JPMA. The Journal of the Pakistan Medical Association
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The National Action Plan for Non-Communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD) incorporates prevention and control of cardiovascular diseases (CVD) as part of a comprehensive and integrated non-communicable Disease (NCD) prevention effort. In this programme, surveillance of cardiovascular risk factors is part of an integrated population-based NCD surveillance system. The population approach to CVD prevention is a priority area in this programme with a focus on broad policy measures and behavioural change communication. ⋯ It highlights the need to ensure the availability of aspirin, beta blockers, thiazides, ACE inhibitors, statins and penicillin at all levels of healthcare. The programme points out the need to conduct clinical end-point trials in the native Pakistani setting to define cost-effective therapeutic strategies for primary and secondary prevention of CVDs. Emphasis is laid on building capacity of health systems in support of CVD prevention and control and building a coalition or network of organizations to add momentum to CVD prevention and control efforts.
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Reliance on revenue generated from tobacco is one of the fundamental barriers to effective tobacco control in Pakistan. The tobacco control component of the National Action Plan for Non-Communicable Diseases Prevention, Control and Health Promotion in Pakistan (NAP-NCD) deems it critical to address this issue. A range of policy and environmental strategies are part of this comprehensive effort; these involve regulating access and limiting demand through restrictions on advertising, marketing, promotion and through price and taxation. ⋯ Other priority areas include the gradual phasing out of all types of advertising and eventually a complete ban on advertising; allocation of resources for policy and operational research around tobacco and building capacity in the health system in support of tobacco control. NAP-NCD also stresses on the need to develop and enforce legislation on smuggling contrabands and counterfeiting and legislation to subject tobacco to stringent regulations governing pharmaceutical products. The adoption of measures to discourage tobacco cultivation and assist with crop diversification; integration of guidance on tobacco use cessation into health services and insuring the availability and access to nicotine replacement therapy are also part of NAP-NCD.
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In Pakistan a public-private partnership--led by the NGO Heartfile and constituted additionally by the Ministry of Health, Government of Pakistan and the WHO Pakistan office--was launched in April 2003. Mandated with the task of developing and implementing a national strategy for achieving national goals for the prevention and control of non-communicable diseases (NCDs). This was the first opportunity to mount a truly 'National Plan of Action' in Pakistan enlisting a broader range of inputs and with the Governments commitment to NCD as a priority. ⋯ The partnership has brought value to all the three partners. The government has harnessed the technical strength of a private sector partner, which in turn is contributing to the country's National Plan within the framework of priorities set by broad-based national consensus; WHO, on the other hand, is gaining experience in working in a country model in which the private sector can be supported through WHO country resources, which are typically earmarked for public sector initiatives. Work is currently underway to implement the first phase of NAP-NCD.