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                By Manjari Peiris     A 5 day National Capacity Strengthening Workshop for Programme Managers on Integrated Prevention and Control of Non-Communicable Diseases was held recently by the Non-communicable Disease Programme of the Ministry of Health at Hilton Residence. This workshop was sponsored by the World Health Organization.   The global burden of non-communicable diseases continues to grow and it is one of the major challenges for development in the twenty first century. The purpose of this workshop was to strengthen capacity of the programme managers to contribute efficiently towards prevention and control of non-communicable diseases and draft a national action plan in consistence with  the global strategy for the prevention and control of non-communicable diseases with the following objectives;   To raise the priority accorded to non-communicable disease in development work at global and national levels, and to integrate prevention and control of such diseases into policies across all government departments;   To establish and strengthen national policies and plan for the prevention and control of non-communicable diseases.   To promote interventions to reduce the main shared modifiable risk factors for non-communicable diseases: tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol.   To promote research for the prevention and control of non-communicable diseases.   To promote partnerships for the prevention and control of non-communicable diseases.   To monitor non-communicable diseases and their determinants and evaluate progress at the national, regional and global levels.                     Non-communicable diseases, principally cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases, caused an estimated 35 million deaths in 2005. This figure represents 60% of all deaths globally, with 80% of deaths due to non-communicable diseases occurring in low and middle-income countries and approximately 16 million deaths involving people under 70 years of age. Total deaths from non-communicable diseases are projected to increase by a further 17% over the next 10 years. The rapidly increasing burden of these diseases is affecting poor and disadvantaged populations disproportionately, contributing to widening health gaps between and within countries.   As non-communicable diseases are largely preventable, the number of premature deaths can be greatly reduced. The current evidence indicates that four types of non-communicable diseases – cardiovascular diseases, cancers, chronic respiratory diseases and diabetes – make the largest contribution to mortality in the majority of low – and middle-income countries and require concerted, coordinated action. These diseases are largely preventable by means of effective interventions that tackle shared risk factors namely; tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. Improved disease management can reduce morbidity, disability, and death and contribute to better health outcomes.   The action plan would take into consideration the four types of diseases and their risk factors together, to emphasize common causes and highlight potential synergies in prevention and control. All the risk factors are associated in equal measure with each of the diseases.   The plan will be based on current scientific knowledge, available evidence and a review of international experience. It comprises a set of actions which, when performed collectively by Member States and other stakeholders, will tackle the growing public health burden imposed by non-communicable diseases. The success of the plan implementation would depend on high level of political commitment and the concerted involvement of governments, communities and health-care providers. It is also required to reorient public health policies and improve allocation of resources.   The global action plan will make a special focus on low and middle income countries and vulnerable populations to mapping the emerging epidemics of non-communicable diseases and analyzing their social, economic, behavioural and political determinants as the basis for providing guidance on the policy, programmatic, legislative and financial measures that are needed to support and monitor the prevention and control of non-communicable diseases.               It will also focus in reducing the level of exposure of individuals and populations to the common modifiable risk factors for non-communicable diseases – namely, tobacco use, unhealthy diet and physical inactivity, and the harmful use of alcohol – and their determinants, while at the same time strengthening the capacity of individuals and populations to make healthier choices and follow lifestyle patterns that foster good health.   The action plan will also draw attention in strengthening health care for people with non-communicable diseases by developing evidence based norms, standards and guidelines for cost-effective interventions and by reorienting health systems to respond to the need for effective management of diseases of a chronic nature.   A panel of expertise from WHO/South-East Asia Regional Office, Dr. Jerzy Leowski (WHO SEARO), Dr. Rajesh Kumar (School of Public Health, Chandigar) and Dr. Adisak Sattam of (WHO Thailand) participated as resource persons.   Dr. Athula Kahandaliyanage, the Secretary to Ministry of Health, said that it is very expensive in providing healthcare to everybody by the government if the present pattern and volume of non-communicable diseases continues to increase.  However he made a special remark that the initiatives taken by the NCD directorate during the past decade have been very effective and fast that it has stepped towards taking many important policy decisions for NCD prevention such as enacting tobacco/alcohol control act and establishing of National Authority on Tobacco/Alcohol. “We need to mainstream health promotion in this sector as much as we could; then only it will be sustainable.” he said.     Dr. Agostino Borra, the Regional Representative for WHO and Dr. Terence de Silva, Deputy Director General (Medical Services), Ministry of Health also participated at the inauguration of the workshop. 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