Narain Jai P, Garg Renu, Fric Anton
World Health Organization Regional Office for South-East Asia, New Delhi, India.
Natl Med J India. 2011 Sep-Oct;24(5):280-7.
Non-communicable diseases (NCDs) are a global health and developmental emergency, as they cause premature deaths,exacerbate poverty and threaten national economies. In 2008, they were the top killers in the South-East Asia region, causing 7.9 million deaths; the number of deaths is expected to increase by 21% over the next decade. One-third of the 7.9 million deaths (34%) occurred in those <60 years of age (compared to 23% in the rest of the world). Of the total deaths in the South-East Asia region (14.5 million), cardiovascular diseases accounted for 25%, chronic respiratory diseases 9.6%, cancer 7.8% and diabetes 2.1%. NCDs are largely attributable to a few preventable risk factors, all of which are highly prevalent in the region-tobacco use, unhealthy diet, lack of physical activity and harmful use of alcohol. Key strategies for the prevention and control of NCDs include (i) reducing exposure to risk factors through health promotion and primary prevention, (ii) early diagnosis and management of people with NCDs, and (iii) surveillance to monitor trends in risk factors and diseases. Tackling NCDs calls for a paradigm shift: from addressing each NCD separately to collectively addressing a cluster of diseases in an integrated manner, and from using a biomedical approach to a public health approach guided by the principles of universal access and social justice. High levels of commitment and multisectoral actions are needed to reverse the growing burden of NCDs in the South-East Asia region.
非传染性疾病是一场全球健康与发展的紧急状况,因为它们导致过早死亡,加剧贫困并威胁国家经济。2008年,非传染性疾病是东南亚地区的头号杀手,造成790万人死亡;预计在未来十年内死亡人数将增加21%。在这790万死亡病例中,三分之一(34%)发生在60岁以下人群中(相比之下,世界其他地区这一比例为23%)。在东南亚地区的总死亡人数(1450万)中,心血管疾病占25%,慢性呼吸道疾病占9.6%,癌症占7.8%,糖尿病占2.1%。非传染性疾病很大程度上归因于一些可预防的风险因素,所有这些因素在该地区都极为普遍,即烟草使用、不健康饮食、缺乏身体活动和有害使用酒精。预防和控制非传染性疾病的关键策略包括:(i)通过健康促进和一级预防减少接触风险因素;(ii)对非传染性疾病患者进行早期诊断和管理;(iii)开展监测以监测风险因素和疾病的趋势。应对非传染性疾病需要一种范式转变:从分别应对每种非传染性疾病,转变为以综合方式集体应对一系列疾病;从采用生物医学方法,转变为以全民可及和社会正义原则为指导的公共卫生方法。需要高度的承诺和多部门行动来扭转东南亚地区非传染性疾病日益加重的负担。