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Probability of death by NCDs has gone up in India: WHO

The probability of dying pre- maturely from a non-communicable disease like cancer has gone up in India between 2010-2012 and it has emerged as the leading cause of fatalities globally, a WHO report said Monday.

Geneva: The probability of dying pre- maturely from a non-communicable disease like cancer has gone up in India between 2010-2012 and it has emerged as the leading cause of fatalities globally, a WHO report said Monday.

The latest global status report on non-communicable diseases (NCDs) conducted by the World Health Organisation (WHO) states that the four main NCDs are cardiovascular diseases, cancer, diabetes or chronic respiratory diseases.

The report is the second in a triennial series tracking worldwide progress in prevention and control of NCDs.

The report states that the probability of dying between 30 and 70 from a non-communicable disease in India has increased to 26.2 per cent in 2012 from 26.1 per cent in 2010. The percentage of such deaths in India is worse than almost the whole of sub-Saharan Africa and South Asia.

Among the P5 countries -- China, France, Russia, the UK, and the US in 2012 only the Russian Federation has a higher probability of death caused by NDCs than India with a 29.2 per cent chance of a person dying a premature death from it, even though it shows a decrease from 2010.

Switzerland fares the best with a 9.2 per cent chance and Tajikistan the worse with a whopping 40.8 per cent chance of a premature NCD death.

Out of the world's 56 million deaths, NCDs were responsible for 68 per cent -- 38 million deaths in 2012 -- making it the leading cause of death globally, the report said.

More than 40 per cent of them (16 million) were premature deaths under age of 70. Almost three quarters of all NCD deaths (28 million), and the majority of premature deaths (82 per cent), occur in low-and middle-income countries, it said.

India in this report has been categorised as a low-middle income country.

Shanthi Mendes, lead author of the report said, "India has the resources. It needs to strengthen its primary health care system in an integrated way not with a vertical approach and working on universal health care coverage. India has reached the space age but what about its people?"

In May 2013 the World Health Assembly adopted the Global NCD Action Plan, for the prevention and control of non- communicable diseases 2013-2020 and a comprehensive global monitoring framework, including a set of nine voluntary global targets and 25 indicators to achieve an overarching target of a 25 per cent reduction of pre-mature mortality from the four major NCDs by 2025.

The nine targets include reduction in harmful use of alcohol, insufficient physical activity, salt/sodium intake, tobacco use and hypertension, halt the rise in diabetes and of obesity, and improve coverage of treatment for prevention of heart attacks and strokes.

There is also a target for improved availability and affordability of technologies and essential medicines to manage NCDs.

According to the report, the cost of inaction in low and middle income countries against preventable NCDs would amount to cumulative economic losses of USD 7 trillion as compared to USD 11.2 billion cost of implementing a set of high-impact interventions to reduce the NCD burden during 2011-2025.

The report, however, makes no mention of comparable statistics of rich countries that also grapple with NCDs though with better statistics.

NCD deaths have increased the most in the Southeast Asian region, from 6.7 million in 2000 to 8.5 million in 2012 with cancers making up for 21.7 per cent -- 8.2 million ?- NCD deaths.

In low and middle income countries, cancer levels vary according to the prevailing underlying risks, with cervical cancer, liver cancer and stomach cancer all causing a larger proportion of deaths than in high-income countries.

In sub-Saharan Africa, for instance, cervical cancer remains the leading cause of cancer death among women. Over three quarters of deaths from cardiovascular disease and diabetes, and nearly 90 per cent of deaths from chronic respiratory diseases, occur in low and middle income countries.

Cardiovascular disease was the leading cause of NCD deaths in 2012 and was responsible for 17.5 million deaths, or 46 per cent of NCD deaths. Of these deaths, an estimated 7.4 million were due to heart attacks and 6.7 million were due to strokes.

Of the total NCD deaths in India, 62 per cent were males and 52.2 per cent were females under 70.

For every 1,00,000 males, a total of 785 deaths were recorded with 79 dying of cancer, 188.5 of respiratory ailments, 348.9 of cardiovascular problems, 30.2 of diabetes.

Similarly, for 1,00,000 females, a total of 586.6 deaths were recorded with 66.3 dying of cancer, 124.9 of respiratory ailments , 264.6 of cardiovascular problems, and 22.7 of diabetes.

In 2012, an estimated 5.9 per cent (3.3 million) of all deaths worldwide and 5.1 per cent of disability-adjusted life years (DALYs) were attributable to alcohol consumption. More than half of these deaths resulted from NCDs.

Of the total alcohol consumption per capita, aged 15 years and over, within a calendar year, in litres of pure alcohol, India has a per capita consumption of 5.2 litres, the report said.

In 2012 there were some 1.1 billion smokers worldwide, with over eight out of 10 tobacco smokers smoking daily. Manufactured cigarettes is the most common form of smoked tobacco and is used by over 90 per cent of current smokers. Globally smoking prevalence is about five times higher among men (37 per cent) than among women (7 per cent).

Six million people are currently estimated to die annually from tobacco use, with over 600 000 deaths due to exposure to second-hand smoke (170,000 of these deaths among children). Tobacco use accounts for 7 per cent of all female and 12 per cent of all male deaths globally.

India has 13.3 per cent of adults aged 15 years and above who smoke tobacco. The highest among the high income countries and overall is Greece 45.1 followed by the Russian Federation 38.8.

Worldwide, obesity has more than doubled since 1980, and in 2014, 11 per cent of men and 15 per cent of women aged 18 years and older were obese. An estimated 42 million children under the age of 5 years were overweight in 2013.

India has 4.9 percent of obese people among people aged 18 years.

Globally, 1.7 million annual deaths from cardiovascular causes have been attributed to excess sodium intake. Though there is no India-specific data in the report, intake levels appear highest in south-east and central Asia and parts of Europe.

Diabetes was directly responsible for 1.5 million deaths in 2012 and 89 million DALYs. The global prevalence of diabetes or being on medication for raised blood glucose) was estimated to be 9 per cent in 2014.

India has 9.5 per cent of diabetic adults while Micronesia seems to be the diabetic capital of the world with 22.5 per cent diabetics.