Jigmi Wangdi

Heart disease and stroke, cancer, diabetes, and chronic lung conditions are the four major non-communicable diseases (NCDs) in the country today.

The urgency surrounding NCDs has escalated following the release of the fifth National Health Survey (NHS) Report 2023, which highlights a troubling rise in risk factors associated with NCDs – tobacco use, physical inactivity, poor dietary habits, and alcohol consumption.

The 2019 STEPS survey reported that 23.9 percent of respondents used tobacco. This figure has risen sharply to 29.8 percent according to the NHS 2023, a significant increase of 24.6 percent. The prevalence of physical inactivity has also surged, from 7.3 percent in 2019 to 18.3 percent in 2023—a dramatic rise of approximately 150.68 percent.

The NHS report also revealed an uptick in high blood pressure, climbing from 28 percent in 2019 to 30.3 percent in 2023, and high cholesterol levels, which have risen from 11 percent to 20.9 percent over the same period.

On a positive side, alcohol consumption has decreased from 42.9 percent in 2019 to 34.5 percent in 2023.

The increasing prevalence of NCDs has led to a substantial rise in the number of referral cases abroad, as local facilities are not equipped to treat these complex conditions.

The cost of referrals has skyrocketed from Nu 206.7 million in 2021-22 to Nu 529.95 million from 2023 to April 2024, marking a 154.3 percent increase over the period. The total expenditure on referrals has reached a whopping Nu 1.2 billion since 2021.

Health officials said that the surge in referral cases predominantly comprises diseases linked to NCDs, many of which are preventable, alongside victims of severe accidents.

Sharing his concerns about the high prevalence of NCDs in the country, Health Secretary Pemba Wangchuk warned that if NCDs are not dealt with swiftly, there is a high chance that every Bhutanese could have an NCD in the next five years. 

To address this escalating public health issue, the health ministry is working on a comprehensive multi-sectoral action plan to combat NCDs.

“This initiative is a top priority,” a health official said. “We are incorporating NHS data into our strategy, which will be later rolled out throughout the country.”

Once finalised, the strategy document will be disseminated to local government leaders in the dzongkhags.

The multi-sectoral action plan will be implemented in the next five years.

Funds for the initiative have already been secured. “The main focus is to create and coordinate awareness programmes to ensure community engagement at the grassroots level,” the health official said.

The health official said that screenings for hypertension and diabetes, among others, are being carried out as part of the clinical approach.

“Once the action plan is implemented, we will ensure that the awareness programmes and screenings are monitored properly. We will coordinate with the focal person in the districts to ensure this happens,” the official said.