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Noncommunicable diseases

Medical records at the health centre in Ngoma, Rwanda

Noncommunicable diseases (NCDs) are chronic diseases that are not caused by acute infections and are not passed on directly person to person. In most cases, such diseases are caused by a combination of genetic, physiological, ecological and social factors.

The four main NCDs are cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. These diseases all have in common that they are often not curable, that they require lengthy treatment and often nursing care, that they severely impact on quality of life and capacity to work, and that they cause high treatment costs and reduced life expectancy.

Noncommunicable diseases kill about 40 million people each year, which means that they account for almost 70 per cent of all deaths worldwide. Each year, more than 15 million people between the age of 30 and 69 die from an NCD. Over 85 percent of these "premature deaths" occur in low- and middle-income countries.

Street scene in Ulanbaataar, Mongolia

Risk factors

Tobacco and alcohol use, physical inactivity and unhealthy diets are the predominant risk factors for NCDs. Ageing populations, poor living conditions in fast-growing cities and the global spread of unhealthy lifestyles are additional factors driving the rapid rise in NCDs.

There are also close links between NCDs and poverty. Socially disadvantaged groups tend to consume harmful products such as tobacco more often, are not always able to consume a healthy and balanced diet, and have only limited access to health services. Consequently, they are more often ill and die earlier than people who have better social protection.

Gazipur District Hospital in Tongi, Bangladesh

Development achievements under threat

Since people of working age often fall ill or have to care for sick relatives, NCDs also affect a country's productivity and competitiveness. According to estimates, this means that NCDs will cause economic losses of more than 7 trillion euros in the period from 2011 to 2025.

In addition, the weak, and often underfunded, health systems in many developing countries and emerging economies are not prepared to cope with the increasing financial burden caused by NCDs. Appropriate strategies and the necessary infrastructure for the prevention, early detection and treatment of such diseases are lacking.

The rise in NCDs may also significantly weaken the impact of poverty reduction initiatives in low-income countries. For example, according to the World Health Organization (WHO), millions of people fall into poverty each year as a result of having to pay for the treatment and care – often over many years – of a chronically ill family member. This may jeopardise or even destroy the development achievements made so far.

Children and teenagers playing football in the old town of Cairo, Egypt

International involvement

In its 2030 Agenda for Sustainable Development the international community set itself the following target: "by 2030 reduce by one-third premature mortality from noncommunicable diseases (NCDs) through prevention and treatment" (Target 3.4).

To support individual countries in their efforts, the WHO has identified 16 cost-efficient priority measures for NCD prevention and control and endorsed a Global Action Plan 2013-2020. This Action Plan contains nine global targets to improve the prevention and control of NCDs. One of the objectives listed in the Plan is to raise the priority accorded to this topic in global, regional and national health strategies. Since many risk factors for NCDs are modifiable, countries should also do more to create health-promoting environments. These efforts need to go beyond strengthening health systems and include all policy areas (health in all policy areas).

Possible measures to prevent noncommunicable diseases include, for instance, taxes on tobacco and alcohol, subsidising healthy food, smoking bans, measures to improve air quality, education programmes in schools or government programmes to improve health and for early detection. In collaboration with the International Telecommunication Union (ITU) the WHO is also supporting the development of mobile applications that provide users with concrete, practical advice for healthier living.

German activities

Worldwide, NCDs and their consequences are putting an increasing strain on public health systems and threatening to undo development achievements in the partner countries of German development cooperation. That is why the German government is engaging in activities such as promoting partnerships between hospitals in Germany and hospitals in developing countries and emerging economies, thus supporting staff training and upskilling, and the exchange of knowledge. At the international level, Germany is pushing for more priority to be given to measures for NCD prevention and treatment in development policy discussions about strengthening and financing health systems.

For the effective prevention of NCDs, it is necessary not only to strengthen health systems but also to link health policies very closely with the work being done on issues such as occupational health and safety, education, nutrition, housing, road safety and environmental protection. Therefore, Germany is supporting its partner countries with a number of projects for the prevention of NCDs: from green urban planning to promoting sports at schools. Germany is also seeking to get private businesses and civil society more actively involved in such efforts, to supplement the work of state health authorities.

Video: Hospital Partnerships - The film

Further information

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