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Main NCDs

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Image by WHO / Sebastian Meyer

Noncommunicable diseases (NCDs), commonly known as chronic or lifestyle-related diseases, are diseases that are not infectious to others. NCDs tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors. The main NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma), and diabetes. NCDs are the world’s biggest killers and a leading cause of death in the Region. Other NCDs include: hypertension, Alzheimer's and osteoporosis.

Burden of NCDs

Every year, more than 2.8 million people in the Eastern Mediterranean Region die from the main NCDs alone. Cardiovascular diseases account for most NCD deaths, followed by cancers, chronic respiratory diseases, and diabetes (including kidney disease deaths caused by diabetes). The rates of mental health disorders, specifically depressive illness and anxiety disorders are also high in countries of the Region. Collectively, the main NCDs are responsible for 66% of all deaths in the Region.

Over half of NCD deaths are premature, occurring before the age of 70, thus affecting economically productive individuals, impoverishing families, and placing a considerable burden on health systems and national economies. NCDs thus can stifle the potential for socioeconomic development.

People at risk

More than 150 million people are living with NCDs in the Eastern Mediterranean Region. Children, adults and the elderly are all vulnerable to the risk factors contributing to NCDs, whether from unhealthy diets, physical inactivity, exposure to tobacco smoke, the harmful use of alcohol or air pollution. These diseases are driven by forces that include rapid unplanned urbanization, globalization of unhealthy lifestyles and population ageing. Unhealthy diets and a lack of physical activity may show up in people as raised blood pressure, increased blood glucose, elevated blood lipids and obesity. These are called metabolic risk factors and can lead to cardiovascular disease, the leading NCD in terms of premature deaths.

Risk factors for NCDs

Modifiable behavioural risk factors

Modifiable behaviours, such as tobacco use, unhealthy diets, physical inactivity, and the harmful use of alcohol, all increase the risk of dying from an NCD.

Metabolic risk factors

Metabolic risk factors contribute to four key metabolic changes that increase the risk of NCDs: raised blood pressure; overweight/obesity; hyperglycemia (high blood glucose levels); and hyperlipidemia (high levels of fat in the blood). In terms of attributable deaths, the leading metabolic risk factor is elevated blood pressure, followed by raised blood glucose and overweight and obesity.

Prevention and control of NCDs

An important way to control NCDs is to focus on reducing the risk factors associated with these diseases. Low-cost solutions exist for governments and other stakeholders to reduce the common modifiable risk factors. Monitoring progress and trends of NCDs and their risk is important for guiding policy and priorities.

To lessen the impact of NCDs on individuals and society, a comprehensive approach is needed requiring all sectors, including health, finance, transport, education, agriculture, planning and others, to collaborate to reduce the risks associated with NCDs, and to promote interventions to prevent and control them.

Investing in better management of NCDs is critical. Management of NCDs includes detecting, screening and treating these diseases, and providing access to palliative care for people in need. High impact essential NCD interventions can be delivered through a primary health care approach to strengthen early detection and timely treatment. Evidence shows such interventions are excellent economic investments because, if provided early to patients, they can reduce the need for more expensive treatment. Countries with inadequate health care coverage are unlikely to provide universal access to essential NCD interventions. NCD management interventions are essential for achieving the Sustainable Development Goal target to reduce premature deaths from NCDs by one third by 2030.

WHO response

The 2030 Agenda for Sustainable Development recognizes NCDs as a major challenge for sustainable development. As part of the Agenda, heads of state and government committed to develop ambitious national responses, by 2030, to reduce premature deaths from NCDs by one third through prevention and treatment (SDG target 3.4). WHO plays a key leadership role in the coordination and promotion of the global fight against NCDs and the achievement of the Sustainable Development Goals target 3.4.

In 2012, the WHO Regional Committee for the Eastern Mediterranean endorsed a regional framework for action, updated in October 2019. This document is a road map for countries in the Region to implement the UN Political declaration on prevention and control of NCDs. The regional framework provides strategic interventions and indicators to assess country progress in the areas of: governance; prevention and reduction of risk factors; surveillance and monitoring; and health care. Implementation of the regional framework will contribute to progress on the nine global NCD targets.

In 2019, the World Health Assembly (WHO’s governing body) extended the WHO Global action plan for the prevention and control of NCDs 2013–2020 to 2030 and called for the development of an Implementation roadmap 2023 to 2030 to accelerate progress on preventing and controlling NCDs. The roadmap supports actions to achieve a set of nine global targets with the greatest impact towards prevention and management of NCDs.