Context: The world is struggling with Non-Communicable diseases (NCD). Nearly 71% of all deaths worldwide occur due to NCD such as hypertension, diabetes, cardiovascular diseases, cancer etc  Given the increasing menace of NCD there is an urgent need for a multi-stakeholder approach to handle the impending crisis.
The top contributors to NCD

• At the Global level: Top contributors of global deaths are cardiovascular diseases(CVD) such as stroke, heart attack, coronary artery disease. 1/4 of deaths occur because of this, especially among young patients.
• Indian subcontinent: There is a rapid progression of these diseases with a high mortality rate
• In India, there are high cases of premature loss of life due to NCD in the 30-69 year age group

About government initiatives

• To address the growing burden of NCD, National Health Mission (NHM), in 2010, launched the National Programme for prevention and control of cancer, diabetes, cardiovascular diseases and stroke. 
• The focus of this programme is to strengthen infrastructure, promote good health, human resource development, early diagnosis, and management & referral services.

How Covid disrupts the NCD services

Because of the rapid spread of Covid, there were disruptions in the management of NCD. According to World Health Organisation (WHO) survey in May 2020, it was found that:

• Low-income countries are the worst affected because of Covid disruption.
• More than 53% of countries have partially or completely disrupted services for hypertension treatment, 49% for diabetes & related complications, 42% for cancer treatment & 31% for cardiovascular emergencies

Reasons for discontinuing the services

• Staff reassigned to support Covid patients
• Postponement of public screening programmes
• Shortage of medicines, technologies etc
• Decreased availability of public transport

Relationship between Covid & NCD

• It was found that persons suffering from both Covid and NCD are at higher risk. Among the NCD, persons with diabetes are in a higher risk category.
• Recent studies show that nearly one in every two Indians living with diabetes are unaware of their condition, and they are at higher risk of dying if they got infected with Covid. This is because of the uncontrolled glucose level in their blood.

What needs to be done?

• A paradigm shift in governance towards effective & participatory leadership with strong vision and communication is the need of the hour to tackle this silent epidemic.
• There is a need to include NCD services in the national Covid preparation strategy. Presently, 42% of lower-income group countries do that
• India should also include tobacco-related activities to address the burden of NCD
• India should work on innovations in the campaign strategy for promoting a healthy lifestyle
• To enhance screening for NCD at the grass-root level. Incentives to ASHA workers for delivery of locally relevant & contextual messages for health promotion are needed.
• India should ensure access to essential NCD medicine and basic health care services in all primary healthcare facilities.
• The use of alternative modalities such as online platforms for disseminating information on exercise & mental health management must be made available.

Road Ahead

• There is an urgent need to adopt a multidisciplinary approach. This should focus on ‘primary healthcare’ with ‘all of the society approach’.
• This should address various challenges like administrative challenges, infrastructure, a strong health workforce & continued access to care for vulnerable people.
• All these can help India achieve the WHO goal of a 25% relative reduction in mortality from NCD by 2025.