KATHMANDU, Dec 6: Nepal is facing a rising burden of non-communicable diseases (NCDs), which now account for 71 percent of total deaths in the country. Of these, 20 percent are premature deaths, according to the WHO STEPS survey. Experts say Nepal can significantly reduce this mortality rate by strengthening NCD care at the primary healthcare level.
These concerns were highlighted during an experts’ meeting jointly organized by BP Koirala Institute of Health Sciences’ (BPKIHS) KHDC program, the Ministry of Health and Population and Geneva University on Friday.
Dr Pomwoti Thapa, chief of the Non-Communicable and Mental Health Section at the Department of Health Services, said the rising prevalence of hypertension, cardiovascular diseases, diabetes, kidney diseases, and cancer—driven by urbanization, increased vehicle access, and unhealthy lifestyles—has contributed to growing premature mortality.
Unhealthy diets, alcohol and tobacco use, lack of exercise, pollution, respiratory diseases, neurological illnesses, and various cardiovascular conditions remain key risk factors, she added.
Dr Sanjeev Kumar Sharma, coordinator of the KHDC program and a nephrologist at BPKIHS, said many NCDs show no symptoms in their early stages but silently damage vital organs. “Even without symptoms, heart valves may be narrowing and kidneys deteriorating,” he said, noting that late-stage NCDs are difficult and expensive to treat.
Sharma emphasized that improving awareness, early screening, access to medication, and timely referrals—starting from the most basic health facilities—could significantly reduce NCD-related deaths.
BPKIHS has been running an NCD strengthening program at the primary level in Mechi Municipality, Phungling Municipality, and Damak Municipality since 2060 BS, providing equipment, training, drug supplies, and telemedicine support.
Although the government launched the PEN (Package of Essential NCD Interventions) program in 2016, its effectiveness has fallen short of expectations. Dr Thapa cited policy hurdles, complex drug procurement processes, unclear budgeting, and weak human-resource management as major obstacles.
She said that although the program has expanded to all 77 districts, follow-up training is lacking and many health facilities continue to face medicine shortages.
Experts stressed the need for unified standards and clear responsibilities among federal, provincial, and local governments. Strengthening local-level accountability, allocating dedicated NCD budgets, improving data systems, and using patient NCD cards for tracking were among the recommendations.
Presentations from Geneva University Hospital, BPKIHS, and other institutions highlighted successful models of primary-level NCD management. Experts concluded that regular exercise, a healthy diet, and routine health screenings are key to preventing kidney and heart conditions and reducing NCD-related deaths.