1. Outlines towards National NCDs Prevention and Control Strategy
Preventive Affair, Ministry of Health
By: Dr Eman Ellabany, MD, PhD
Medical Epidemiologist, NFP-NCD, , Egypt

2. www.who.int/chp Good afternoon.
It's my pleasure to share with you the overall messages and key findings of this new WHO global report: Preventing chronic diseases: a vital investment. Several misunderstandings about chronic diseases have contributed to their global neglect. This report dispels these misunderstandings with the strongest evidence and proposes a way forward for stopping the rising global epidemic.

3. Prevention of chronic diseases is a vital investement
Did you know??
Prevention of chronic diseases is a vital investement
people died from
chronic diseases
in 2005
The lives of far too many people in the world are being blighted and cut short by chronic diseases such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes.
Globally, 58 million people will die in million of these deaths will be as a result of chronic diseases. This means that 60% of all deaths in 2005 are due to chronic diseases.
The projected 35 million death toll from chronic diseases is double the number of deaths from all infectious diseases (including HIV/AIDS, tuberculosis, and malaria), maternal and perinatal conditions, and nutritional deficiencies combined.

4. WHO developed the Global Strategy and action plan to prevent NCD
There is global attention towards prevention of non communicable diseases.
WHO developed the Global Strategy and action plan to prevent NCD
MOH is planning to develop the national strategy targeting Egyptians in all governorates

5. Global Situation of Chronic Diseases
The evidence of the increasing burden of chronic disease in low and middle income countries is now very clear.
In 2005, the major chronic, non-communicable diseases accounted for 60% of all deaths and 47% of the global burden of disease.
About half of the 35 million people died from chronic disease in 2005 were under 70 years
By 2020, these figures are expected to rise to 73% and 60%, respectively.
80% of chronic disease deaths are already occurring in low and middle income countries

6. Causes of chronic diseases
The causes of the main chronic disease epidemics are well established and well known. The most important modifiable risk factors are:
unhealthy diet and excessive energy intake;
physical inactivity;
tobacco use.
These causes are expressed through the intermediate risk factors of raised blood pressure, raised glucose levels, abnormal blood lipids (particularly low density lipoprotein – LDL – cholesterol), and overweight (BMI ≥ 25) and obesity (BMI ≥ 30).
The major modifiable risk factors, in conjunction with the non-modifiable risk factors of age and heredity, explain the majority of new events of heart disease, stroke, chronic respiratory diseases and some important cancers.

7. Main causes of death, worldwide, all ages, 2005, WHO report, 2005
The majority of deaths worldwide for all ages are due to chronic diseases. Cardiovascular diseases (mainly heart disease and stroke) are responsible for 30% of all deaths. Cancer, chronic respiratory diseases, and diabetes are also major causes of mortality.
The contribution of diabetes is underestimated because although people may live for years with diabetes, their deaths are usually recorded as being caused by heart disease or kidney failure.

8. In Egypt
The prevalence of type II diabetes mellitus is (126 mg/dl) 15.8% , while the prevalence of hypertension (≥ 140/90 mmHg) 26%
Over weight and Obesity represent 66% of Egyptian population aged from about 70% of Egyptian are physically inactive

9. Vision health promotion and chronic disease prevention and control.
Comprehensive and integrated action for:
health promotion and chronic disease prevention and control.
Slow and reverse the adverse trends in the common chronic disease risk factors.

10. MoH priorities Adoption and implementation of:
WHO Global NCD prevention and control strategy
WHO Global strategy on Diet, Physical Activity and Healthy life style, which was endorsed by the World Health Assembly in 2004
These Strategies describe actions needed to support the adoption of
healthy life styles, healthy dietary habits and practicing of regular
physical activity for healthy society

11. Objectives
PROMOTE
Promote healthy living (better diet, more physical activity and tobacco cessation) and healthy societies, especially for the poor and those living in disadvantaged populations.
PREVENT
Prevent premature deaths and avoid unnecessary disability due to chronic diseases. The solutions exist now, and many are simple, cheap and cost effective.
TREAT
Treat chronic diseases effectively, using latest available knowledge. Make treatment available to all, especially those in the poorest settings.
CARE
Help provide appropriate care by facilitating equitable, affordable and good quality health care for major chronic diseases.

12. Mission
Provide leadership and direction for national efforts to promote health and
to prevent and control major chronic diseases and their risk factors
Tackling health’s social and economic determinants,
reorienting efforts within the health sector, working with other sectors,
including finance and education, and engaging the civil society,
thus adopting a “health-in-all-policies” approach

13. Core functions Advocacy Coordination and strengthening of advocacy and
communication on key messages, resource
mobilization, and the development of partnerships.
Aim is to ensure increased prominence of chronic
disease and health promotion issues on the health
agenda; ensure necessary funding to close the
knowledge-action gap; and to encourage an integrated
chronic disease management model based on primary
health care.

14. Core functions
Providing information for policy makers and stakeholders
Providing information at country level spans
the work to all health facilities.
The National database will be a tool which
collates existing country level data and
provides comparable estimates for major
chronic disease risk factors

15. Core functions Health Promotion Health promotion aims to address the
underlying determinants of population risks;
promote multi-sectoral policies and
programmes to improve health and reduce
health inequalities; and support development
of evidence-base for interventions.

16. Core functions Surveillance and Population-based Prevention
Surveillance and primary prevention are fundamental to the Ministry's mission.
The main aims are to reduce population levels of risk by controlling major common risk factors for chronic disease and to assist in monitoring trends of major risk factors.

17. Core functions Prevention and Management
Integrated chronic disease prevention and
management aims to reduce overall risk in high-risk individuals and provide appropriate health care (affordable, equitable and good quality) for major chronic diseases.

18. Way forward
Collaboration between various Stakeholders is essential for
working on evidence to achieve, assist in
establishing/ updating programmes and implementing
activities on NCD in the following priorities;
Development of NCDs prevention & control Strategies
Comprehensive and synergistic NCDs programmes
Integration of NCDs care into the primary health care system,
Strengthening/updating the existing NCDs services
Legislation related to employment
Health insurance & social security- related issues

19. Thank You