Multisectoral Action Plan for the Prevention and Control of Non Communicable Diseases (2014-2020)

There is no exact national policy related to Non-Communicable Diseases (NCDs), however, there is Multisectoral Action Plan for the Prevention and Control of Non-Communicable Diseases (2014-2020). 

In the year 2000, World Health Assembly resolution endorsed the global strategy for the prevention and control of NCDs, with a particular focus on developing countries. The global commitment to prevention and control of NCDs was further strengthened with the adoption of the Political Declaration at the High-level Meeting of the UN General Assembly (UNGA) on the Prevention and Control of NCDs by Head of the States in September 2011 in New York in which Nepal is a signatory.

Some documents relevant to the NCD prevention and control in Nepal include:

1. Global Strategy for the Prevention and Control of Non-Communicable Diseases (2000)
2. WHO Framework Convention on Tobacco Control (2003)
3. Global Strategy on Diet, Physical Activity and Health (2004)
4. Resolution WHA60.23 on Prevention and control of non-communicable diseases: implementation of the global strategy (2007)
5. 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Non communicable Diseases (2008)
6. Global Strategy to Reduce the Harmful Use of Alcohol in 2010 (WHA63.13).
7. Action Plan for the prevention and control of NCDs in South-east Asia, 2013-2020 (2013)

As a follow up of High-Level Political Declaration, the Government of Nepal had decided to deliver on its commitment through a multisectoral approach. The Multisectoral Action Plan was developed between July and December 2013 with the financial support from WHO and the Government of Russia which is titled as "Multisectoral Action Plan on the Prevention and Control of NCD in Nepal, 2014-2020".

Twelve thematic groups were formed namely:

1. Cardiovascular Diseases
2. Chronic Obstructive Lung Diseases
3. Cancer
4. Diabetes Mellitus
5. Oral Health
6. Mental Health
7. Road Traffic Injuries
8. Tobacco
9. Alcohol
10. Unhealthy Diet
11. Physical Exercise and Healthy Behavior
12. Air Pollution

Action Plan for Prevention and Control of NCDs for Nepal (2014-2020)

The vision, goal, objectives, and targets of the multisectoral plan are as follows:

Vision

All people of Nepal enjoy the highest attainable status of health, well-being, and quality of life at every age, free of preventable NCDs, avoidable disability, and premature death.

Goal
The goal of the multisectoral action plan is to reduce preventable morbidity, avoidable disability and premature mortality due to NCDs in Nepal.

Specific Objectives

1. To raise the priority accorded to the prevention and control of NCDs in the national agendas and policies according to internationally agreed development goals through strengthened international cooperation and advocacy
2. To strengthen national capacity, leadership, governance, multisectoral action, and partnership to accelerate country response for the prevention and control of NCDs
3. To reduce modifiable risk factors for NCDs and underlying social determinants through creation of health-promoting environments
4. To strengthen and orient health systems to address the prevention and control of NCDs and underlying social determinants through people centered primary health care and universal health coverage.
5. To promote and support national capacity for high quality research and development for the prevention and control of NCDs
6. To monitor the trends and determinants of NCDs and evaluate progress in their prevention and control

Targets

In line with the sentiments of South East Asia Regional NCD targets, Nepal also adopts the same 10 targets to be achieved by 2025.

1. 25% relative decrement in overall mortality from cardiovascular diseases, cancers, diabetes, or chronic respiratory diseases
2. 10% relative decrement in harmful use of alcohol
3. 30% relative decrement in the prevalence of current tobacco use in persons aged over 15 years
4. 50% relative decrement in the proportion of households using solid fuels as the primary source of cooking
5. 30% relative decrement in mean population intake of salt/sodium
6. 25% reduction in the prevalence of raised blood pressure
7. Halt the rise in obesity and diabetes
8. 10% relative decrement in the prevalence of insufficient physical activity
9. 50% of eligible people receive drug therapy and counseling (including glycemic control) to prevent heart attacks and strokes
10. 80% availability of affordable basic technologies and essential medicines, including generics, required to treat major NCDs in both public and private facilities

Eleven Strategic Policies (Further Description)

• High political commitment
• Multisectoral response
• Tobacco
• Alcohol
• Unhealthy diet
• Physical inactivity
• Indoor air pollution
• Essential NCDs (CVDs, COPDs, diabetes, and cancer)
• Oral health
• Mental health
• Surveillance, research, monitoring, and evaluation

The Nepal Multisectoral Action Plan also relies on the following overarching principles and approaches:

• Focus on equity
• Multisectoral actions and multi-stakeholder involvement
• Life-course approach
• Balance between population-based and individual approaches
• Empowerment of people and communities
• Health system strengthening
• Universal health coverage
• Evidence-based strategies
• Management of real, perceived or potential conflicts of interest

References:

GoN, WHO Nepal, Multisectoral Action Plan for the Prevention and Control of Non Communicable Diseases (2014-2020)