Dr Le Thi Tuyet Lan, Chairperson of Ho Chi Minh City Respiratory Association;
Dr Duong Quang Trung, Chairperson of Ho Chi Minh City Medical Association;
Ms Tran Thi Hoa, Vice-Chairperson of Phu Nhuan People's Committee;
Dr Le Thi Thanh, Director, Phu Nhuan Preventive Medicine Center;
Colleagues; ladies and gentlemen.
Good morning. It's a pleasure to join you here for the launch of the Pilot Programme on the NCD Essential Services Package, an initiative based on WHO protocols. It is intended to reduce the growing burden of noncommunicable diseases by addressing the problem at the level of primary health care. I thank you for inviting me to participate in this important event.
Noncommunicable diseases, such as cardiovascular disease, diabetes, cancer and chronic respiratory diseases, are rising globally at an alarming rate. Of the roughly 60 million deaths that occur worldwide each year, nearly 60% are linked to noncommunicable diseases, or NCDs. Put another way, NCDs kill nearly twice as many people annually as do all communicable, maternal, perinatal and nutritional conditions combined.
In addition, NCDs are responsible for a considerable share of disability and roughly half of the global burden of disease. In comparison, communicable diseases, maternal and perinatal conditions, and nutritional deficiencies combined cause about 40% of the global burden of disease.
Here in the Western Pacific Region, NCDs are responsible for around 25 000 deaths every day and account for seven out of every 10 deaths. By contrast, AIDS claims an estimated 200 people daily in our Region.
Sadly, NCDs are claiming victims at younger ages in the developing world, as compared with the developed world. In China, for example, 22% of deaths from cardiovascular disease between 2000 and 2030 are projected to occur in people aged 34 to 64. In the United States of America, that age group will account for only 12% of such deaths.
The chronic diseases associated with NCD can also trigger poverty as principal bread-winners and others who contribute to a household's livelihood are disabled or die. The cumulative affect on the national economy can drive down a nation's gross domestic product.
In Viet Nam, WHO estimates that two thirds of the half million deaths that occurred in 2004 were the result of noncommunicable disease. And recent surveys show that NCD prevalence is sharply increasing. For example, the National Hospital of Endocrinology found that diabetes nearly doubled from just 2.7% in 2002 to 5.5% in 2008. The National Heart Institute found a near doubling of hypertension rates over the same period. The findings are not surprising. Viet Nam is among the countries with highest adult male smoking rates—more than 55%. The harmful use of alcohol also is common here. A recent survey in Ho Chi Minh City found that daily per capita salt consumption at more than 33 grams, six times the WHO-recommended level.
We know that these problems can be solved. The elimination of risk factors — mainly tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol — could prevent up to 80% of heart disease, strokes and type 2 diabetes, as well as over a third of cancers.
The WHO Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases (2008–2013) helps guide Member States in the fight against NCDs. It takes a people-centred approach and encompasses the entire continuum of care. While health systems strengthening is an integral part of the plan, the plan is supportive of existing regional strategies and action plans.
The Action Plan offers a two-pronged approach to prevent and control noncommunicable diseases. The first focuses on common NCD risk factors and calls for participation by the whole of government and society. The second prong focuses on the health sector and emphasizes the management NCDs at the primary health care level.
By attacking this problem at the level of primary health care, we can substantially cut direct and indirect health costs and reduce hardships for patients and their families. Such an approach also can significantly reduce the overload in the current hospital system. While a stronger emphasis on primary health care can impact all areas of health, it is particularly important for NCDs as they are usually chronic and often incurable. If we do not strengthen primary health care as a means of reducing noncommunicable diseases, our hospitals soon will be overwhelmed by NCD patients.
The Pilot Programme on the Essential NCD Services Package is intended to help tackle the noncommunicable diseases burden at the level of primary health care. The package of essential services should be implemented along with other efforts to strengthen primary health care—which is one of the priorities of the World Health Organization.
WHO sincerely appreciates the hard work of the Ho Chi Minh City Respiratory Society, the Health Authority of Phu Nhuan District and partner institutes and organizations in piloting this NCD essential package in Phu Nhuan district.
If the programme proves to be as successful as we believe it will be, the Ho Chi Minh City Health Department and Viet Nam's Ministry of Health could deploy it throughout the country. WHO remains committed to support the pilot project and other actions on noncommunicable diseases and other public health problems in Viet Nam and across the Region.
Thank you very much.