Partnerships a must to tackle lifestyle diseases

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Partnerships a must to tackle lifestyle diseases

Tuesday, November 24, 2020

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The experience of the novel coronavirus pandemic has been replete with lessons learnt, not the least of these the sobering reminder of the need to prioritise the prevention and care management of non-communicable diseases (NCDs), including diabetes, hypertension, and mental health disorders.

This is in addition to the need for public-private partnerships to help assure ourselves of the success we aim for in beating lifestyle diseases while also adapting to life with COVID-19.

This need is reflected in existing data.

The most recent Jamaica Health and Lifestyle Survey (JHLS) reveals that one in three Jamaicans has hypertension, one in two is overweight or obese, and one in eight has diabetes. Still, many are unaware of their condition and are engaging in behaviours likely to increase their risk of NCDs, including high consumption of sugar-sweetened beverages, low consumption of fruits and vegetables. and low physical activity.

Our COVID-19 experience, meanwhile, has demonstrated the critical role that NCDs play in determining health outcomes for people who become infected with the virus.

A report published by the World Health Organization (WHO) reveals, among other things, that obesity increases the risk of becoming severely ill from COVID-19, and that people with diabetes were up to three times more likely to have severe symptoms or die from COVID-19. It also revealed that hypertension, cardiovascular and cerebrovascular disease increased the odds for severe COVID-19 by 2.3, 2.9, and 3.9 times, respectively.

COVID-19 has also restricted access to routine care for people with comorbidities, as evidenced by a rapid assessment conducted by the WHO and involving 163 countries on the impact of the pandemic on NCDs services. Seventy-seven per cent of countries surveyed reported disruption in NCDs activities, while 75 per cent reported a disruption in NCDs services.

We need, therefore, to address the burden of chronic NCDs. One approach is through the building of a strong behaviour-modification strategy, as exemplified by the Jamaica Moves programme, which focuses on physical activity, nutrition, and routine health checks.

We understand, of course, that it is no easy feat to transform mindsets from poor health practices that, in the long run, become a significant impediment to economic growth and development. Therefore, in this financial year, we intend to expand the programme of prevention to include supportive policies and legislation to enable a strengthening of the primordial prevention strategies.

These will include:

* tabling of the tobacco control legislation and the alcohol policy;

* advancing front-of-package labelling and completing research to support new policies on the use of salt and sugar;

* establishing the NCDs task force to support consultation and collaboration, research, and development in the area of NCDs prevention; and

* completing the trans-fat study to establish empirical evidence to support new policies in relation to fats and the consumption of fats in our foods.

I have, in my sectoral presentations, sought to advance the health and wellness agenda of the Government, and its imperative in the development of a productive economy. As outlined in the 10-year Strategic Plan and the Capital Expenditure Development Plan for health facilities, the Government is seeking to tackle the rising scourge of NCDs and the associated risks, both from the public health and economic perspectives.

Integral to this strategic direction is the establishment of a framework to tackle the challenge of NCDs, anchored not only in prevention, treatment, and care, but also infrastructure development. These are pillars reflected in the Health Systems Strengthening for the Prevention and Care Management of NCDs Programme, now being implemented with the financial support of the Inter-American Development Bank and the European Union.

This programme is seeing, among other things, the organisation and consolidation of integrated health systems networks, including the purchase of medical equipment and infrastructure improvement at primary care facilities. Also included in the scope of work is the design and implementation of a sustainable electronic health records platform focusing on digitisation of key processes within an improved chronic care model.

However, tackling the NCDs problem is not a job that is wholly the remit of the Ministry of Health and Wellness. Of necessity, we require the partnership of a variety of stakeholders, including private health care providers.

The type of collaboration we foresee is embodied in the recently launched public-private partnership to which the Government is committing $100 million in the pilot phase and in which eight health centres and four private facilities in Clarendon, St Ann, and Kingston and St Andrew will provide treatment to approximately 5,000 diabetes and/or hypertensive patients.

Mental illnesses are NCDs that are often hidden or overlooked due to silence and stigma. Yet, Jamaica is faced with a relatively high burden of disease. The JHLS estimated the prevalence of depression at 14 per cent in the overall population, 10 per cent in men and 19 per cent in women.

This is likely to worsen during COVID-19 as Jamaicans struggle with isolation, acute illness, loss, and fear. In addition, the WHO has reported that the novel coronavirus pandemic also disrupted mental health services in 93 per cent of countries worldwide.

To address this, we recently launched the COVID-19 Mental Health Response Programme to provide support at the community level. This, too, requires collaboration from external stakeholders. In particular, we require individual volunteers and the support of actors from the private and service sectors.

I have no doubt that working together we can scale the hurdle of chronic NCDs while also successfully adjusting to life with COVID-19.

Dr Christopher Tufton is the minister of health and wellness and Member of Parliament for St Catherine West Central.


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