Non-Communicable Diseases Control Initiative in the WHO - EMRO Area.

A meeting of WHO experts and heads of WHO Collaborating Centres in the Eastern Medittaranean Region was recently held at WHO-EMR Head office in Cairo, Egypt. The WHO Headquarters in Geneva wanted the EMR Office to evaluate the possibility of starting an initiative in this region similar to the CINDI in Europe and the CARMEN in the Americas.

Experts from EMR [which is made up of a total of 22 countries including those from the Middle East and North Africa as well as Iran, Afghanistan and Pakistan] presented data on the prevalence and morbidity and mortality of Cardiovascular diseases in their respective countries. As expected, not only did Hypertension emerge as the leading disease in the non-communicable disease category, the figures were shockingly high and amongst the highest in the world. The average general population prevalence figures for Hypertension ranged from 10% to 15% and were 25% to 35% for the adult populations. The prevalence of Diabetes and Hyperlipidemia, Cancers and Renal disorders were very high as well. The Eastern Medittaranean Region it seems, has not only one of the highest Non-Communicable Disease burden, but, many countries of the region continue to have a very high Communicable Disease burden still continuing as a remnant of the past. What is also clear from the data available is that the Non-Communicable Diseases, in particular Cardiovascular Diseases, have clearly overtaken the established burden of Communicable Diseases as the leading cause of mortality and morbidity.

While this change in disease pattern has gradually occurred, the medical profession and healthcare at large, the public and the Governments of these countries have yet to fully realize the magnitude of the shift in disease burden that has occurred. The WHO and the Ministries of Health in the EMR continue to focus most of their attention to Communicable Diseases which is necessary but sadly to the exclusion of efforts needed for stemming the burgeoning epidemic of cardiovascular diseases. This is sad because as is becoming apparent in this region, the treatment of cardiovascular disease is generally lifelong and much more expensive than that of Communicable Diseases and this burden will surely be beyond the capacity of the region to bear. It seems a colossal healthcare challenge is brewing in this region and one that has insidiously grown without raising the alarm necessary for its control and prevention.

It is apparent that the countries of the EMR will have to set in motion preventive measures on a war-like footing. The WHO Regional Office can provide the necessary support and prod the Governments of the region into recognition of this epidemic and the needed preventive measures. Experts from the CINDI and CARMEN programmes can help the EMRO countries avoid pitfalls and learn from the two successful initiatives. The Hypertension Leagues of the region must play their due part in this effort. The time for action by the EMR countries is NOW.

( PROF. AZHAR MASOOD A. FARUQUI )
MBBS; FACC; FRCPC; FCPS; FAHA,
FOUNDER-PRESIDENT,
PAKISTAN HYPERTENSION LEAGUE & EXECUTIVE DIRECTOR,
PROFESSOR OF CARDIOLOGY & CHAIRMAN,
ACADEMIC FACULTY, NATIONAL INSTITUTE OF CARDIOVASCULAR DISEASES

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