Amsterdam – A shift has occurred in the MENA region over the past 30 years, seeing chronic diseases take more lives than their infectious counterparts.
This same shift is taking place in developing areas across the world where the rate of death by infectious diseases has begun to decrease, thanks to improved hygiene, sanitation, and mass vaccination.
However, non-communicable diseases (NCD) such as diabetes and cardiovascular diseases remain largely incurable. The global death rate from NCDs is 539 per 100,000 people, and in the MENA-region, this figure rises to 654 per 100,000.
WHO statistics report that 46% of total NCD mortality in the Saudi Arabia, Lebanon, and Egypt is due to cardiovascular diseases. Lower rates are observed in Djibouti (14%) and Somalia (5%). Mortality due to cardiovascular disease in the region is expected to increase dramatically over the next decade.
The associated risk factors for many of these types of diseases are tobacco consumption, physical inactivity, depression, being overweight, diabetes and hypertension. Regionally, tobacco consumption is measured to be the highest in Syria and lowest in Oman. The prevalence of smoking overall is almost 6 times higher for men than women. The increasing popularity of water pipes is increasing throughout the region, often replacing cigarettes.
The highest level of insufficient physical activity is observed in Saudi Arabia and the lowest can be found in Jordan. According to the Saudi Health Information survey, 75% of women and 46% of men engage in little to no physical activity.
The total prevalence of obesity is highest in Qatar (42,3%) followed by United Arab Emirates (37.2%), Bahrain (35.1%), and Saudi Arabia, (34.7%). Hypertension was observed at its highest rate in Somalia (26.4%), Morocco (25.3%), and Djibouti (24.4%).
In spite of the massive risk NCDs pose, public knowledge and awareness of cardiovascular disease symptoms appears to be very low, which leads to poor control of risk factors.
Therefore, upstream approaches (or “primary prevention”) are necessary from the government to battle this epidemic through education, mosques, television commercials and public health events.
At present, a higher priority is given by governments for treatment, helping to mitigate risk factors, reduce mortality, lower the risk of cardiac events, and improve quality of life, but this can often be more costly and less effective than primary prevention measures.
The government can more productively reduce risk factors by working on multiple intervention levels – working to prevent these risk factors before they emerge and working to treat them once they do.
Public programs can be implemented to increase awareness regarding physical activity and healthy diets, and restrictions on processed foods can reduce salt and fat contents.
Furthermore, some policy measures that have found success elsewhere include banning advertisements on alcohol and tobacco products, increasing taxes on tobacco, banning indoor smoking in public areas, and providing health information related to alcohol, and tobacco consumption.
The Eastern Mediterranean Regional office of the World Health Organization (EMRO) has set up a strategy plan for 2012 to 2021 with an increased focus on NCDs. EMRO will support national governments in developing guidelines for the management of NCDs, especially among refugee populations.