More attention needs to be paid to the management of non-communicable diseases.
Non-communicable diseases (NCDs) are a leading cause of death. Currently, 65-75% of hospitalized patients suffer from NCDs, and these diseases are becoming more prevalent among younger people.
Nghe An Newspaper had an interview with Dr. Le Anh Tuan, Specialist Level 2 – Head of the Department of Non-Communicable Disease Prevention and Control, Nghe An Center for Disease Control, regarding related issues.
Reporter (R)According to the latest report from the Ministry of Health, it is estimated that in Vietnam, deaths from non-communicable diseases account for up to 77% of all deaths from all causes each year. Could you elaborate on what non-communicable diseases are? Why are non-communicable diseases the leading cause of death?
Doctor Le Tuan Anh:According to the World Health Organization, non-communicable diseases (NCDs) are diseases that are not contagious, also known as chronic diseases, and are not transmitted from person to person. These diseases progress slowly over a long period. NCDs encompass many diseases, but the most notable are four main categories: cardiovascular diseases (such as hypertension, myocardial infarction, and stroke), cancer, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes. Other categories include neurological and mental disorders, chronic joint diseases, and injuries from accidents.
Non-communicable diseases (NCDs) have several characteristics, including complex etiologies; multiple risk factors; no infectious origin; slow onset; prolonged disease progression; persistent treatment; and lasting consequences for patients and society. Risk factors for NCDs include lifestyle habits, physical or chemical agents. These factors, when present, increase the likelihood of developing NCDs or dying from them. Statistically, NCDs share four common risk factors: smoking (including tobacco); lack of physical activity; alcohol abuse; and an unhealthy diet.
According to the World Health Organization, non-communicable diseases are becoming increasingly prevalent in the community, are a leading cause of death and disability, cause significant economic losses in society, and pose major challenges to the health systems of countries, especially low- and middle-income countries.
According to a 2016 survey in Vietnam, there were 548,800 deaths nationwide, with non-communicable diseases accounting for 77% (44% died before the age of 70; mainly due to cardiovascular diseases, cancer, diabetes, and chronic obstructive pulmonary disease). On average, Vietnam has approximately 12.5 million people with hypertension, 3.5 million with diabetes, 2 million with chronic heart and lung diseases, and nearly 126,000 new cancer cases each year. Thus, one in five adults has hypertension and about one in 25 adults has diabetes. Furthermore, more than half of hypertension patients and about 70% of diabetes patients in the community remain undiagnosed.
In Nghe An province, according to statistics from commune health stations, in 2023, approximately 120,471 patients with hypertension and 33,230 patients with diabetes were detected. Currently, hospital reports show that 65-75% of inpatients suffer from non-communicable diseases. Hospitals with specialized departments for cancer, cardiology, endocrinology, etc., are constantly overloaded.
Non-communicable diseases are the leading cause of death in Vietnam because of its high alcohol consumption and smoking rates. The high alcohol consumption increases the risk of injuries, strokes, and heart attacks. The high smoking rate also contributes to many diseases, from cancer and chronic obstructive pulmonary disease to cardiovascular diseases.
Furthermore, the general public's awareness of non-communicable diseases is still low, leading to inappropriate behaviors, lifestyles, and dietary habits. In addition, the rate of screening and early detection in Vietnam remains low; and the management and treatment of non-communicable diseases at the primary healthcare level face many difficulties.
The World Health Organization also warns that, after the Covid-19 pandemic, the world will face another pandemic called non-communicable diseases. Therefore, countries need to continue investing and focusing resources on prevention activities as well as care and treatment for people with non-communicable diseases.
PV:Clearly, non-communicable diseases are very dangerous and are on the rise. To prevent and control non-communicable diseases, what solutions are Vietnam in general and Nghe An in particular implementing?
Doctor Le Tuan Anh:Currently, the prevention and control of non-communicable diseases and mental health disorders is a priority in Vietnam's health policy. The Ministry of Health and the Government have issued many policies aimed at gradually controlling non-communicable diseases and reducing the burden on higher-level hospitals by bringing the management and treatment of non-communicable diseases to the grassroots level. On January 29, 2022, the Prime Minister issued Decision 155/QD-TTg approving the National Plan for the Prevention and Control of Non-Communicable Diseases and Mental Health Disorders for the period 2022-2025.
In accordance with the Prime Minister's directive on the prevention and control of non-communicable diseases, on November 29, 2023, the People's Committee of Nghe An province issued Plan No. 920/KH-UBND on the prevention and control of non-communicable diseases and mental health disorders in Nghe An province for the period 2023-2025.
Based on the plan of the Nghe An Provincial People's Committee, health units and the People's Committees of districts, cities, and towns have also issued their own plans for the prevention and control of non-communicable diseases. Accordingly, the solutions implemented by localities include: Strengthening management, leadership, direction, and operation; solutions regarding mechanisms and policies, including the allocation of budget funds for the prevention and control of non-communicable diseases and strengthening the enforcement of legal regulations on controlling risk factors and promoting health-enhancing factors; communication to raise health awareness, minimize risky behaviors, and prevent non-communicable diseases; strengthening the provision of preventive services, early detection, management, treatment, and care for patients with non-communicable diseases; developing and improving the capacity of the non-communicable disease prevention and control service delivery system; and developing a system for monitoring and managing information on non-communicable diseases and risk factors.
The Provincial Center for Disease Control has also issued a plan for the prevention and control of non-communicable diseases. This plan focuses on measures to strengthen communication to help people understand the dangers of non-communicable diseases; improving the quality of non-communicable disease management and treatment services at health stations to more effectively manage non-communicable patients in the community through monitoring, capacity building training, etc.
To prevent and control non-communicable diseases, currently, 100% of health stations in the province have implemented hypertension management and treatment, and conducted screening for hypertension and high-risk factors for diabetes at the stations, making it easier for people to access non-communicable disease management and treatment services, especially in remote areas.
PVThe preventive and control measures implemented are very proactive; however, why are non-communicable diseases on the rise? Is it because we haven't implemented the aforementioned measures effectively?
Doctor Le Tuan Anh:Currently, the prevention and control of non-communicable diseases in Vietnam in general and Nghe An in particular still face many difficulties and limitations. These include a low rate of screening and early detection of non-communicable diseases; difficulties in managing and treating non-communicable diseases at the grassroots level; some commune health stations do not have a sufficient list and quantity of essential medicines for the management and treatment of non-communicable diseases and do not perform capillary blood glucose testing for the management and treatment of diabetes; and the management of information on non-communicable diseases and mental health disorders in the area is not yet complete.
Non-communicable diseases often progress silently, only being detected when complications arise. People are still not fully aware of the dangers of these diseases and therefore do not pay enough attention to prevention and control. Uncontrolled smoking and alcohol consumption are common. Many harmful habits and lifestyles still increase the risk of non-communicable diseases.
Dr. Le Anh Tuan, Specialist Level 2 – Head of the Department of Non-Communicable Disease Prevention and Control, Nghe An Center for Disease Control and Prevention.
The reasons stem from insufficient attention to prevention and control activities, which are not given the same importance as the prevention of infectious diseases. Funding for prevention and control at the healthcare level is virtually non-existent or has not been allocated. Due to a lack of funding, prevention and control activities have not been fully and comprehensively implemented, especially screening to detect diseases and risks. Health centers currently face difficulties in staffing, having to implement too many health programs simultaneously, while their numbers and qualifications are limited.
To overcome these difficulties and move towards effective prevention and control of non-communicable diseases (NCDs), and to minimize risk factors, it is necessary to continue promoting communication about risk factors and risky behaviors that cause NCDs, and to raise public awareness. Local authorities at all levels need to allocate funding for more effective NCD prevention and control activities.
Changing harmful lifestyle behaviors, early screening and detection, and timely treatment are extremely important in preventing non-communicable diseases.
PVIt is known that the incidence of non-communicable diseases is increasing alarmingly among young patients. Meanwhile, the phenomenon of young people "sleeping during the day and working at night," and children spending all day glued to smartphones and computers with little physical activity... is becoming increasingly common. What advice can you give to the public regarding this worrying issue?
Doctor Le Tuan Anh:Due to advancements in science and technology, we now encounter many young people who "sleep during the day and work at night," disrupting their daily routines. This is accompanied by unhealthy eating habits, with an increase in fast food restaurants, sugary and fatty foods, and sugary and alcoholic beverages. The rates of obesity and nearsightedness among young people are also raising alarming concerns. This explains the surge and younger age of onset of non-communicable diseases.
Equally concerning is the increasing trend and younger age of children using e-cigarettes and heated tobacco products. Tobacco, e-cigarettes, and new addictive substances have been gradually infiltrating the school environment at all levels, from middle school to high school. The rate of e-cigarette use among students aged 13-17 increased from 2.6% in 2019 to 8.1% in 2023. In the 13-15 age group, the rate more than doubled from 3.5% in 2022 to 8% in 2023.
The aforementioned risk factors will lead to a range of non-communicable diseases in children, from overweight and obesity, diabetes, hypertension, depression and mental disorders, cardiovascular diseases, metabolic disorders, eye diseases, musculoskeletal disorders... to diseases causing impaired lung function due to obstruction, acute lung injury, respiratory disorders, chronic cough, chronic bronchitis; causing cardiovascular damage, increasing the risk of atherosclerosis, thrombosis, atherosclerosis, myocardial infarction, coronary artery disease, hypertension and a history of stroke; causing DNA damage, increasing the risk of cancer; causing oral diseases and digestive diseases.
To prevent and control the development of non-communicable diseases, it is clear that we need to eliminate risk factors. This includes quitting smoking; increasing physical activity and actively participating in sports; limiting alcohol consumption; and maintaining a healthy diet. Regarding diet, it's necessary to limit salt intake, processed foods, fried foods, and sugary drinks; and increase consumption of green vegetables and fresh fruits. A healthy diet will help protect health and reduce the risk of non-communicable diseases.
Preventing non-communicable diseases in children requires creating healthy and engaging play environments, paying attention to nutrition, and ensuring appropriate dietary intake. Families need to find solutions to adjust children's lifestyles, behaviors, and daily activities; in particular, good cooperation is needed to prevent the rate of children using e-cigarettes and heated tobacco products.
PVThank you, sir!
