwhelm already over-stretched health services and challenges the health systems, absorbing substantial amounts of resources. Many more people are at high risk of developing an NCD in the near future due to risk behaviors including smoking including exposure to second hand smoke, harmful use of alcohol, unhealthy diets, limited or lack of physical activity and obesity.

According to the Ministry of Health’s Statistical Bulletin 2009, 3 out of 4 deaths were as a result of heart diseases, cancer, diabetes mellitus and chronic liver disease (all NCDs).  The number of deaths from NCDs has increased considerably from 650 deaths in 2004 to 3,705 in 2008.  Approximately 36,000 persons (12% prevalence) live with diabetes and approximately 50,000 persons (20% prevalence) live with hypertension.

The economic impact of NCDs goes beyond the costs of health care services. Indirect costs, such as lost productivity, can match or exceed the direct costs. In addition, a significant proportion of the total cost of care is carried by patients and their families. People die from NCD’s at younger and younger ages and are often bread earners and caretakers.  Their dependants often suffer enormous financial burden and economic hardship in addition to the loss of a loved one.

We have a clear understanding now on how the living conditions and lifestyles influence people’s health and quality of life.  Contributing factors to the rising incidence and prevalence of NCDs include: Poverty, uneven distribution of wealth, lack of education, rapid urbanization and ageing, and the economic, social, gender, political, occupational, behavioral and environmental determinants of health.

There is also growing recognition that NCDs can only be successfully prevented and controlled through linkages and partnerships with sectors outside of health, notably legal system, agriculture, education, trade, development, finance, urban planning and transportation, water and sanitation, among others. Cross-sector partnerships, which combine resources, competencies and reach, are seen as an essential part of the solution, not only across government sectors, but with NGOs, professional associations, academia and the private sector.

Progress in implementing comprehensive NCDs strategies and policies has been hampered by fragmented, scarce and lack of resources. Scarce resources and lack of policies and strategies for controlling NCDs are key challenges in the Region. There is the need for a strong advocacy in favour of prioritizing NCDs and for technical assistance in implementing and monitoring cost-effective and integrated approaches for the early detection and management of cardiovascular diseases, cancers, diabetes, sickle cell disease, chronic respiratory diseases, oral health and establish standards of health care for common conditions.

The past seven years have witnessed major new policy developments and strategic initiatives for NCDs at Caribbean, national, sub-regional levels, many with the active participation and support of International Agencies and donors.  Most notable is the Caribbean Community (CARICOM) Port of Spain Declaration on NCDs (2007), the political declaration from the High-level Regional Consultation of the Americas against NCDs and Obesity (2011), the Aruba Call for Action on Obesity (2011), as well as the United Nations High Level Meeting 2011 on the Prevention and Control of NCDs.

According to the World Health Organizations, interventions to prevent NCDs on a population-wide basis are not only achievable but also cost effective and the income level of a country or population is not a barrier to success. Low-cost solutions can work anywhere to reduce the major risk factors for NCDs.

Some interventions are considered ‘best buys’ – actions that should be undertaken immediately to produce accelerated results in terms of lives saved, diseases prevented and heavy costs avoided. These include:

Protecting people from tobacco smoke and banning smoking in public places;

1.               Warning about the dangers of tobacco use;

2.               Restricting access to retailed alcohol;

3.               Enforcing bans on alcohol advertising and raising taxes;

4.               Reduce salt intake and salt content of food;

5.               Replacing trans-fat in food with poly-unsaturated fat;

Promoting public awareness about diet and physical activity through mass media

In concluding, Eng. Vlugman acknowledged the  collaboration with PAHO/WHO and the Ministry of Health for the the development of the Strategic Plan 2013-2020.