In Pakistan, rapidly altering lifestyles are closely followed by changes in public health. Traditionally, for the past decade, maternal, child health, and infectious diseases have remained top priorities. However, the incidence of non-communicable diseases has significantly increased in Pakistan, and the time has come for a perceptible shift in policy planning from communicable to non-communicable diseases (NCDs).
NCDs include cardiovascular disease, stroke, diabetes, mental health disorders, cancers, and chronic airway respiratory diseases. These chronic conditions afflict almost half of the individuals in Pakistan. Unfortunately in terms of capacity, policy formulation, funding, and technical expertise, Pakistan is not geared to combat the NCDs seeping into the population.
It is estimated that globally around 38 million people die annually due to NCDs; today, deaths due to NCDs exceed deaths attributable to communicable diseases. The Global Burden of Disease 2010 data indicates that NCDs are responsible for around 77 percent of age consistent deaths in Pakistan. The impact in terms of disability is significantly higher.
The population of Pakistan is close to 200 million. Around 40 million Pakistanis experience high blood pressure, 32 million suffer from heart disease, 24 million are obese, 18 million suffer from cholesterol-related issues, 8 million are diabetics, and 50 million individuals suffer from mental health disorders (note that a single individual may have one or more of these conditions). In Pakistan, on a daily average, 2,000 individuals die because of NCDs, which could be prevented.
It is projected that in the years from 2010 to 2025 around 3.8 million citizens of Pakistan may die due to NCDs. Associated expenditures by the state are in the range of $152 million to $296 million, without factoring in the economic burden of disability and mental health conditions.
In order to combat death and disease in Pakistan due to NCDs, certain measures are endorsed by researchers as being relatively cost-effective: interventions (for example, an emphasis on physical exercise to encourage health), phasing out tobacco usage as well as consumption of salt, and finally affordable pharmacotherapy to preclude and minimize the harmful effects produced by NCDs.
However, international donors and agencies, while accounting for a relatively small slice in total health spending, have an uneven sway on policy formulation in Pakistan. Conventionally, their attention has been geared toward communicable diseases and the health of mothers and children. Generally, international donors continue to be impervious to the emerging challenges of NCDs, which is leading health policy in Pakistan astray.
The need of the hour is shifting the focus toward primary care for NCDs, specifically involving timely detection and management along with efforts to prevent NCDs. Health policy makers should be jolted out of their complacent attitude and cater to the public health priorities instead of taking cues from donors or populist driven campaigns. Otherwise, the state of Pakistan will be the end loser, becoming deprived of the productive capacity of its citizens and saddled with the economic cost of treatment. The management of individuals with NCDs needs to be prioritized and timely and appropriate action taken to forestall a looming social and economic catastrophe in the making.
Razeen Ahmed has done his Bachelor of Science in Business and Management from the London School of Economics and Political Science . He is currently involved in research in the areas of finance, energy, and health policy related to sustainable development.