. 2014 Sep;111(1):31–44. doi: 10.1093/bmb/ldu018

Table 2.

WHO global strategy for prevention and control of NCDs

WHO objective for NCD control and prevention	Status	Key challenges and opportunities
To establish and strengthen national policies and plans for the prevention and control of NCDs	All SEAR countries have NCD-related departments within respective ministries of health 90% of SEAR countries report funding for treatment and control and prevention of NCDs National policies and/or programs for prevention, control or surveillance of NCDs in India, Bangladesh, Sri Lanka and Pakistan	Challenges: Implementation and enforcement of policies and programs are often delayed or different compared with plans outlined in strategic documents such that the intended effects are lower than expected Limited human and financial resources being made available to implement prevention and control plans Opportunity: Increasing concern about NCDs among the middle class and wealthy may improve political will to address this disease burden
To promote interventions to reduce the main shared modifiable risk factors for NCDs: tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol	India: National Rural Health Mission piloting NCD component in some areas Tobacco consumption and diabetes are particularly targeted by localized and policy interventions in the region	Challenges: Poverty is a potent underlying determinant of unhealthy diet, tobacco use and harmful alcohol use and is beyond the direct purview of public health Infrastructure to make physical activity possible is expensive and difficult to construct in densely populated urban centers Cultural acceptability of physical activity and healthy diet adoption Opportunities: Media consumption, schooling and physical accessibility of remote regions are higher in the region today than ever before, providing opportunities to reach a wider population Successes in maternal and child health may be instructive for behavior change campaigns targeting NCDs
To monitor NCDs and their determinants and evaluate progress at the national, regional and global levels	WHO STEPS surveys completed or initiated in all countries to monitor NCD risk factors Demographic and health surveys in the region provide anthropometric and behavioral data relevant to NCDs; future studies may incorporate additional objective measures of chronic diseases and their risk factors (e.g., hypertension, fasting glucose) Cancer registries in India and Sri Lanka	Challenge: Lack of sustainable funding for infrastructure and human resources to maintain surveillance systems Opportunities: Secondary analyses of existing data to estimate burdens and modifiable risks Conversion of data to actions and interventions to lower NCD burdens Wider use of registries and data systems to promote quality monitoring and improve outcomes

WHO objective for NCD control and prevention

Status

Key challenges and opportunities

To establish and strengthen national policies and plans for the prevention and control of NCDs

All SEAR countries have NCD-related departments within respective ministries of health
90% of SEAR countries report funding for treatment and control and prevention of NCDs
National policies and/or programs for prevention, control or surveillance of NCDs in India, Bangladesh, Sri Lanka and Pakistan

Challenges:

Implementation and enforcement of policies and programs are often delayed or different compared with plans outlined in strategic documents such that the intended effects are lower than expected
Limited human and financial resources being made available to implement prevention and control plans

Opportunity:

Increasing concern about NCDs among the middle class and wealthy may improve political will to address this disease burden

To promote interventions to reduce the main shared modifiable risk factors for NCDs: tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol

India: National Rural Health Mission piloting NCD component in some areas
Tobacco consumption and diabetes are particularly targeted by localized and policy interventions in the region

Challenges:

Poverty is a potent underlying determinant of unhealthy diet, tobacco use and harmful alcohol use and is beyond the direct purview of public health
Infrastructure to make physical activity possible is expensive and difficult to construct in densely populated urban centers
Cultural acceptability of physical activity and healthy diet adoption

Opportunities:

Media consumption, schooling and physical accessibility of remote regions are higher in the region today than ever before, providing opportunities to reach a wider population
Successes in maternal and child health may be instructive for behavior change campaigns targeting NCDs

To monitor NCDs and their determinants and evaluate progress at the national, regional and global levels

WHO STEPS surveys completed or initiated in all countries to monitor NCD risk factors
Demographic and health surveys in the region provide anthropometric and behavioral data relevant to NCDs; future studies may incorporate additional objective measures of chronic diseases and their risk factors (e.g., hypertension, fasting glucose)
Cancer registries in India and Sri Lanka

Challenge:

Lack of sustainable funding for infrastructure and human resources to maintain surveillance systems

Opportunities:

Secondary analyses of existing data to estimate burdens and modifiable risks
Conversion of data to actions and interventions to lower NCD burdens
Wider use of registries and data systems to promote quality monitoring and improve outcomes

SEAR, South East Asia Region; STEPS, STEPwise approach to surveillance; WHO, World Health Organization.

Source: WHO.⁶⁴