EDITORIAL NON-COMMUNICABLE DISEASES: BANGLADESH PERSPECTIVE

Non-communicable diseases (NCDs) are significantly responsible for disease burden, morbidity and mortality. At least 25 % of the deaths in primary and secondary government health facilities are caused by these diseases. Presently, Bangladesh does not have a community-based public health programme for NCDs. Only hospital-based information is available. 1 We are being told that NCDs in the developing world represent a ‘race against time’. 2 Major constituents of NCD include coronary heart disease, ischaemic stroke, haemorrhagic stroke, cancers, chronic obstructive airways disease, asthma. NCDs account for the majority of the global burden of disease and, in low and middle-income countries (LMICs), are projected to increase markedly. Table 1 shows the estimated 10 leading causes of death in 2000 Data for population surveillance of NCDs are limited in many countries. The World Health Organization has set up a range of projects aimed at improving the amount and quality of relevant data. The Surveillance of Risk Factors (SuRFs) project, launched in 2003, presents chronic disease risk factor profiles from 170 WHO member states. These data include tobacco and alcohol use, patterns of physical inactivity, low fruit/vegetable intake, obesity, blood pressure, cholesterol, and diabetes. The Non-communicable diseases have a considerable toll on individuals, societies and health systems. Located in South Asia, Bangladesh has a population of about 150 million and a per-capita health expenditure of US $ 64 will not be sufficient enough to combat with this condition. 3 The world Health Report 2002 had illustrated that NCDs accounts for almost 60 % of deaths and 46 % of the global burden of disease. If present trends continue, by 2020, these diseases are expected to account for 73 % of deaths and 60 % of disease burden. 4 The major limitations which are being faced for initiation of surveillance on NCDs include lack of advocacy, lack of logistic and other facilities as well as difficulties in the generating resources for newer initiatives.