The pandemic has disrupted the health services for the people living with non-communicable diseases (NCDs) across the world despite the fact that they are more vulnerable to develop severe forms of Covid-19 than any other.
“Management of NCDs requires repeated interactions with the health system over long periods of time. This includes- requiring access to essential medicines as well as rehabilitation services. Not receiving this care can have devastating consequences for people living with NCDs and with the rapid spread of Covid19, the ability of countries to address NCDs has been severely impacted,” Monika Arora, President elect NCD Alliance, said in a recent webinar.
She stressed on developing a “people centred” healthcare during and beyond the pandemic to address the challenge.
In Bangladesh, NCDs such as heart diseases, stroke, cancer, diabetes and chronic lung diseases account for 67 of total deaths. The rate is increasing with the demographic transition towards ageing population.
But according to the Bangladesh Health Watch report, the country’s health system is not prepared to tackle the challenges of NCDs.
“We must act now,” Prof Sohel Reza Choudhury, Head of the Department of Epidemiology & Research of the National Heart Foundation Hospital and Research Institute, told Bangladesh Post.
“We must prioritise their healthcare like Covid-19. It is now evident that patients with COVID-19 who have co-morbidities, such as hypertension or diabetes, are more likely to develop a more severe form of the disease.”
But the lockdown and disruption of health services are particularly problematic for them.
Eminence, an NGO that works with public health issues in Bangladesh, said every health guideline and policy should prioritise NCDs and its related management aiming COVID-19 and the future pandemic.
“There should be special treatment arrangements for the people living with NCDs. The capacity and competencies of the health system should be strengthened for the early detection, resource allocation, and management of NCDs and their risk factors. NCDs healthcare services should be affordable for the lower-income and poor people. The prices of medicine and expenses of treatment should be vulnerable people friendly,” it said in a policy brief.
“There should be specific arrangements such as open places to walk or do exercise, affordable medicines, and testing facilities for us who have diabetes,” a 75-year-old diabetic patient Md Nurul Amin told Bangladesh Post.
Prof Sohel Reza Choudhury also said that the drugs for NCDs are not affordable for all.
“So people tend to miss the drug when they feel better. And sometimes they think that my diabetes is now under control so I don’t need to take any medicine. But they forget it’s because of the medicine his/her diabetes is under control,” he said.
“Same goes to high blood pressure. Many people don’t know they suffer from high blood pressure. Many of them who know their high blood pressure do not take drugs regularly. There is a huge gap in both detection and treatment.”
“But those are low hanging risk factors to check stroke and heart attacks which are the leading causes of premature deaths in Bangladesh.
“If we take proper steps, we can control high blood pressure and diabetes. And for that we need to give those drugs free to people,” he said, adding that COVID has shaken up the health sector.
“Acute heart attacks do not get adequate care because health facilities are overwhelmed with COVID patients. Even transports are occupied by COVID patients. In lockdown people cannot go out to follow up their treatment. In our hospital (Heart Foundation), we have also observed that. Emergency patients come at the terminal stage when it’s too late.
“We should ensure treatment facilities for the patients with NCDs. If we involve all facilities for COVID treatment, then non-COVID mortality and morbidity will go up. Tertiary health care facilities should have prepared for NCDs. If patients don’t get service, then they will die,” he said.
“Lack of early diagnosis also leads to cancer problems. We will face the problem later due to lack of early diagnosis. It’s a worldwide problem because people don’t go for cancer screening,” he said.
There is a growing recognition among the NCD community that to achieve better health outcomes, there is a need to revise prevention and health delivery models for NCDs and to ensure they are driven by the needs of the affected population, Monika Arora of NCD Alliance said.
“Decision making processes at all levels must include voices of communities and people most affected.”