Almost every Pakistani can claim to having at least one relative (either in the extended or immediate family) suffering from a cardiovascular problem - a generalisation well-substantiated by the World Banks recently released report titled Tackling Non-communicable Diseases in South Asia.
According to the report, non-communicable diseases (NCD), which are diseases that are not contagious, impose the largest health burden in Pakistan. Of the NCDs, cardiovascular diseases are the major constituent amongst Pakistanis. Other diseases in this category include psychiatric conditions, respiratory diseases, cancers, injuries, etc.
The worrisome fact is that the demographics of Pakistan, though favourable with a younger population at the moment, are gradually changing. Consequently, as the population ages, the health burden from NCDs is expected to increase.
"The proportion of the population 65 years and older - particularly prone to NCDs - will increase from 3.9 percent in 2000 to 5.4 percent in 2025," the report said.
A rather unconventional view of NCDs holding back development and poverty reduction efforts deserves mention. Chronic diseases, and the increase in their prevalence thereof, can affect labour productivity, and also lead to higher consumption and lesser savings because of increased dependency ratios.
"Projections suggest that over the next 10 years, deaths from heart disease, stroke, and diabetes may lower GDP in India and Pakistan by 1 percent," the report said, citing the World Health Organisation.
While this highlights the need for increased focus on the health sector, it has sadly been mired by an inconsistency in policymaking. An action plan for the prevention and control of non-communicable diseases, drafted in 2003, could not be implemented due to a change in government.
Further, primary care for preventive services for NCDs is inadequate, and healthcare human resources are neither well-trained, nor well-distributed. This can be gauged from the fact that 85 percent of physicians work in urban areas, and even amongst those, the general practitioners, whom patients visit more frequently, are not trained to deal with NCDs.
Adding to the ado is the insufficient provision of medicines; of the 32 essential medicines needed for chronic conditions, less than 8 percent were actually present in the public sector, rendering patients resort to private outlets, where very few of the low-priced generics are available.
A more focused health strategy is the need of the day for the country, especially with regard to non-communicable diseases. And this does not only mean drafting an NCD policy and plan, but also working towards its implementation, increasing awareness amongst the masses regarding prevention of NCDs, and also retooling the health workforce for the prevention and treatment of NCDs.
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