Combatting NCDs: strong partnership is key

Noncommunicable diseases (NCDs) such as heart and lung diseases, cancer, and diabetes account for 80% of all deaths in Kyrgyzstan. In 2015, the probability of premature death from an NCD for a person living in the country was 1 in 4.

One of the most effective measures to prevent NCDs is to reduce the main risk factors, including tobacco use, harmful use of alcohol, unhealthy diet and insufficient physical activity. Yet surveys conducted in Kyrgyzstan with the support of WHO have shown a high prevalence of risk factors among the population.

For example, a 2013 STEPwise approach to surveillance (STEPS) survey found that every second man in Kyrgyzstan smokes. It also revealed that 3 out of 4 people eat fewer fruits and vegetables than recommended and lack sufficient physical activity. A 2017 FEEDCities survey of street foods found they contained high levels of trans fat and salt, which, if regularly consumed in excess, increase the risk of coronary heart disease and cause high blood pressure.

Addressing NCDs requires taking into account political, economic, social and environmental determinants of health, and necessitates a whole-of-government approach. With this in mind, WHO in Kyrgyzstan uses its convening power to strengthen policy dialogue across government. National authorities from different sectors jointly developed Kyrgyzstan’s strategies on NCD control (2013–2020) and on health protection and promotion with support from WHO and other development partners. A recent review of the national NCD strategy highlights opportunities to further improve intersectoral dialogue.

Currently, almost 4% of Kyrgyzstan’s gross domestic product is lost due to NCDs. In 2017, WHO collaborated with the United Nations Interagency Task Force on NCDs and the United Nations Development Programme to analyse the economic burden of NCDs as well as the costs and benefits of investing in NCD prevention and control in the country. They found that the reduced cost of a healthier population will outweigh the investment needed to lower the prevalence of NCDs by 12 times.

An effective measure for preventing and controlling NCDs is to address them at the primary health-care level. In 2015, Kyrgyzstan began piloting the WHO PEN protocols, a package of essential NCD interventions for prevention, early detection and treatment at the primary health-care level in low-resource settings. The country scaled up PEN implementation in 2016, and in 2017 WHO assessed the effectiveness of these measures in pilot sites to plan the future approach to NCD control in primary care.

A 2016 WHO review of acute and rehabilitative services for heart attack and stroke gave a comprehensive picture of care provided to patients with cardiovascular diseases, and offered recommendations for improvement. To enhance the foundation of health services for cancer patients, WHO also supported the establishment of a national cancer registry.

Kyrgyzstan has taken substantial steps to combat tobacco smoking. In 2015, the country passed a law increasing taxation on tobacco products, and introduced graphic warnings on tobacco products to increase people’s awareness of the damaging effects of smoking on health. The Government will continue increasing taxes on tobacco products until 2022.

However, many anti-tobacco actions are now slowing down. A renewed, consolidated effort with international support is essential to further protect the population from the harmful consequences of tobacco use and to implement the WHO Framework Convention on Tobacco Control.

Reducing premature mortality from NCDs by one third is a target of the global Sustainable Development Goals. Kyrgyzstan recognizes the urgent need to battle NCDs, and prioritizes their prevention and control in the draft national sustainable development strategy for 2018–2040. WHO in Kyrgyzstan continues to lead and coordinate all partners in health to increase the capacity of the national health system to diagnose, treat and prevent NCDs more effectively.