FATALITIES from non-communicable diseases, particularly cardiovascular diseases, are alarmingly high. The National Health Bulletin 2018 says that the main cause of morbidity in district and medical hospitals was cardiovascular diseases. In medical college hospitals, 54.24 per cent of death is caused by heart diseases. The scenario is similar in upazila hospitals. Of the cardiovascular patients, 22 per cent are worryingly young. The government and the World Health Organisation recorded a sharp increase in the annual heart disease mortality rate from 17 per cent in 2014 to 30 per cent in 2018. Epidemiologists at the National Heart Foundations note tobacco use, high level of sodium intake, stressful socio-economic condition and the availability of high-sucrose drinks as major reasons that have caused cardiovascular diseases in a large majority of the population. The lack of health infrastructure in rural and urban areas is also a major cause of fatality. Government interventions in this regard still remain in assessment stages. It has not been as prompt as it needed to be to stop the epidemic turn in heart diseases.

The public health infrastructure is generally not designed to address non-communicable diseases. Primary healthcare facilities available in upazilas are largely geared towards providing care for communicable diseases, immunisation and family planning services where cardiac diseases require specialised treatment by trained physicians with technologically complex medical facilities. Rural areas are deprived of these facilities. High fatality rates are, therefore, recorded in district and upazila hospitals. Even in major public hospitals, patients often struggle to get the required services as medical technology is ill maintained. In this column, we have earlier written about the dire state of intensive care units and high-tech machines in major hospitals. While it is important to ensure proper treatment, more important it is to prevent non-communicable diseases. In terms of developing prevention strategies for non-communicable diseases, Bangladesh lags far behind. A comprehensive strategy needs to be immediately put in place that would dissuade smoking through health tax, discourage unhealthy drink and packaged food items from entering market through effective food safety measures and market regulation. In urban areas, the promotion of bicycle could push people into physical activities and reduce air pollution that also bears significance in the prevention of non-communicable diseases.

The government, under the circumstances, must immediately review its primary healthcare facilities in rural areas to ensure that cardiac patients are not left unattended. It must also develop a non-communicable disease prevention strategy that is not limited to social awareness programmes, but is meant to address the root causes of such diseases by way of policy intervention in food safety and the promotion of bicycles as healthy and sustainable transport. The socio-economic cost of further delay in prevention of non-communicable diseases may, otherwise, prove to be too high.