What NCDs?
adminWhat NCD?
Noncommunicable Diseases (NCDs) comprise Diabetes, Cancer, Heart, and Lung Diseases resulting from exposure to the shared risk factors of Diet high in sugar, salt, and fat; physical inactivity; tobacco use; and harmful use of alcohol!
NCDs are included in the Sustainable Development Goals (SDGs) of the United Nations with the 33 x 30 promise: “by 2030 reduce by one third [relative to 2015 levels] premature mortality from NCDs through prevention and treatment and promote mental health and well-being.” By delivering on this there is the promise of alleviation of suffering, bringing comfort, and saving lives and potential. To date, only 15 countries are projected to achieve that target.
Whats there in a name or acronym? The first question is what is this NCD? There are two main issues that are problematic: the grouping and naming effects
Grouping Effect : NCD is the name for a group of 4 diseases and using the technically correct terms they are: Cardiovascular Diseases, Diabetes, Cancer and Chronic Respiratory Diseases. Here lies a problem – How can we have one target for a group of diseases which can either make it easier or harder to accomplish? There are reasons why these diseases have been grouped together and it is because of their similarity in nature, causation, time lapse and sequelae. The same could be said of infectious diseases and groupings are around viral, bacterial and fungal infections and categories used for academic purposes more than anything else. For There are also inconsistencies and anomalies in defining them – we have cardiovascular and respiratory diseases that are diseases of specific organ (heart and lungs) and then we have diabetes and cancer that has multi-organ effects. So maybe the grouping should be made up of Heart, Lung and Muti-organ diseases. Or for better branding it should be Diabetes and Cancer if we want to stick to the main four.
The main consistency across all of the diseases are the shared risk factors of unhealthy diet, physical inactivity, tobacco use, and harmful use of alcohol. If one follows the track of naming in infectious diseases, one could name or brand them according to the causal factor then it could be Diseases of unhealthy diet, physical inactivity and substance abuse which is theoretically a big added advantage in addressing them. In fact there is better reason for Covid, SARS, H1N1 to be grouped together as Communicable Diseases but they are not so they have all been cured or eliminated and yet the NCD plague continues into eternity.
The beauty of infectious disease is that they have individual brands to themselves for a given short time – Covid, SARS, H1N1 according to the various names they place on each virus. It starts, a brand is provided, the world pays attention, all the resources are diverted and all hands on deck and through a course of urgent integrated actions it mostly gets controlled. Meanwhile the group of diseases NCD is there always and the discussion is more around how many diseases do we include – 4 or 5 diseases? Should mental disorder be included since it shares some of the causal factors? Guess what? Mental Disorders is another group of diseases so instead of deciphering the group we add more diseases or groups of them to the definition, much to the continuing lackadaisical attitude, stagnation of implementation and lacklustre performance in addressing and delivering on the promise.
The other issue being discussed for ages is in the naming, the fact that we name something by describing what it is not, rather than what it is! There is an automatic layered questioning when starting a discussion on NCD – What is that? Its Non …. something. So what is it ? It is a group consisting of four diseases. So what are they? They are Cardiovascular Diseases,Diabetes, Cancer and Chronic Respiratory Diseases. By then we have lost the common person and only medical personnel have interest to converse further.By naming or branding them as the Big Four one could immediately decipher an easier communication
In addition, Noncommunicable or Non-transmissible is inaccurate because there is evidence of infectious cause to some of the diseases in the group and risk behaviours that are root causes can be transmissible. It is weak as a title or brand because of lack of specificity and face value to grouping of diseases. Like Apple phones where people associate directly with Steve Jobs, other brands like Samsung we don`t think of a face so it is with NCD whilst for epidemic we define by the brand or the source.
What is needed is a C-change and it begins with naming and branding. It is like countries close to the equator that has only one season compared to the countries where the four seasons are distinct that makes them well prepared for change that results in ultimate progress.
Fundamentally the world is facing a group of diseases that are cumbersome in volume, chronic in nature, a population that is complacent about it, solutions that are complex to implement with impacts that are catastrophic if not addressed early enough. This is the current definition of noncommunicable diseases. Its results are telling – funders are not interested, population have a laisser fare attitude towards it, the workers are tired and worn out, suffering continues and premature deaths still on the rise – despite the many commitments both at national and international level.
So whats the recommended action? The question: Is it time to break the boundaries and go specific? If yes then we are set free to focus on specific diseases and maximise the efforts globally whilst maintaining the cross collaboration and integrated action. If not then lets do a better job at branding – I would simply call them the `Big Four` opportunities for living – its more accurate – NCD has overtaken the burden of communicable diseases globally – and catchy for branding and use.
