Health
C
o
nnect
Inside
• Best Buys in Noncommunicable Disease Prevent ion and Cont rol 2
• Noncommunicable diseases: t he Count ry Capacit y Survey 2017 3
• Commit ment t o act ions: Expanding basic NCD services at t he primary healt h care level 3
• Workplace
int ervent ions t o address noncommunicable
diseases 5
• NCD Focus: Depression 6
• Voices f rom t he Region 8
• Knowledge Cent re 10
• Announcement s 11
• News highlight s 12
Noncom m uni cabl e diseases (NCDs) are maj or cont r i but or s t o r i si ng mor bi di t y and mor t al i t y pat -t erns in -t he Sou-t h-East Asia Region and have emerged as a grave public healt h chal l enge. In 2015 al one, t he Regi on had 4. 4 million pre-mat ure deat hs due t o NCDs, whi ch was t he hi ghest among al l WHO Regions.
Ut most pr i or i t y needs t o be accor ded t o prevent t heir occurrence. To ef f ect ivel y addr ess NCDs, a popul at i on- w i de heal t h appr oach i s needed. Thi s appr oach shoul d include broader socioeconomic det erminant s of healt h, aided by prevent ion, and reaching individuals at risk and t hose already diseased and af f ect ed. This means t hat responsibilit ies f or ef f ect ive cont rol of NCDs are cert ainl y cross-sect oral, much beyond t he role of t he healt h sect or.
Owing t o t he gravit y of t he NCD pandemic, t here are myriads of innovat ions growing in
the ield of NCD prevention. These include
econom i c i nt er vent i ons, engagem ent of
communi t i es and bui l di ng communi t i es of pract ice, and ef f ort s t o improve a dependable level of NCD care at t he primary healt h care level. All t hese give us great assurance and immense hope t hat t he commit ment s made at t he 2011 UN High Level Polit ical Declarat ion on NCDs and t he moment um t o achieve t he 2025 NCD t arget s and 2030 SDG t arget s will be realized.
In addit ion t o NCDs, ot her areas such as environment al healt h, road saf et y, violence and inj uries, and ment al healt h need urgent at t ent ion.
WHO will play it s part t o promot e learning and shar e exper i ences and best pr act i ces among Member St at es. We are int roducing an ENe w s on NCDs, “ He al t h Con n e c t ” , corresponding t o t he 2017 World Healt h Day,
the irst of its series. I hope that this periodic
release of Healt h Connect will become anot her means t o be inf ormed on t he NCD response
among Member States, WHO Country Ofices
and part ners t o creat e a posit ive change. I look f orward t o seeing int erest ing cont ribut ions
from the ield in every publication.
Dr Poonam Khet rapal Singh
Message from Dr Poonam Khetrapal Singh
WHO Regional Director for South-East Asia
Thi s new sl et t er i s an i nf or mat i on- shar i ng plat f orm f or Member St at es of t he WHO Sout h-East Asia Region. It highlight s lat est updat e in t he Region in t he area of noncommunicable diseases and it s risk f act ors; disabilit y, violence and inj ury prevent ion; ment al healt h; wat er, sani t at i on and heal t h; occupat i onal and environment al healt h; and healt h promot ion and educat ion.
We invit e cont ribut ions accompanying high resolut ion digit al phot ographs and web links. Please rest rict art icles t o 200-300 words. All art icles, t ransit ions and phot os are subj ect t o edit ing, available space, and accept ance pol i cy. Pl ease send your cont r i but i ons t o singhan@who. int
Editorial Board
Dr Thaksaphon Thamarangsi Dr Palit ha Mahipala Dr Gampo Dorj i
Ms Mart ha Lorena Bonilla Espinosa
Managing Editor: Ms Anika Singh
Design:
Mr Subhankar Bhowmik
Noncommunicable diseases are one of t he maj or public healt h and development challenges of t he 21st cent ury in forms of
bot h human suffering t hat t hey cause and t he harm t hey
inlict on the socioeconomic fabric of countries particularly
in low- and middle-income count ries (LMICs) in t erms of product ivit y loss and demand on healt h syst ems. As such, in view of formulat ing feasible solut ions, t he global economic impact analysis was done by t he World Economic Forum and Harvard School of Public Healt h, and WHO has used economic dat a t o come up wit h most cost-effect ive int ervent ions t o scale up int ervent ion packages at t he count ry level.
Economic Impact of NCDs
Alt hough t he econom-i c consequences ar e st aggering by cont rast,
indings from WHO in -dicat e t hat t he price t ag f or scale-up imple-ment at ion f or core set of NCD i nt er vent i on st rat egies are compar-at ively low. WHO int roduced t hese int ervent ion packages known as ‘ Best buys’. A best buy is an int ervent ion t hat is highly cost ef f ect ive but also cheap, f easible and cult ur-ally accept able t o implement and provide ext ra years of healt hy lif e avert ing one DALY f or less t han t he average annual income per person.
WHO Choice Method
Best buys are being produced using a st andardized met hod t hat is a generalized cost -ef f ect ive analysis known as WHO Choice Met hod.
Cost for Best Buys
The WHO choice t eam analyses t he menu of policy opt ions available and proposes t he most cost -effect ive int ervent ion for Member St at es t o use or scale up. The size of t he healt h
gain is measured using an epidemiol ogical model t hat includes all of t he healt h out comes likely t o be impact ed by t he int ervent ion using t he t wo scenarios – one in which int ervent ion is implement ed and t he ot her not implement ed. The dif f erence in disabilit y-adj ust ed lif e years (DALYs) bet ween t hose t wo scenarios represent s t he healt h gain. The expect ed size of populat ion healt h impact f or t he int ervent ion is calculat ed based on t ot al DALYs avert ed in t he st andardized populat ion of 10m.
Som e of t h e m ost c ost - e f f e c t i ve h i gh i m p ac t int ervent ions (best buys) are ment ioned below:
Risk Factors/
Disease Intervention
1. Tobacco • Tax policy t o reduce demand
• Comprehensive ban of t obacco advert ising, promot ion, sponsorship
• Plain/ st andard packaging
• Eliminat ion of secondhand smoke in public places
2. Alcohol • Increase t ax
• Ban advert ising
• Reduce availabilit y by reducing densit y of ret ail out let s
3. Diet (salt reduct ion)
• Volunt ary ref ormulat ion process wit h indust ry
• Support ive environment in public inst it ut ions – schools, hospit als
• Behaviour change communicat ion
• Front of pack labels 4. Speciic
int erven-t ions
• Counselling and drug t herapy f or
CVDs risk ≥ 30s ≥ 20 • HPV 2 doses 9–13 years
• Cervical cancer screening > 30–49 years
Dr Palitha Mahipala Coordinat or, Noncommunicable Diseases and Environment al Healt h
WHO Regional Ofice for South-East Asia
Best Buys in Noncommunicable Disease
Prevention and Control
NCDs kill 38 million people each year
75% of t hese deat hs (28 m) occur in LMICs
16 m NCD deat hs occur bef ore age 70 years
CVD account s f or 17. 5 m deat hs annually
Cancer account s f or 8. 2 m deat hs annually
Respirat ory diseases account f or 4 m deat hs annually
Diabet es account s f or 1. 5 m deat hs annually
These 4 groups account s f or 82% of all NCD deat hs
Tobacco use, physical inact ivit y, harmf ul use of alcohol, and unhealt hy diet s increase t he risk of dying f rom NCDs
Cumulat ive economic loss in LMICs f rom 2011–2025 - US$ 7 t rillion
LMICs per person US$ 25/ year
MICs per person – US$ 50/ year
UMIC per person – US$ 139/ year
Populat ion-based measures t o reduce t obacco, harmf ul use of alcohol
LMIC – US$ 2 billion/ year US$ 0. 4/ per person
Cancer prevent ion,
counselling and drug t herapy f or CVPs and cancer – US$ 11. 4 billion
To respond t o t he growing burden of noncommunicable diseases (NCDs), WHO conduct s periodic assessment of nat ional capacit y f or NCD prevent ion and cont rol t hrough t he use of a global survey known as t he NCD
Count ry Capacit y Survey (NCD CCS).
The irst NCD CCSs were carried out
in 2000, 2005, 2010, 2013 and 2015. Since 2013, WHO planned t o conduct t he survey every 2 years. The 2017 survey is current ly open, and al l Member St at es ar e i n t he process of complet ing t he dat a collect ion.
The sur vey i s expect ed t o gener at e d e t ai l e d i n f o r m at i o n f r o m c o u n t r i e s on t hei r cur r ent capaci t i es t o addr ess n o n c o m m u n i c a b l e d i se a se s, a sse ss inf rast ruct ure and governance, policy act ion, surveillance and healt h syst ems response, as well as ident if y areas t hat require f ut ure pr i or i t i zat i on and st r engt heni ng i n NCD int ervent ions.
The survey result s will be used t o monit or progress in nat ional ef f ort s t o implement NCD prevent ion and cont rol
act ivit ies as well as monit or implement at ion of t ime-bound commit ment s made by Heads of st at e and government s in t he 2011 Polit ical Declarat ion of t he High-Level Meet ing of t he General Assembly on prevent ion and cont rol of NCDs. This survey also provides dat a t o prepare t he report t o t he Unit ed Nat ions Secret ary-General , in advance of t he next UN High level meet ing on NCDs t hat will be held in 2018.
At t he count ry l evel , t he survey wil l be most usef ul t o moni t or t he Count r y NCD capacit y progress, and t he result s will help ident if y t he areas t hat need f urt her st rengt hening and f ocus in t he coming years.
For i nf or mat i on on t he NCD Count r y Capacit y Survey 2015, visit : ht t p: / / www. who. int / chp/ ncd_capacit y/ en/
Dr Kumari Vinodhani Navaratne
Medical Oficer, Noncommunicable Diseases
Policy and Governance
WHO Regional Ofice for South-East Asia
Noncommunicable diseases: the Country Capacity
Survey 2017
Commitment to actions: Expanding basic NCD services at
the primary health care level
Car e f or noncom m uni cabl e di seases ( NCD) r equi r es com p r ehensi ve and cont i nuous ser vi ces; cover i ng promot ion, prevent ion, t reat ment , rehabilit at ion and long-t erm care. Along-t long-t he 69long-t h Session of long-t he Regional Commilong-t long-t ee f or Sout h-East Asia Session held in Sept ember 2016, Healt h Minist ers adopt ed t he Col ombo Decl arat ion t o be t he f ramework in st rengt hening f ront line services t o address NCDs. Since t he declarat ion, count ries are moving f orward t o implement t he commit ment s. Early 2017, Nepal has allocat ed addit ional resources t o implement package of NCD services in 10 among 75 dist rict s in t he count ry wit hin t he year. Timor-Lest e has planned t o init iat e Package of Essent ial Noncommunicable (PEN) Disease int ervent ions among 2 of t he 13 dist rict s in t he count ry. In Myanmar, t he government has mobilized f unds t o expand NCD services in 80 of 330 t ownships in t he count ry. Maldives has adapt ed t he WHO PEN prot ocols in February 2017 in preparat ion t o st rengt hen NCD services at primary healt h care f acilit ies.
Primary healt h care workers demonst rat ing PEN services in Myaungt agar rural healt h cent re in Myanmar, January 2017
Del i ver y of NCD ser vi ces r eq ui r es ef f ect ive int egrat ion of NCD programmes w i t h i n t h e h e a l t h sy st e m s t h r o u gh innovat ive means. Member St at es have also t aken numerous policy and programmat ic i ni t i at i ves t o i ncl ude ear l y det ect i on of cardiovascular diseases, diabet es, chronic r espi r at or y di seases and cancer s wi t hi n t heir essent ial heal t h services. Going by t he current moment um, t here is cause f or opt imism t hat t he Region will be successf ul in achieving 25 by 25 NCD t arget s – a 25% relat ive reduct ion of premat ure NCD deat hs by 2025 and moving f urt her by one t hird t owards t he 2030 SDG deadline.
To download t he Colombo Declarat ion, please visit : ht t p: / / apps. who. int / iris/ bit
-st ream/ 10665/ 254819/ 1/ Colombo_Declarat ion. pdf
For ‘ Impl ement ing t ool s. Package of Essent ial Noncommunicable (PEN) disease int ervent ions f or primary heal t h care in l ow-r esour ce set t i ngs’ r ef er t o: ht t p: / / w w w. w ho. i nt / car di ovascul ar _di seases/ publicat ions/ pen2010/ en/
For t he Regi onal NCD Act i on Pl an, vi si t : ht t p: / / www. sear o. who. i nt / ent i t y/ noncommuni cabl e_di seases/ document s/ sea_ncd_89/ en/
Dr Gampo Dorj i NCD Management Noncommunicable Diseases Unit
WHO Regional Ofice for South-East Asia
Medical oficers and primary health care workers practising use of cardiovascular risk prediction chart during PEN training in Nepal, March 2017
WHO-SEARO has been organizing act ivit ies, mot ivat ional t alks t o promot e BTC component s among st af f including: t al k by Mr Mi l kha Si ngh, l egendar y Indi an at hl et e t o
inspire staff to stay active; talk on ofice syndrome,
st ress management ; display of healt h promot ion mat erials t hrough t he building; regular yoga and zumba classes f or st af f ; and acknowledging “ Be t he Change” champions every
month – staff who have made signiicant lifestyle changes
f or bet t er healt h.
Member St at es are welcome t o select and adapt t he ‘ Be t he Change’ package in t heir respect ive count ries, based
on their priorities and context. The WHO Regional Ofice
f or Sout h-East Asia is happy t o provide t echnical support t o raise awareness, design, implement and evaluat e of healt hy workplace programmes, which may cover healt hy diet , physical act ivit y, st ress management , screening and early t reat ment f or NCDs and risk f act ors, and ot her healt h pr omot i on act i vi t i es. For mor e i nf or mat i on, cont act : t hamarangsit @who. int
Initiatives by countries to promote physical
activities
• Healt h Minist ry of Thailand has made several ef f ort s t o promot e physical act ivit y among government st af f . Physi cal act i vi t y sessi ons ar e r egul ar l y conduct ed on Wednesdays and Fridays wit hin t he government premises. Promot ion of physical act ivit ies has now
been institutionalized in government ofices and in a
number of municipalit ies
• Minist ry of Work and Human Set t l ement , Gidakom Dist rict Hospit al, and t he Zilukha Nunnery in Bhut an have adopt ed physical act ivit y programmes at t he workplace
• WHO Represent at ive of Timor-Lest e is championing “ walk t he t alk” t o promot e physical act ivit ies and encouraging all st af f t o become role models f or healt h promot ion
Workplace interventions to address
noncommunicable diseases
Be the Change programme
Be the Change (BTC) was launched by WHO Regional Ofice
f or Sout h-East Asia (WHO-SEARO) during t he 2016 World Healt h Day. It is t he Regional Direct or’s special programme designed t o be a comprehensive package of NCD prevent ion int ervent ions at t he workplace t o promot e healt h, well-being and work product ivit y of st af f members. It has not
only beneitted staff at the Regional Ofice, but has been advocated to all WHO country ofices and at the
Sixty-nint h Session of t he Regional Commit t ee f or Sout h-East Asia and ot her WHO meet ings. The ‘ healt hy meet ings’ , in part icular, is an ef f ort t o demonst rat e some of t he BTC act ivit ies and encourage ot her organizat ions t o promot e healt hy workplaces t o prevent NCDs.
The BTC f ocuses on t he six WATCH component s: • WATCH your plat e: t o promot e healt hy eat ing • WATCH your weight and waist
• WATCH your st eps: t o promot e physical act ivit y • WATCH your st ress level
• WATCH your change: t o encour age r egul ar screening
• WATCH your t obacco and alcohol consumpt ion
Advocacy materials for World Health Day 2017
Posters
Factsheet
The “ Let ’ s t alk” post er series capt ures 5 scenarios: at home, at clinic, at school, at workplace, out doors
Brochure
Calendar
The 2017 Calendar- f eat uring winning ent ries f rom t he Regional MindART Compet it ion
Planner and Bookmarks
The 2017 planner and bookmarks has illust rat ions based
on afirmations to support people with depression to
overcome t he challenges and help build resilience and posit ive coping skills
Wall art
Wall art wit h “ Let ’ s t alk” message, inst alled at t he WHO
Regional Ofice for South-East
Asia’s caf et eria wall
NCD Focus: Depression
“Depression: Let’s talk” - theme for
World Health Day 2017
Depr essi on i s a com m on m ent al di sor der. Gl obal l y, 322 mil l ion peopl e of al l ages suf f er f rom depression. Depression is t he leading cause of disabilit y worldwide and a maj or cont ribut or t o t he overall global burden of disease. In t he WHO Sout h-East Asia Region, 86 million people suf f er f rom depression. The number of people living wit h depression has increased by more t han 18% bet ween 2005 and 2015.
In r ecogni t i on of “ depr essi on” as a publ i c heal t h priorit y area, t he t heme f or t he World Healt h Day 2017
i s ‘ Depr essi on: Let ’ s t al k’ . The t heme r ei t er at es t he
relevance and signiicance of mental health, i.e. the “No
Healt h Wit hout Ment al Healt h” concept . The overall goal of t he campaign is t hat more peopl e wit h depression, in al l count ries, seek and get hel p, and it f ocuses on simple measures such as encouraging people t o t alk about
depression as a irst step towards recovery.
Regional MindART Competition
As a run-up t o t he World Healt h Day, a Regional post er compet it ion ‘ MindArt ’ was organized f or yout h in t wo cat egories:
• Cat egory A (age 13–17 years) • Cat egory B (age 18–25 years)
The part icipant s designed post ers wit h messages on support st rat egies t o prevent / overcome depression and promot e posit ive ment al healt h.
The 13 winning art ent ries along wit h messages f rom young art ist s are f eat ured in WHO 2017 calendar.
Winners:
Anupriya Nandy, 15, India Best overall art work, Cat egory A
Nehal Vij ay, 15, India
Best concept design, Cat egory A
Hrudya Anna James, 21, India Best clarit y of message, Cat egory B
Kiran Kumari, 18, India
Best concept design, Cat egory B
Paulina Popy Kirana, 25, Indonesia
Best digit al art , Cat egory B
Siddhart ha Sinha, 14, India Best expression in art , Cat egory A
Fariza Tanvir, 14, Bangladesh Best support st rat egy t o prevent depression, Cat egory A
Abhishek Kumar Yadav, 17, India Best depict ion of t heme, Cat egory A
Meghna Bhuyan, 14, India Best creat ive design, Cat egory A
Diksha Kaul, 21, India Best support st rat egy t o overcome depression, Cat egory B
Didula Chennet h Weerarat hne, 15, Sri Lanka
Best support st rat egy t o
overcome depression, Cat egory A
Surj a Bdr Pradhan, 20, Bhut an Best art work, Cat egory B
Musanna Nabi Chowdhury, 21 Bangladesh
Best concept design, Cat egory B
Let’s talk song
Understanding depression video
Staff engagement activities
The song is f rom t he point of view of t his ‘ Depression’ charact er, in a monologue wit h t he individual. ‘ Depression’ t alks about how it is aware of t he kind of negat ive impact it has on t he individual, and st at es how it can t ransf orm int o goodness if only t he individual accept ed it and t alked it out , inst ead of running away f rom it .
The video shows how depression af f ect s people, in part icular young adult s, women af t er child birt h and t he elderly, and how t alking about it can help.
The lyrics reveal ‘ depressed’ as someone who has lost somet hing vit al: hope,
conidence, desire, willingness, energy; and how awareness of such aspects and talking about it can help in inding that vital thing which is lost.
In line wit h t he WHO SEARO’s campaign on “ underst anding depression t hrough dif f erent f orms of art ” , t his musical video raises awareness about ‘ depression’ using dif f erent art f orms: dance choreography, sand art , drawing, art in t herapy.
The musical video showcases WHO Regional Ofice for South-East Asia’s efforts to raise
awareness about ‘ depression’ using dif f erent art f orms: dance choreography, sand art , drawing, art in t herapy.
It also has byt es f rom st udent s f rom t he Regional MindART compet it ion, counsellor, school principal and f oot age f rom t he art t herapy workshop we did at t he old age home.
As a run-up t o t he World Healt h Day 2017 st af f engagement act ivit ies were organized in WHO Regional
Ofice for South-East Asia to promote positive mental
healt h.
Sri Lanka launches NCD Alliance
The Sout h-East Asia Region has a number of civil societ y organizat ions cont ribut ing t o t he healt h agenda. Sri Lanka
is one of the irst Member States to formalize a cohesive
civil societ y movement on NCD prevent ion and cont rol, t he NCD Alliance Lanka. The Alliance became ef f ect ive af t er it s launch on 4 Sept ember 2016 in Colombo, Sri Lanka, on t he Eve of t he Sixt y-nint h Regional Commit t ee Session.
Civil societ y organizat ions are key part ners in t he NCD response. In NCD prevent ion and cont rol, civil societ y has at least t hree maj or unique f unct ions. First , advocacy and galvanizing act ion at all levels t o st imulat e public and polit ical awareness and int erest in NCDs; second, ensuring account abilit y by t racking commit ment s by government s and ot her st akehol ders—incl uding t hose of t he privat e sect or; and t hird, in t he area of service delivery, civil societ y organizat ions can ext end and enhance NCD care t o supplement t hose provided by government s. What ever t he f unct ion, it is import ant t hat government , civil societ y and ot her st akeholders work in part nership t o synergize
the responses for maximum eficiency.
Training network for tobacco cessation to be
established in Bangladesh
WHO Regional Ofice for South-East Asia coordinated with WHO headquarters, WHO Country Ofice for Bangladesh,
All India Inst it ut e of Medical Services, New Delhi, and t he Nat ional Inst it ut e of Prevent ive and Social Medicine, Dhaka,
to support this irst-ever activity aimed at strengthening
t obacco cessat ion services in Bangladesh.
Bangladesh has high prevalence of t obacco use wit h 45% of adult men smoking and more t han 9 % of yout h using t obacco product s. The smokeless t obacco use prevalence among adult women is 28% while it is 26% among adult men. Nearly 70% of smokers and 50% of smokeless t obacco users are willing t o quit t obacco in t he count ry. However, limit ed support for t obacco cessat ion is available in a few nongovernment healt
h-care facilit ies. The Tobacco Free Init iat ive Unit support ed t he Bangladesh Government in capacit y-building of healt h care facilit ies in t obacco cessat ion. ‘ Training of Trainers (ToT)’ on Brief Tobacco Int ervent ion was held on 8–9 January 2017
in Dhaka. This training of the Master trainers is the irst
st ep t owards est ablishing a ‘ Training Net work for Tobacco Cessat ion’ in Bangladesh.
Taking forward the agenda on alternative
livelihoods for tobacco farmers and workers
Sout h-East Asia is a maj or t obacco growing Region, wit hIndia and Indonesia being among the ive largest growers of
t obacco in t he world. The WHO Framework Convent ion on Tobacco Cont rol Art icle 17 relat es t o providing economically viabl e al t ernat e l ivel ihood opt ions t o t obacco growing f armers and workers. This is t he least-implement ed FCTC
Article globally. The WHO Regional Ofice for South-East
Asia organized a Regional Int ercount ry Consult at ion on Alt ernat ive Livelihoods f or Tobacco Farmers and Workers t o t ake f orward t he commit ment of ef f ect ive implement at ion of Art icle 17 in SEAR Member St at es on 27-28 March, 2017 at Colombo, Sri Lanka. The workshop was inaugurat ed by Dr Raj it ha Senarat na, Hon’ ble Minist er of Healt h, Nut rit ion and Indigenous Medicine, Sri Lanka.
Dr Jagdish Kaur Regional Adviser, Tobacco Free Init iat ive (TFI) Unit
WHO Regional Ofice for South-East Asia
Water safety plans progress in
South-East Asia
Globally, 750 million people st ill lack access t o saf e drinking wat er,
posing signiicant health risks,
increased medical expenses and l oss of pr oduct i vi t y. The WHO
Regional Ofice for South-East Asia
in collaborat ion wit h Aust ralian Aid, is support ing Wat er Saf et y Planning (WSP) so t hat people in t he Region can access saf er wat er.
Voices from the Region
Int er-count ry consult at ion on alt ernat ive livelihoods f or t obacco f armers and workers
The aim is t o support Member St at es t o know t he wat er syst em t horoughly, and work out reliable, realist ic and responsible ways t o make sure t hat t he syst em works t o provide access t o saf er, cleaner wat er.
Int ensive support has been ext ended t o Bangladesh, Bhut an, Indonesia, Myanmar, Nepal, Sri Lanka and Timor-Lest e. This includes ident if ying t he main risks t o wat er qual it y, devel oping st andard operat ing procedures and moni t or i ng pl ans, and bet t er al l ocat i on of r esour ces. Furt her, operat ional support is provided t o India, Maldives and Thailand.
To t ake f orward t his agenda in Indonesia, a wat er saf et y planning audit will t ake place in June by a wat er qualit y expert f rom Yarra Valley Wat er in Melbourne. The audit is combined wit h t raining of local audit ors, wat er suppliers, and government st af f .
Ms Payden and Dr David Sutherland Wat er, Sanit at ion and Healt h Unit
WHO Regional Ofice for South-East Asia
Strengthening emergency and trauma care in
primary health care setting
Road trafic injuries kill approximately 316 000 people
annually in t he Sout h-East Asia Region account ing f or 25%
of the global total road trafic deaths, and up to 50% deaths
are of vulnerable road users including pedest rians, cyclist s and mot orcyclist s. The SDG-3 t arget aims t o halve t hese numbers by 2020.
The core of road saf et y and t rauma care programme in t he Region includes innovat ive approaches, part nerships across sect ors and opt imal use of resources. To buil d part nerships and t ake f orward t his work, t he WHO Regional
Ofice for South-East Asia in collaboration with WHO
Collaborat ing Cent re Khon Kaen Universit y, Thailand, and JPN Apex Trauma Cent re, New Delhi, India, organized a capacit y-building workshop on t rauma care f or six of t he SEAR count ries (Bangladesh, India, Indonesia, Myanmar,
Sr i Lanka and Thai l and) . The par t i ci pant s i ncl uded surgeons, nurses, policy-makers and senior administ rat ors. The aim of t he workshop was t o enhance collaborat ion bet ween t wo WHO collaborat ing cent res at t he level of capacit y-building, educat ion and research. As a f ollow-up t o t he workshop, ef f ort s cont inue t o improve pre-hospit al care, capacit y-building in emergency care at primary level f acilit ies, and st rat egies t o improve advocacy f or resource generat ion and healt h promot ion.
Dr Patanj ali Dev Nayar Regional Adviser, Disabilit y, Inj ury Prevent ion and Rehabilit at ion
WHO Regional Ofice for South-East Asia
Leaderships toward sustainable health
promotion and active lifestyles
Mu l t i se c t o r al c o o r d i n at i o n at l o c al go v e r n m e n t administ rat ion in Bhut an has been est abl ished as part of mainst reaming Heal t h in Al l policies and addressing broader det erminant s of healt h.
The Healt h Promot ion Division of t he Depart ment of Public Healt h had organized a nat ionwide consult at ive workshop t o priorit ize public healt h and social issues wit h local government s and ot her communit y members at t he
Dzongkhag (dist rict ) and Gewog (subdist rict )levels. The local leaders of 20 dist rict s deliberat ed on t he dist rict-speciic priorities and developed local level health promot ion act ion plan as a measure t o combat priorit y public healt h and social issues in t he respect ive dist rict s. The maj orit y of t he dist rict s priorit ized cont rol of alcohol use, physical act ivit y promot ion and healt hy diet s; wat er and sani t at i on, domest i c vi ol ence and gender -based violence, suicide prevent ion, and reproduct ive healt h. In t hese meet ings, a demonst rat ion of physical act ivit ies f or t he local leaders was also organized.
Dr Suvaj ee Good Programme Coordinat or Healt h Promot ion and Social Det erminant s of Healt h
WHO Regional Ofice for South-East Asia
Local leaders of Eastern Bhutan identify district-speciic priority
healt h promot ion act ivit ies.
Knowledge Centre
Mental health status of adolescents in
South-East Asia: Evidence for action
Ment al healt h problems in young people present not only a maj or public healt h challenge but also a development issue in low- and middle-income count ries and may be cent ral t o achieving dif f erent Sust ainable Development Goals. According t o WHO’s Global Healt h Est imat es 2015, suicide or self -harm is t he second most common cause of mort alit y – af t er road i nj ur i es – among peopl e aged 15–29 year s i n t he Sout h-East Asi a Regi on. An ur gent t ask in addressing adolescent ment al healt h is improving and expanding t he evidence base t o inf orm policies and programmes, generat e public awareness of ment al healt h issues and mobilize social support f or adolescent s.
To bring visibilit y t o t he problem of ment al healt h issues on t he eve of World Healt h Day wit h t he t heme of ‘ Depression” and campaign slogan of “ Depression: Let ’s
talk”, the Regional Ofice with active support from national
collaborat ors published a document , Ment al Heal t h St at us of Adol escent s in Sout h-East Asia: Evidence f or Act ion. The document cont ains inf ormat ion on ment al healt h and subst ance use among 13–17 year old st udent s collect ed as part of Global School Healt h Surveys in Member St at es. It
also includes individual country proiles as well as regional
indicat or sheet s providing a comparat ive snapshot across all count ries.
South-East Asia Journal for Public Health on
depression and suicide
In response t o t he Worl d Heal t h Day campai gn sl ogan “ Let ’ s t al k ” , ex p er t s f r om across t he Region were invit ed t o i n f or m an d e x p an d t h e di al ogue on depr essi on and suicide t hrough papers in t he WHO Sout h-East Asia Journal o f Pu b l i c He al t h i ssu e o n Depression and Suicide: t owards new paradigms in prevent ion
and care. This issue il l ust rat es how new paradigms of care and prevent ion f or depression and suicide are being adopt ed across t he Region. The j ournal can be accessed at ht t p: / / w w w. sear o. w ho. i nt / publ i cat i ons/ j our nal s/ seaj ph/ en/
Frequently Asked Questions about Stroke
In low- and middle-income count ries, which include t hose of t he WHO Sout h- East Asi a Region, over 11 million st rokes occur every year. This causes deat hs of more t han 4 million p eop l e annual l y and l eaves approximat ely 30% of survivors seriously disabled. For t he 70% of sur vi vor s who r ecover, t he likelihood of suf f ering addit ional st r okes i s gr eat l y i ncr eased: ‘ Recurrent ’ st roke account s f or about one in every f our episodes of t he lif e-t hreat ening condit ion.
FAQs on st r oke ar e a usef ul i nf or mat i on r esour ce on st r oke. To dow nl oad mat er i al s r el at ed t o st r oke, pl ease r ef er t o: ht t p: / / w w w. sear o. w ho. i nt / ent i t y/ noncom m uni cabl e_di seases/ advocacy/ w or l d- st r oke-day2016/ en/
Frequently Asked Questions about Diabetes
Over 90 m i l l i on adul t s have d i ab e t e s i n t h e Sou t h - East Asia Region. Half of t hose wit h diabet es remain undiagnosed. A large proport ion of diabet es cases ar e pr event abl e. Mai nt ai ni ng normal body weight , engaging in regular physical act ivit y and eat ing a healt hy diet can reduce t he risk of diabet es. Diabet es is also t reat able. Diabet es can be cont rolled and managed t o prevent complicat ions.18–19 April: Regional workshop on WASH SDG
baseline and target setting, Bangkok, Thailand
Wat er and sani t at i on has a dedi cat ed Sust ai nabl e Development Goal (SDG 6), which seeks t o achieve saf ely managed drinking wat er and saf ely managed sanit at ion by 2030. Target 6. 1 on wat er st at es t hat “ by 2030, achieve universal and equit abl e access t o saf e and af f ordabl e drinking wat er f or all” and t arget 6. 2 on sanit at ion st at es t hat “ by 2030, achieve access t o adequat e and equit able sanit at ion and hygiene f or all, and end open def ecat ion, paying special at t ent ion t o t he needs of women and girls and t hose in vulnerable sit uat ions” .The SDG wat er and sanit at ion goal and t arget s are st rict er t han t hose under t he MDGs, f ocusing more on wat er qualit y, saf ely managed sanit at ion and handwashing pr act i ces. These new el ement s i n SDG 6 r equi r e t he est ablishment of new baseline values and t arget s and new met hods t o monit or t hem.
At t he gl obal l evel , 11 WASH SDG i ndi cat or s ar e proposed f or global f ollow-up and review, and are not necessarily applicable t o all nat ional cont ext s. Indicat ors f or regional, nat ional and subnat ional levels of monit oring will be developed at t he regional and nat ional levels. WHO is cust odian agency along wit h a f ew ot her UN agencies f or monit oring indicat ors (f or saf ely t reat ed wast ewat er) and 6. a and 6. b (f or means of implement at ion).
The Regional workshop organized by WHO Regional
Ofice for South-East Asia will be an opportunity for
count ries t o discuss t he met hods f or est ablishing baseline values against monit oring t he SDG WASH t arget s. The new indicat ors are demanding in t erms of implement at ion and monit oring so it is essent ial t hat key minist ries involved f rom each count ry get t oget her wit h part ners f rom ot her count ries in t he Region and wit h JMP expert s t o discuss t he work done so f ar in preparing count ry baseline report s, consensus on t ar get s and most i mpor t ant l y, di scuss met hods of monit oring t he t arget s.
19–21 April: International Conference on
Autism and Neurodevelopmental Disorders
(ANDD2017), Thimpu, Bhutan
The conf er ence i s bei ng or gani zed by t he Mi ni st r y of Heal t h and Fami l y Wel f ar e, t he Gover nment of t he People’s Republic of Bangladesh, Minist ry of Healt h, Royal Government of Bhut an, and WHO Regional Ofice for South-East Asia. The obj ect ive of t he conf erence is t o provide a plat f orm f or policy-makers t o engage wit h st akeholders in sharing best pract ices and t o promot e cooperat ion and par t ner shi ps acr oss t he Regi on f or ef f ect i ve and sust ai nabl e pr ogr amme devel opment f or i ndi vi dual s, f amilies and communit ies living wit h aut ism and ot her neurodevelopment al disorders.
19–20 June: Second meeting of the Technical
Working Group on Health Literacy and Health
Promotion, Global Coordination Mechanism for
NCDs t o be held in Geneva t o discuss count ry act ions t o
implement and pilot healt h lit eracy in NCDs.Announcements
Inviting success stories on climate change for the Minister’s Roundtable at
the WHO Regional Committee (RC) for South-East Asia
The Sevent iet h Session of t he WHO Regional Commit t ee (RC) f or Sout h-East Asia is t o be held in Maldives f rom 6 t o 10 Sept ember 2017. It is expect ed t o be at t ended by Healt h Minist ers and represent at ives of all 11 Member St at es of t he Region, Unit ed Nat ions and ot her agencies, and nongovernment al organizat ions. Every year a t opic is select ed f or t he Roundt able, which is of maj or concern t o all count ries. This year, Member St at es
have select ed “ Building healt h syst em resilience t o climat e change” as t he t heme of t he Minist erial Roundt able. The purpose of t his session is f or Member St at es t o share various act ions t aken t o address climat e change and discuss f urt her medium- and longer-t erm
measures t o improve healt h syst em resilience t o climat e change.
To showcase success st ories at t he RC, we invit e Member St at es t o submit success st ories in t he areas of mit igat ion and adapt at ion st rat egies t o address adverse impact s of climat e change. For submission of st ories and more inf ormat ion, please cont act t he
New Mental Healthcare Bill 2016 passed in the
Parliament, India
On 27 March 2017, t he Parliament passed t he new Ment al Healt hcare Bill. The Ment al Healt hcare Bill aims t o provide f or t he right t o bet t er healt h care f or ment ally ill pat ient s and decriminalises suicide.
Also, t he Prime Minist er of India, Mr Narender Modi, t alked about depression, suicide and World Healt h Day in his ‘ Mann Ki Baat ’ address. Mann Ki Baat (t ranslat ed as “ Heart ’ s Voice” ) is an Indian radio programme host ed by Prime Minist er Narendra Modi in which he addresses t he people on radio and ot her news channels on mat t ers close t o his heart .
Saima Wazed Hossain: WHO Champion for
Autism in South-East Asia Region
Worl d Heal t h Organizat ion Sout h-East Asia Region has designat ed Ms Saima Wazed Hossain, a st rong advocat e
© World Health Organization 2017
Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence.
World Health House Indraprastha Estate Mahatma Gandhi Marg New Delhi-110002, India
News highlights
f or aut ism, as it s champion t o enhance commit ment and generat e awareness and act ion t o address t he suf f ering of children wit h aut ism spect rum disorder, as well as t heir parent s and caregivers.
“ Ms Hossain’s dedicat ed and unprecedent ed ef f ort s have put aut ism high on t he healt h agenda in her count ry Bangladesh, and helped get subst ant ial regional and global at t ent ion t o aut ism spect rum disorder and ot her ment al and neurodevelopment al disorders. Her support as Regional Champion is expect ed t o garner moment um f or awareness and act ion in member count ries, as much remains t o be done f or aut ism in across t he Region, ” Dr Poonam Khet rapal Singh said on t he occasion of World Aut ism Day observed on 2 April every year. For press release, please visit : ht t p: / / www.searo.who.int / mediacent re/ releases/ 2017/ 1645/ en/
Never give up on someone with a mental illness. When “I”
is replaced by “We”, illness becomes wellness.
