Saturday, February 11, 2012

NCDs shall receive top priority in Indonesia

Elly Burhaini Faizal has reported in The Jakarta Post that following the reported increase in deaths from non-communicable diseases overtaking deaths from infectious diseases, the government has prioritized efforts to fight non-communicable diseases this year.

The Health Ministry is planning to improve campaigns for healthy lifestyle to reduce the risks of non-communicable diseases while at the same time continuing its fight against infectious diseases.

The Health Ministry’s disease control and environmental health director general Tjandra Yoga Aditama is reported to have said that the threat of non-communicable diseases such as heart and blood-related diseases, diabetes mellitus and other degenerative and chronic diseases had greatly increased.

“Noncommunicable diseases cause more deaths in the country than infectious diseases, and problems of the heart and blood vessels are the top causes of death,” he had told The Jakarta Post.

Realization by experts that most non-communicable diseases are consequence of unhealthy lifestyles and poor living conditions, the Government contemplates to include in the disease control programs not only curative treatments but also preventative approaches.

The prevention measures would include a campaign for healthy lifestyle among people with common risk factors such as smokers, heavy drinkers, and people who are inactive or have unhealthy diets.

Tjandra has pointed out that at the centre of NCDs problem lies the modern lifestyle, characterized by increased mobility and low social activity, unhealthy eating patterns, lack of physical exercise, sedentary-behavior such as too much sitting or watching television, and harmful use of alcohol.

Obesity in current epidemic form affecting many countries comes not only from modern sedentary lifestyles but also poor diet. With unhealthy eating habits, more people are in the obese category and have high levels of cholesterol and blood glucose, resulting in a higher risk of endocrine and metabolic disorders.

Poor awareness on the dangers of smoking aggravates the problem, he added.

Basic health research study conducted in Indonesia, in 2007,  has revealed quite a high prevalence of non-communicable diseases in which hypertension accounts for 31.7 of the total disease, followed by joint problems (30.3 percent); accident-related injuries (25.9 percent); stroke (8.3 percent); heart problems (7.2 percent); cancer and tumor (4.3 percent); asthma (3.5 percent); and diabetes mellitus (1.1 percent).

The data reveals that stroke accounts for 15.4 percent of the total leading causes of deaths, placing it at as the most common cause of death among all age groups, followed by hypertension (6.8 percent); ischemic heart disease (5.1 percent); and other heart diseases (4.6 percent).

“We should have made non-communicable diseases a priority 10 years ago as the leading causes of death have shifted from infectious diseases to the non-infectious ones,” said Hasbullah Thabrani, a professor of public health from University of Indonesia’s School of Public Health.

With such a high incidence of deaths caused by non-infectious diseases, Health Minister Endang Rahayu Sedyaningsih is reported to have vowed in a statement to take wide-ranging measures to cut both deaths and impairments in the quality of  life caused by non-communicable diseases.

Successful campaigns in the fight against infectious diseases will be carried out along with non-communicable diseases through both health promotion and disease prevention, she is reported to have committed. The commitment is seems to be a victory for public health experts as they have long argued that tackling non-communicable diseases  due to sharp increase in deaths and disability they cause.

A very important statement made in the context of non-communicable diseases is reportedly made by Hasbullah Thabrani, a professor of public health from University of Indonesia’s  School of Public Health. He has said, “We should have made non-communicable diseases a priority 10 years ago as the leading causes of death have shifted from infectious diseases to the noninfectious ones,”. “Unlike a decade ago, cardiovascular diseases currently account for the majority of deaths, with other non-communicable diseases, such as high blood pressure, diabetes mellitus and cancer, contributing to the development of those [cardiovascular] diseases,” he has reportedly told.

The report has pointed out that in spite of NCDs related fatalities being preventable their incidence will increase unless adequate actions are taken for change in behavior. For example, the government requires implement of  “no-smoking zones” as stipulated in article 15 of Law No. 36/2009 on Health. The regulation is necessary for control of consumption of cigarettes and reducing the number of both active and passive smokers.

Like many other countries the problem seems to be similar in Indonesia where the government does not appear to have made enough efforts to educate people on the importance of healthy living habits. The danger of smoking, and its far reaching effects will only multiply given no strong measures to counter massive cigarette advertisements by tobacco companies to lure young people to start smoking.

The situation is amply summed up by Elly Burhaini Faizal in his article in The Jakarta Post report, “ Tobacco companies spend annually an estimated Rp 3-4 trillion on cigarette ads, while the ministry’s budget for health promotion and education is only about Rp 100 billion per year”.

According to a report released by the Canada-based Cameron Institute, Indonesia loses US$37.2 billion a year, about 7 percent of its gross domestic product, due to non-communicable diseases (NCDs) such as cancer, high blood pressure, heart problems and diabetes. The figure is based on healthcare costs and an estimate of lost potential household income from workers who were debilitated by illness or died prematurely.

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