Tackling NCDs

Saturday, 12 September 2020 00:00 -     - {{hitsCtrl.values.hits}}

As a country with an aging population, Sri Lanka is facing a growing number of people affected by Non-Communicable Diseases (NCDs), which has become the number one killer over the past decade. As more people become vulnerable to NCDs, healthcare authorities estimate that as much as 75% of all deaths in Sri Lanka can be linked to NCDs and the country will have to find a way to tackle this growing challenge.  

It is rather ironic that as a developing nation, Sri Lanka has to deal with health problems plaguing both rich and poor countries. On one hand, malnutrition levels in children under five are very high in the island, as with a poor country, but on the other hand, 75% of ill-health can be traced back to NCDs such as diabetes, cancer, high blood pressure, and kidney diseases among others, mirroring a developed country. 

Given the relatively low health spending of about 4% of GDP, NCD care in Sri Lanka is increasingly financed by out of pocket spending by the general public. This includes but is not limited to one in four Sri Lankans having diabetes and the number of cancer patients increasing yearly. The overburdened nature of the public health system means more people are being left out of State-subsidised healthcare. 

Tackling NCDs early on with better prevention and treatment would significantly spare poor people from the crushing burden of poor health, lost earnings, deepening poverty and the risk of disability and premature deaths. 

A South Asia regional study has found that South Asians suffer their first heart attack six years earlier than other groups worldwide. They are also more vulnerable to diseases such as diabetes at an earlier age. This burden of NCDs will rise in the future, in part due to further aging of the population with the doubling of the population over the age of 65 from 12.1% to 24.4% over the next 30 years. 

The burden of NCDs is also increasingly shifting towards the poor. Risk factors such as obesity, smoking, high sugar and salt diets, and alcoholism are also on the rise, helped along their destructive path by sedentary lifestyles. Studies encourage Sri Lanka to adopt a number of population based and individual patient based approaches to reduce unhealthy behaviours in the general population and control heart disease, diabetes, cancers and other NCDs. 

More efforts such as more effective legislation on the use of transfats and tobacco as well as public education to reduce salt intake would help delay the onset of these diseases. Encouraging people to exercise regularly and eat healthily needs greater emphasis as well, especially when the national diet is heavy in starch. At the clinic level, aspirin and beta blockers for high risk individuals could reduce the chances of cardiovascular diseases. This is not a problem that can be fixed with a pill, however, and getting the right information to people in the right way remains the biggest challenge of all. 

Caught in economic downturns and aspirational consumption patterns, more and more people are finding it difficult to balance their lives. This challenge has a direct impact on Government finances.