NCDs spreading in ‘epidemic’ proportion in Bangladesh but govt unready

The non-communicable diseases or NCDs such as cancer, cardiovascular diseases, chronic lung illness, and diabetes are rising in an ‘epidemic’ proportion in Bangladesh, but the government is not prepared to tackle those lifestyle diseases, experts say.

In 2010, deaths due to non-communicable diseases or NCDs accounted for 58.3 percent of the total fatalities in Bangladesh. In six years, according to the WHO, it rose to 66.9 percent in 2016.

One in four Bangladeshi adult aged 25 years or over are hypertensive, while one in 10 having had diabetes in 2016.

“The problem is rising by the day, there is no doubt. It's already an epidemic,” a WHO NCD expert, Dr M Mostafa Zaman, told bdnews24.com on Sunday, on the sidelines of a conference in Dhaka.

The Bangabandhu Sheikh Mujib Medical University (BSMMU), icddr,b, and British Medical Journal (BMJ), who recently formed a tripartite initiative called ‘Clinical Research Platform, Bangladesh’, organised the two-day first-ever conference on NCDs at the BSMMU.

Health Secretary Md Asadul Islam inaugurated the conference in the presence of BSMMU Vice-Chancellor Prof Kanak Kanti Barua.

The conference is aimed at developing a “strong platform and strengthening research collaborations” between clinicians and public health researchers in Bangladesh.

It is also aimed at developing pragmatic strategies for tackling NCDs in Bangladesh and achieving SDG target of 3.4, focused on ‘reduction of pre-mature mortality by one-third from NCDs within 2030 through prevention and treatment, and to promote mental health and wellbeing’.

Prof Kanak Barua said NCDs are rising in Bangladesh. “In 1990, seven out of 10 deaths were related to communicable or infectious diseases. But now it's just reversed – seven out of 10 deaths are due to NCDs,” he said in his written statement.

According to the NCD Alliance, those diseases are spreading aggressively in South Asia, particularly Bangladesh, with the most worrying fact being that more young people in the region are affected by these ailments than in any other part of the world.

This results in financial hardship and threatens poverty reduction programmes, including national development.

GOVT NOT PREPARED

“Deaths due to NCDs are very high. But the investment for its prevention and treatment is insufficient compared with the problem,” the WHO expert Dr Zaman said.

He said the government is not controlling the risk factors of those diseases such as tobacco, junk food and soft drinks.

“We are talking about the control of risk factors, but at the same time we kept the door open for investments of Japan Tobacco,” he pointed out. “It was not right to let them in.”

“We see how junk food is being promoted and advertised in Bangladesh. A famous cricketer can be seen in the advertisement where he says he rose to this position because of that soft drink. It’s a complete lie. But there is nobody to challenge that. Our laws and regulations should stop it,” he said.

“Sugar should be regulated. But we see government always tries to keep sugar prices cheaper,” he said.

“We have to think again about our policies and laws – how to prevent NCDs. It’s a serious problem.  If two-thirds people die of NCDs, then the investment should be two-thirds of the health budget. But in reality,  the budget is less than 5 percent,” Dr Zaman added, calling it “hypocrisy”.

Prof AK Azad Khan, president of the Diabetic Association of Bangladesh, also lamented the poor preventive mechanisms.

“It needs strong political will,” he said talking to bdnews24.com.

“Most of those diseases are preventable. It needs a lifestyle change. It has relations with environment. How people will walk in Dhaka? Is there any way? No way.

“We are giving permission for schools and colleges but where will the students play?…Do we ever consider that before giving them permission?” he said.

“Bangladesh is one of the earliest countries that banned smoking in public places. But it's not being implemented. Fast food shops should not be allowed to sell near schools. But in Bangladesh schools are the main targets of fast food shops,” he said, calling for urgent action.

“It's (NCD) already an explosion. We need to act fast,” he said.

The Bangladesh Health Watch report in 2017 had also warned the government that it was not prepared to tackle the challenges of NCDs.

It had called upon the government to make primary level health facilities “the focus of all activities” including prevention of those diseases.

It also urged the government to establish a “comprehensive surveillance system and registry” for the major NCDs at the national level including monitoring and evaluation of NCD programmes.

Prevention of risk factors such as fast-food and tobacco has also been stressed at that report.