A joint mission of the United Nations Interagency Task Force on the Prevention and Control of Noncommunicable diseases (NCDs) visited Sri Lanka from 5-9 October to support the government in tackling NCDs - principally cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases.
In Sri Lanka, NCDs cause more than three fourth of all deaths and nearly 1 in 5 people die prematurely from NCDs.
Sri Lanka is the second country in the WHO South-East Asia Region to host a Joint Mission of the Task Force.
The mission included representatives from the International Organization of Migration (IOM), International Labour Organization (ILO), Joint United Nations Programme on HIV/AIDS (UNAIDS), United Nations Development Programme (UNDP), United Nations Population Fund (UNFPA), United Nations Educational, Scientific and Cultural Organization (UNESCO), United Nations Children's Fund (UNICEF), UN Volunteers (UNV), World Food Programme (WFP), World Bank and the World Health Organization (WHO), which led the mission.
During the visit the Joint Mission met with high-level officials from central and local government, the President of Sri Lanka, Speaker of the Parliament, development partners, representatives of the private sectors, professional associations and civil society.
A quick snapshot of current national NCD response in place is as follows:
Source: WHO NCD Progress Monitor 2015
Mission outcome
The mission reviewed the measures in place and concluded that bolder measures are needed to address the epidemic of NCDs if Sri Lanka wants to meet the overarching target to reduce premature mortality by 33% in 2030.
The mission concluded that the epidemic of NCDs is now become a serious economic as well as public health issue in Sri Lanka and is fuelled by tobacco use, unhealthy diet, harmful use of alcohol and physical inactivity.
More than one third of adult males in the country are tobacco users. One out of three people have raised blood pressure, and a third of women are overweight. Consumption of salt is two to three times higher than recommended.
“As the former health minister I was closely involved with WHO in NCD prevention and control program and my Government as well as the cabinet of ministers are fully committed to take this agenda forward. WHO in addition to Ministry of Health should work with other ministries and other UN agencies to support the Government” H.E. Maithripala Sirisena, President of Sri Lanka.
“The ministry of National Policies and Economic Affairs, which is under the Prime Minister is well placed to coordinate and monitor the implementation of the National Multisectoral Action plan for Prevention and Control of NCDs. This is a timely effort“ Hon. Niroshan Perera, State Minister of National Policies and Economic Affairs.
“In addressing the issues of NCDs, prevention should be the main strategy. I strongly believe it requires a whole-of-government and whole-of-society approach to be realized. The Ministry of Health is playing the coordinating role in bringing the government, non-governmental organizations and the civil society to work together and facilitating their work. We also need to further strengthen provision of good quality and affordable health care to the people close to their homes” Dr Palitha Mahipala, Director-General of Health Services, Sri Lanka.
“Fulfilling the commitment of implementing the four time-bound commitments for 2015 and 2016 included in the 2014 UN Outcome Document on NCDs is now a priority for Sri Lanka. This requires a broad range of stakeholders to tackle the epidemic, implement best buys to reduce the four main NCD risk factors, an enable primary health care to respond. Developing such a broad national NCD response requires technical assistance from the whole-of-UN agencies resident in the Sri Lanka,” says Dr Nick Banatvala from WHO in Geneva.
Moving forward
“To ensure that the UN Agencies in Sri Lanka scale up their support for the national NCD response in a coordinated manner, the UN Task Force is recommending that the UN agencies in Sri Lanka establish a UN Thematic Group on NCDs under the leadership of WHO”.
The Joint Mission discussed the draft National Multisectoral Action Plan for Prevention and Control of NCDs 2016-2020, which sets out a blueprint for all parts of government to work together with development partners to combat the NCD epidemic. “The key now is to priortise action, coordinate an effective response and ensure accountability”, Dr Banatvala adds.
“The United Nations is committed to support Government of Sri Lanka scale up action to tackle NCDs. The levels of NCDs are now a grave concern and we recognise that the government is taking this issue seriously at the very highest level” says Mr Subinay Nandy, UN Resident Coordinator and UNDP Resident Representative in Sri Lanka.
“The Sustainable Development Goals adopted on 25 September 2015 by the leaders of 193 UN member countries include specific NCD related targets under Goal 3: ‘Ensure healthy lives and promote wellbeing for all at all ages’. In this context, we called the Task Force to provide assistance to Sri Lanka in quantifying the costs of the management of NCDs and interventions to prevent and control NCDs, their returns and the costs of inaction” he added.
Policies to tackle NCDs
“We know that there is a set of very cost-effective and affordable evidence-based policies for tackling NCDs that was endorsed by the World Health Assembly. These include for example raising tax on tobacco, banning all forms of tobacco advertising, replacing trans fats with polyunsaturated fats, restricting or banning alcohol advertising, preventing heart attacks and strokes, promoting breastfeeding, implementing public awareness programmes on diet and physical activity, and preventing cervical cancer through screening.
If implemented they can result in dramatic reductions in NCDs over a fairly short period of time. Delivering on the NCD strategy will require the government to harness the collective efforts of a range of civil society and private sector partners, as well as ratifying the Protocol to eliminate illicit trade in tobacco products as part of implementation of the Framework Convention on Tobacco Control” says Dr Jacob Kumaresan, WHO Representative to Sri Lanka.
“Non-Communicable Diseases (NCDs) are a burden on Sri Lanka’s growth. The World Bank is engaged with the Government in a $200 million operation to upgrade the standards of performance of the public health system and enable it to respond well to the challenges of malnutrition and noncommunicable diseases. But more remains to be done across multi sectors to reduce NCD related risks” said Françoise Clottes, World Bank Country Director for Sri Lanka and the Maldives.
“In Sri Lanka 25 percent of the adult population is overweight, 80 percent do not have a healthy diet with adequate quantities of fruits and vegetables, around 40 percent engage in low physical activity and 22 percent use tobacco” said Clottes outlining the risk factors leading to the Non-Communicable Disease burden in Sri Lanka.