PUBLIC health policies are designed more for health services delivery, especially in the management of non-communicable diseases, than for health protection and prevention. Experts, therefore, at a workshop that research and advocacy organisation PROGGA held in Dhaka on May 9, said that a policy shift towards the prevention of non-communicable diseases, which account for a 70 per cent of death, could bring down the out-of-pocket health expenditure. The Non-communicable Disease Control Programme annual survey reports that one in four suffered from hypertension, one in 12 people suffered from diabetes and one in nine suffered from obesity in 2021鈥�22. The diseases, also known as chronic diseases, include cancer, kidney failures, diabetes and respiratory failures, among others, which are preventable in most cases, but the government鈥檚 efforts are minimal to none. Long-term campaigns are important ot inform people of the factors, including health and food habits, that increase risks of chronic diseases. Experts, therefore, urge the government to consider a health promotion authority that would focus exclusively on empowering individuals to enhance control over and improve their health.
Root causes of chronic diseases include people鈥檚 uninformed health behaviour, unregulated marketing of adulterated food and environmental pollution. In 2019, a National Institute of Preventive and Social Medicine survey showed that 90 per cent of people had not taken the required number of fruit and amount of vegetables while about 44 per cent used tobacco. Dietary salt intake has also been reported high. In this context, a health promotion authority can work towards creating an environment conducive to encouraging individuals to engage in healthy way of life while motivating them to reduce dietary salt and sugar intake and abstain from tobacco and alcohol consumption. An unregulated food market and unabated environmental pollution also contribute to the epidemiological shift to chronic disease. The proposed health promotion authority would coordinate with the environment department and food safety authorities. The burden of disease prevention, as public health activists suggest, must not be solely on individual citizens. Public agencies responsible for ensuring food safety and minimising the health impact of environmental pollution should also play their role. Public agencies need to improve their institutional attitude towards larger health safety issues, especially when the Directorate General of Health Services repeatedly says that the number of patients with asthma and respiratory diseases is increasing in urban areas because of poor air quality.
It is time that the government reckoned with the epidemiological transition and revisited its public health policies and strategies to strike a balance between the prevention and the treatment of disease. It must seriously consider setting up a health promotion authority dedicated to empowering individuals to enhance control over their health and to improve the performance of public agencies mandated to ensure food safety and contain environmental pollution.
