Common Challenges for Tackling NCDs
The policy options framework provides a guide to strategic decisions. However, the country context and past experiences and traditions are major factors that must also be considered. In South Asia, four main areas of common challenges are as follows:
* There are low levels of awareness and lack of urgency. Many governments seem to have poorly understood the overall disease burden until recently, and even today they can often access only cursory information. Burden assessments are both challenging and resource intensive.
* Challenges remain with gaining buy-in and commitment from multisectoral stakeholders—
especially those which do not have a tradition of working together.
* Some governments—as well as providers, patients, and the general population—may consider
NCDs part of the normal aging process and may assume that they can do nothing. Because of
NCDs’ insidious nature at onset with minimal or no symptoms, they do not call attention to
themselves and even rather advanced stages may not be appreciated by those affected or
diagnosed until a catastrophic event occurs (e.g., heart attack, stroke, or kidney failure).
* Some leaderships are concerned that NCD efforts may divert resources from unfinished MCH
and infectious disease and nutrition issues.
* Few new resources are available and other issues such as climate change, which is an emerging
issue for the entire region, are competing for limited funds.
* While some health policies may be justified in discouraging behaviors such as smoking where
inadequate of inaccurate information is prevalent, for other behaviors, a government role in
“dictating” a lifestyle to constituents needs more careful consideration as to its ramifications
surrounding personal informed choice.
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