Brunei Darussalam tackles rise of non-communicable diseases

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The rising incidence of non-communicable diseases (NCDs) is placing an increasing burden on Brunei Darussalam’s health care system and economy, though the government is stepping up efforts to improve the nation’s health.

NCDs have been the main cause of death in Brunei Darussalam for more than 30 years, with a shift away from traditional lifestyles and dietary patterns seen as the underlying cause, according to the Ministry of Health (MoH).

If unchecked, the increasing incidence of NCDs could put a strain on the country’s health care system, as well as affect social and economic growth.

“Without a change in our behaviour, the number of obese adults in the country is forecast to soar. This will prove devastating for the country and pose a real barrier towards our national development,” the MoH said in a statement in June.

Rising to the challenge

In response, the government has launched the Brunei Darussalam National Multisectoral Action Plan for the Prevention and Control of NCDs (BruMAP-NCD) 2013-18­ – a broad programme to boost the prevention and treatment of NCDs ­– as part of the MoH’s Vision 2035, known as “Together Towards a Healthy Nation”.

The programmes aim to reduce premature mortality from NCDs by 18% by 2018, a goal that is in line with the global target of a 25% reduction by 2025.

Under the BruMAP-NCD’s five objectives ­– to reduce tobacco use, promote a balanced and healthy diet, increase physical activity, identify people at risk of NCDs and manage effectively, and improve the quality of care and outcome of NCDs management – health officials have laid out a number of more specific national targets.

For example, the government aims to curb tobacco consumption by 30% by 2018 and to make public places smoke-free by the end of this year.

In terms of diet, state agencies are targeting a 10% reduction in salt usage, encouraging more Bruneians to engage in regular exercise and mandating improved diets for children by regulating the products offered at school canteens, as well as implementing health programmes in the country’s workplaces.

Overall, these lifestyle changes aim to achieve a 1% reduction in the rate of increase of obesity and diabetes by 2018.

Meanwhile, measures to bolster treatment will include initiatives to identify people at risk of developing NCDs, provide support for the effective management of illnesses and ensure the availability of affordable technologies and generic medicines in both private and public health care facilities.

Risk of obesity

The need for such measures is crucial especially as the country is seeing an increase in obesity in its youth, which is leading to higher levels of NCDs in the adult population.

Obesity is reaching alarming levels among the country’s young people, with half of the nation’s children over the age of five either overweight or obese, according to a statement made by Awang Haji Zulkarnain bin Haji Hanafi, minister of health, in mid-October.

“From 2008 to 2014, obesity among school children in Brunei Darussalam increased from 12% to 18%,” he said. “This means that obesity rises by 1% every year. If this issue is unresolved, every single child in Brunei could potentially be obese in the near future.”

As a result of this growing trend, health conditions normally seen in adults are occurring in children, including Type 2 diabetes, high blood pressure and sleep disorders.

The increasing rate of excessive weight in childhood is also likely to contribute to obesity later in life, with the MoH showing that currently 62% of Bruneians are either overweight or obese. Furthermore, 30% of the total population suffer from high blood pressure, 12.4% from diabetes and 70% from above-average levels of cholesterol.

Measurable success

Although Brunei Darussalam still has a way to go to curtail NCDs, progress is already being made, according to the World Health Organisation (WHO).

The WHO’s “NCDs Progress Monitor” released last year indicated that Brunei Darussalam had made the most strides out of all ASEAN countries in preventing and combatting NCDs. The country achieved 10 out of 18 indicators on the WHO’s index, such as smoke-free policies and health warnings to reduce tobacco usage, advertising bans and pricing policies to limit alcohol intake, drug therapy and counselling for high-risk individuals, and public awareness on diet and physical activity.

Brunei Darussalam scored higher than other countries in the region, such as Cambodia (3), Myanmar (2) and Laos (1), as well as slightly better than Singapore (9) and Malaysia (8).

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