Non-Communicable Diseases, Risk Factors and Solution

Since death is inevitable and every soul will taste it, there is no need to fear or worry about it but we must be concerned about circumstances causing or leading to untimely and avoidable deaths particularly among young persons.

It can be very painful facing the reality of the death of loved ones in their prime age especially when some of them even left parents behind. Experts believe that certain factors are responsible for untimely and avoidable death and that such could be prevented.

Aside accidents, Non-Communicable Diseases (NCD) have been identified as the leading cause of death and disability worldwide. According to Dr. Adeniyi Samuel Oginni, a Public Health Physician, 39.5 million people die from Non-Communicable Diseases (NCDs) every year. Oginni who is the Executive Secretary of Osun Health Insurance Agency said death due to NCDs constitutes 65% of global deaths. In his presentation at the Osun State House of Assembly, last week, Oginni said 38.9 percent people die in their prime age as a result NCDs. He said NCDs are leading cause of morbidity and mortality in persons below 70 years.

He explained that cardiovascular diseases, hypertension, cancer, diabetes mellitus, chronic respiratory diseases, sickle cell disease; mental disorders are major NCDs in Nigeria. He identified smoking of tobacco, harmful alcohol intake, physical inactivity and unhealthy diet as major NCDs risk factors. Oginni said “Low and Middle-income countries bear 80% of the burden of premature deaths with most deaths occurring in the 40s and 50s age bracket. Most of these premature deaths are preventable through strengthened and responsive health systems, and public policies in sectors outside health."

Now, It’s good that we know that most of the premature deaths are preventable and we can begin to tackle the problem and promote healthy living. That was why the 2019 Global Week for Action on Non-Communicable Diseases was marked last week with focus on ensuring healthy lives for all by dealing with NCDs in line with the Universal Health Coverage target of SDG goal 3.

The major NCDs in Nigeria include cardiovascular diseases which come with hypertension, coronary heart diseases and stroke, Cancer, Diabetes mellitus, Chronic respiratory diseases (e.g. COPD, asthma), sickle cell disease; mental, neurological and substance use disorders; violence and road traffic injuries; and oral health disorders. The major NCDs risk factors or causes include tobacco use -smoking, harmful alcohol intake, physical inactivity, unhealthy diet, environmental pollutants and also the climate change as globalization and industrialization have adjusted the ecosystem with unhealthy lifestyle patterns.

Up till 2015, no more than about 2-3 per cent of all Official Development Assistance (ODA) for health was actually targeted at NCDs but surprisingly, NCDs were not addressed in the Millennium Development Goals (MDGs). Meanwhile, the 2030 Agenda for Sustainable Development adopted at the United Nations Summit on Sustainable Development in September 2015, recognises NCDs as a major challenge for sustainable development. It is imperative that momentum be built to make increase funding available to countries which are going to be most affected in the next 10-20 years from the growing NCD burden.

At individual level, Nigerians must imbibe healthy lifestyle as panacea to NCDs so as to reduce preventable deaths which is rampant among the middle age in the country. Collectively, we must embark on Necessary advocacy, galvanise broader health and developmental agenda, push for enhanced good governance that would integrate the prevention and control of non-communicable diseases into the nation’s health-planning processes and development plans so as to strengthen national non-communicable diseases programmes. These are some of the ways to address the scourge of NCDs in Nigeria. We desire a world where everyone has the opportunity for a healthy life, free from preventable suffering; stigma, disability and death caused by NCDs. We must unite to stimulate collaborative advocacy, action and accountability for NCD prevention and control in Nigeria.

The collaboration among some non-profit organizations representing the four main NCDs is very apt and highly commendable. The NCD Alliance was founded in 2009 by four international NGOs including Global Cancer Control, International Union against Tuberculosis and Lung Disease, International Diabetes Federation and World Heart Federation having realised that NCDs share common risk factors and the diseases should share common solutions.

Therefore, working together as an alliance has provided a mutual platform for collaboration and joint advocacy. The alliance also works with many partners that share a common interest in improving the lives of people living with NCDs and addressing their risk factors. At the moment, the alliance unites a network of over 2,000 civil society organizations in more than 170 countries. These include the NCD Alliance Nigeria, founded in 2011. It is one of 60 national NCD Alliances. So far, it comprises the Nigerian Heart Foundation among other NGOs working on diabetes, respiratory disorders and cancer as well as many CSOs among which is Christian Initiative for Nation Building (CINB).

The NCD Alliance Nigeria used the 2019 Global Week for Action on Non-Communicable Diseases as an avenue to sensitise the people of Osun State on the dangers of the NCDs. The team took the message to the orientation camp of the National Youth Service Corps and educated corps members of the NCDs and its dangers. The team led by Dr. Oginni also took the message to Osun State House of Assembly and sensitised the lawmakers of NCDs. The team also held a focus group discussion with persons living with NCDs to elicit from them challenges facing them in accessing care and obtaining their needed daily medicines and routine tests and suggestion as to how they think these challenges can be overcome.

The advocacy to the legislature yielded good result as the Speaker of the House, Hon Timothy Owoeye said the house will direct security operatives in the state to begin to arrest and prosecute whoever smokes in public places in compliance with the state law on smoking enacted in 2009. The Speaker said as part of immediate action to address the scourge of NCDs, implementation of the state law prohibiting smoking in public places has become very necessary. He also said that henceforth, every Thursday, between 6am and 8am, Osun legislators will have physical fitness exercise session at the legislative quarters. While commending the Osun State House of Assembly for this responsive and proactive move, I’d like to appeal to the Federal Government to implement the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) to reduce smoking and use of tobacco.

In conclusion, in dealing with the scourge of NCDs in Nigeria, all hands must be on deck to arrest and overcome it in order to reduce the rate of avoidably preventable premature mortality from NCDs. Individuals must moderate their lifestyles by eating healthily, doing physical exercise regularly and avoiding smoking and other uses of tobacco as well as drinking of alcohol. Also, government should provide access to affordable essential medicines and vaccines for NCDs and ensure the inclusion of prevention and treatment of NCDs in the benefit packages of State Social Health Insurance Schemes in order to accelerate progress towards the attainment of Universal Health Coverage (UHC).

Hameed Oyegbade writes from Osogbo, Osun State...... [email protected] .....08032546950