Non-communicable diseases (NCDs) are chronic conditions such as heart disease, cancer, diabetes and respiratory diseases. They cause 38 million deaths annually, with three quarters occurring in low and middle income countries. The four main NCDs - cardiovascular diseases, cancers, respiratory diseases and diabetes - account for 82% of NCD deaths. Key risk factors include tobacco use, physical inactivity, unhealthy diet and harmful use of alcohol. Prevention strategies involve reducing exposure to risk factors through measures like banning tobacco advertising and restricting alcohol access. Population-wide interventions promoting healthy behaviors can help control the growing NCD burden in a cost-effective manner.

1. Introduction to Non Communicable Diseases

2. Definition
 An EURO symposium in 1957 gave the definition
“ an impairment of bodily structure and/or function
that necessitates a modification of the patient’s
normal life, and persisted over an extended period of
time.”

3.  Commission on Chronic Illness in USA has defined
“Chronic Diseases” as :
“Comprising all impairments or deviations from normal,
which have one or more of the following characteristics:
a) Are permanent
b) Leave residual disability
c) Are caused by non-reversible pathological alteration
d) Require special training of the patient for rehabilitation
e) May be expected to require a long period of
supervision, observation or care”

4. Major Types of NCDs

5. Age Distribution of NCDs
Younger Age-group
 Accidents and Injuries
 Rheumatic Heart Disease
 Diabetes
 Blindness
 Psychiatric disorders
Elderly
 Hypertension
 Coronary Heart Disease
 Diabetes
 Stroke
 Malignancies
 Obesity
 Blindness
 Psychiatric disorders
 Others

6. The Problem
 Noncommunicable diseases (NCDs) kill 38 million people
each year.
 Almost three quarters of NCD deaths - 28 million - occur in
low- and middle-income countries.
 16 million NCD deaths occur before the age of 70; 82% of
these "premature" deaths occurred in low- and middle-income
countries.
 Cardiovascular diseases account for most NCD deaths, or 17.5
million people annually, followed by cancers (8.2 million),
respiratory diseases (4 million), and diabetes (1.5 million).
 These 4 groups of diseases account for 82% of all NCD deaths.
 Tobacco use, physical inactivity, the harmful use of alcohol
and unhealthy diets all increase the risk of dying from an
NCD.

9. Common Risk Factors
NON-MODIFIABLE
 Age
 Sex
 Family History
 Genetic Factors
 Personality
MODIFIABLE
 Cigarette Smoking
 Alcohol Abuse
 Dyslipidemia
 Raised blood pressure
 Overweight and obesity
 Sedentary Life Style
 Unhealthy diet
 Stress
 Environmental Risk
Factors

10. Tobacco
• 6 million people die each year from tobacco use
each year, both from direct tobacco use and second hand smoke.
• By 2020, this number will increase to 7.5 million
• smoking is estimated to cause about
 71% lung cancer
42% chronic respiratory disease
Nearly 10% cardiovascular disease

11. Insufficient Physical Activity
 Approximately 3.2 million people die each year due to
physical inactivity.
 Globally in 2010, around 23% of adults aged 18+ years
were insufficiently physically active
 More than 80% of school going adolescents aged 11-17
years were insufficiently physically active.
 Regular physical activity reduces
the risk of cardiovascular diseases,
including high BP, diabetes, breast
and colon cancer & depression.

12.  The harmful use of alcohol results in the death of 3.3
million people annually.
 There are 60 different types of diseases where alcohol
has a significant causal role.
 It also causes harm to the well-being and health of people
around the drinker.
 In 2010, the worldwide total consumption was equal to
6.2 litres of pure alcohol per person 15 years and older.
Harmful use of Alcohol

13. Unhealthy Diet
 Approximately 16.0 million (1.0%) disability adjusted life years and 1.7 million
(2.8%) of deaths worldwide are attributable to low fruit and vegetable
consumption.
 Adequate consumption of fruit and vegetables reduces the risk for
cardiovascular diseases, stomach cancer and colorectal cancer.
 Decreasing dietary salt intake from the current global levels of 9–12 grams per
day – to the recommended level of 5 grams per day – would have a major
impact on blood pressure and cardiovascular disease.
 High consumption of saturated fats and trans-fatty acids is linked to heart
disease.

14. Raised Blood Pressure
 Globally, around 22% of adults aged 18 and over had
raised blood pressure in 2014
 It is estimated to cause 7.5 million deaths, about
12.8% of all deaths.
 It is a major risk factor for cardiovascular diseases.

15. Obesity
 Globally, around 39% of adults aged 18 and
over were overweight in 2014
 In 2014, 13% of adults aged 18 and over in the
world were obese.
 At least 2.8 million
people die each year due to
overweight or obese.

16. Raised Cholesterol
 Globally, around 39% of adults
aged 25 and over had raised
cholesterol in 2008.
 It increases the risk heart disease and stroke.
 Raised cholesterol is estimated to cause 2.6 million deaths
annually.

17. Cancer Related Infections
 At least 2 million cancer cases per year, 18% of the
global cancer burden, are attributable to few specific
chronic infections
 Principal infectious agents are
Hepatitis B virus
Hepatitis C virus
Helicobacter pylori

18. Environmental Risk Factors
Occupational Hazards
Air pollution
Water pollution

20. Gaps in Natural History
 Absence of a known microbial agent
 Mulatifactorial causation
 Long latent period
 Indefinite onset

21. Prevention

23.  Protected people from tobacco smoke and
banning smoking in public places
 Restricting access to retailed alcohol,
enforcing bans on alcohol advertising and raising taxes
on alcohol.
 Reduce salt intake in food
 Replacing trans-fat in food
with PUFA

24. Rahagiri in CP
 Promoting public
awareness about physical
activity and diet.

25. Cost Effective and Low Cost Population Wide Interventions
 Nicotine dependence treatment
 Enforcing drink-driving laws
 Restrictions on marketing of foods and beverages high in
salt, fats and sugar
 Food taxes and subsidies to promote healthy diets
 Healthy nutrition environments in schools
 Nutritional information and counseling in health care
 Vaccination against HPV

26. Global NCD Action Plan 2013-2020
 Target 1 - A 25% relative reduction in the overall mortality from cardiovascular
diseases, cancer, diabetes, or chronic respiratory diseases
 Target 2 - At least 10% relative reduction in the harmful use of alcohol, as
appropriate, within the national context
 Target 3 - A 10% relative reduction in prevalence of insufficient physical
activity
 Target 4 - A 30% relative reduction in mean population intake of salt / sodium
 Target 5 - A 30% relative reduction in prevalence of current tobacco use in
persons aged 15+ years
 Target 6 - A 25% relative reduction in the prevalence of raised blood pressure
or contain the prevalence of raised blood pressure, according to national
circumstances.
 Target 7 - Halt the rise in diabetes and obesity
 Target 8 - At least 50% of eligible people receive drug therapy and counselling
(including glycaemic control) to prevent heart attacks and strokes
 Target 9 - An 80% availability of the affordable basic technologies and essential
medicines, including generics, required to treat major NCDs in both public and
private facilities

27. Thank You