A fitter 2016?

WITH an aging population to contend with, Sri Lanka is hoping to find sustainable ways to deal with non-communicable diseases (NCDs) to ensure a healthy future and kicking off the new year with a national sports and fitness week.  

The move comes after the World Bank earlier this year loaned the Sri Lankan Government US$ 200 million to improve its health services to combat NCDs. 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, 85% 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 4% of GDP in 2012, NCD care in Sri Lanka is increasingly financed by out of pocket spending by the general public. Tackling NCDs in South Asia 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.

NCDs have already become the largest contributor to the burden of disease in Sri Lanka, accounting for 85% of ill-health and early death. 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 an aspirational consumption pattern, more and more people are finding it more important to make money rather than concentrate on their health. The economic cost is already being felt by the country and likely to increase significantly in the coming decades. Changing this attitude of complacency will be the hardest challenge of all.