The World Health Organization (WHO) and the United Nations Development Programme (UNDP) conducted an initial data collection mission in Cambodia to develop an investment case on noncommunicable diseases (NCDs). The study seeks to quantify the social and economic costs of NCDs on the country’s economy and to identify the most cost-effective interventions at the national level.
Cambodia has experienced sustained economic development in the last decades. At the same time, Cambodia is undergoing an epidemiological transition, and NCDs may soon threaten the country’s health and social development progress if needed protective actions are not taken immediately.
Cardio-vascular diseases, diabetes, cancers and chronic lung diseases account for more than 60 percent of total deaths in Cambodia. One in four people died prematurely with NCDs as the leading cause.
Common risk factors
These four major NCDs share common risk factors: unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. About 2 million Cambodians use tobacco with 42.5% of adult males smoking cigarettes and two in three (6.52 million) adults in Cambodia were exposed to second-hand smoke at home. Alarmingly, almost half of children live in homes with people who smoke in their presence.
With almost 90% of people using solid fuels while cooking, indoor air pollution is one of the major contributing factors for chronic respiratory diseases, lung cancer (among women), as well as deaths from respiratory infections (among children). Five in ten Cambodians do not eat enough fruits and vegetables and consume high amounts of trans fats, added sugar and salt in diets.
Drunk-driving is the main cause of death on the roads. In 2016, 13 percent of total number of road traffic deaths was attributed to alcohol consumption. It is determined that inefficient enforcement of laws related to drunk-driving has led to a 2.1 percent drop in Gross Domestic Product (GDP).
“NCDs in Cambodia cannot be tackled by the health sector alone. Effective policies and interventions to tackle NCDs and their causes and determinants depend on many other sectors,” said Dr Liu Yunguo, WHO Representative in Cambodia. “The National Multisectoral Action Plan on NCDs 2018-2027 that was launched during the Task Force mission became an important step in scaling up national NCDs response. In particular, it outlined actions for twenty-two line ministries,” he added.
The National Multisectoral Action Plan on NCDs 2018-2027
The implementation of the NCD Action Plan will be facilitated by the national NCD Task Force, involving all relevant ministries and non-state actors. Promoting a multisectoral response to NCDs, the Mission met with representatives from the Ministries of Health, the Ministry of Economy and Finance, the Ministry of Industry, the Ministry of Public Work and Transportation, the Ministry of Labour, the Ministry of Education, Youth and Sports, and the Ministry of Environment and others. The Mission also met with the UN Resident Coordinator and the UN Country Team, as well as development partners and civil society representatives.
“NCDs strain health systems and divert scarce resources away from other health and development priorities. They hold back national and local economies in countries poor and rich alike,” said Nick Beresford, UNDP representative in Cambodia. “A whole-of government approach is essential because social and economic backgrounds of people shape the patterns of diseases. NCDs worsen poverty, inequality and disability, particularly among the most vulnerable. These approaches reflect the interconnected nature of the social, economic and environmental dimensions of sustainable development that lie at the heart of the 2030 Agenda for Sustainable Development.”
“Cambodia has shown a strong commitment to protect the population from NCD risk factors, in recent years approving comprehensive tobacco legislation that raises the taxes for tobacco products, bans smoking in most public places, restricts tobacco advertising, promotion and sponsorship, and introduces pictorial health warnings on cigarette packs,” said Dudley Tarlton, UNDP Programme Specialist.“ The NCD investment case will provide the evidence and incentives to expand this approach to other health harming products, such as alcohol, sweetened beverages and foods rich in salt, sugar and unhealthy fats.”
The Mission was informed that enforcement challenges still persist in many areas, and there are several key evidence-based NCD prevention measures that could be implemented across all sectors of the Government. When every ministry plays a greater role in NCD prevention, each one of them can benefit from the increased productivity and economic gains a healthier population.
The UN Task Force will analyse the data collected to develop the NCD investment case with the aim of providing the Royal Government of Cambodia with the final report by the end of the year. The investment case will describe how NCDs affect Cambodia’s economy through additional health care expenses, and due to premature deaths and decreased workforce productivity.
The final NCD investment case will also explain the benefits of investments in certain cost-effective NCD actions.
The Cambodia’s NCD investment case is being developed under the UNDP-WHO Joint Global Programme on NCD Governance, with the financial support of the Government of the Russian Federation.