A transition to NCDs

Amid concerted efforts by the government through legislative regulations and large-scale investments to create a healthier population, non-communicable diseases (NCDs) continue to be a major concern in the Sultanate.
About 68 per cent of the deaths in Oman are reported to be caused by NCDs while 18 per cent of them occur amongst people between the ages of 30 and 70 years. This means that nearly one in every five adult dies from NCDs before they should.
A total of 75 per cent of hypertensive patients and 52 per cent of diabetics do not even know they have the disease. Of these, only 67 per cent and 64 per cent, respectively, are controlled.
“Oman witnessed an epidemiological transition to non-communicable diseases possibly because of a number of factors, including lifestyle changes together with demographic changes evident from ageing of the population,” the Ministry of Health said in its annual report for 2015.
The prevalence of diabetes has continued to increase over the past two decades. Due to this alarming trend, diabetes is currently considered a priority health problem by the Ministry of Health (MoH).
According to the World Life Expectancy website, coronary heart disease tops the list among the 20 major causes of deaths in Oman, followed by hypertension, diabetes and stroke.
World Health Organisation (WHO) data shows that 38 million people worldwide die from NCDs each year, with 28 million of those deaths occurring among people living in low- and middle-income countries.
“NCDs — including but not limited to cancer, cardiovascular disease, diabetes, chronic lung diseases, mental and neurological disorders, and injuries — present a rapidly expanding worldwide public health and development crisis,” says the global agency.
Dr Douglas Bettcher, director of WHO for the prevention of NCDs, says the world is not on track to meet the target set by the sustainable development goals of a one-third reduction in premature NCD deaths by 2030.
“We need to urgently accelerate progress in the battle to beat NCDs,” adds Dr Bettcher.
Experts stress that urgent steps are needed for coordinated action between health and other relevant sectors to reduce the prevalence of NCDs in the Sultanate.
Osama Makkawi, Unicef Representative in Oman, said, “Tackling non-communicable diseases is critical as it will support the children of Oman in reaching their full potential and living in a disease-free environment.”
According to Dr Said al Lamki, Director-General of Primary Health Care, the social and economic transformation enjoyed by the Sultanate and the changing lifestyle and lack of physical activity has contributed significantly to the rise in cardiovascular diseases.
The Sultanate is one of the several countries selected by WHO to receive integrated support for rapid progress in achieving nine global targets for prevention and control of NCDs, including a 25 per cent reduction in NCD deaths by 2025 and realising objectives in relation to NCDs in an agenda for sustainable development 2030.
Last year, the United Nations Interagency Task Force on the Prevention and Control of NCDs carried out a joint mission to Oman and reported that a large majority of Omani adults have insufficient intake of fruits and vegetables, that 40 per cent are physically inactive and one in seven Omani men use tobacco.
More than 50 per cent of the population is overweight, more than 40 per cent of adult Omanis have hypertension and 12 per cent have been diagnosed with diabetes.
At the same time, the global organisation has lauded the efforts made by the Sultanate to combat NCDs such as heart and lung disease, cancer and diabetes.
The WHO said that since 2015, the Sultanate has succeeded in achieving a 10 per cent reduction in the salt content of bread in the main bakeries. In 2016, this initiative has set a more ambitious goal of reducing salt content by 20 per cent in bread and expanded its focus to cheese as well.
The Ministry of Health hopes to create a national monitoring system to follow the progress of health indicators like urine sodium content and blood sugar levels. Researchers found that while Oman has several health regulations, the policies are not always implemented well.
Regulations have been passed to prevent tobacco use in outdoor public spaces. In this regard regional agencies are also involved in Oman’s response.
The Nizwa Health Lifestyle Project was founded in 1999 to work with the city government and local businesses to reduce the number cases relating to NCDs.
Nizwa successfully implemented an indoor smoking ban in 2010 and is hoping to expand this success to outdoor areas. Residents of Nizwa supported a tobacco ban nearly unanimously in a survey.
Local restaurants and bakeries are preparing healthier food and breads to prevent NCDs in Oman. The recent Healthy Restaurants Initiative is a pilot programme in which restaurants create menus with reduced sodium, fat and sugar.
The initiative has been successful so far, but will need time to scale up and expand through the country.

SAMUEl KUTTY