Bhutan takes the lead in fighting lifestyle diseases

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Infectious diseases draw most of the attention (and money) in global health, particularly around such maladies as malaria, HIV/AIDS and diarrhea in children. But noncommunicable diseases are responsible for 17 million premature deaths worldwide and will cost the world economy $30 trillion between 2010 and 2030. Without intervention, low-income countries could have eight times more noncommunicable disease-related deaths than wealthier countries by 2030. And such interventions are often as lengthy and expensive as noncommunicable diseases are closely linked to lifestyle and develop gradually over time.

Enter Bhutan. The small Himalayan kingdom may become the world’s model for fighting noncommunicable disease. Bhutan’s work “on heart disease prevention and control, in particular, serves as a model for others to follow,” says Cherian Varghese, a doctor with the WHO.

Bhutan is the first country to implement the WHO’s prevention plan for noncommunicable diseases in “low-resource” countries. It adopted the plan after a 2014 survey showed nearly 40 percent of its 750,000 citizens were overweight or obese; half did not engage in physical activity. “As we live longer and enjoy greater prosperity, we are also succumbing to lifestyle diseases,” says Tshering Tobgay, Bhutan’s prime minister. The problems are particularly acute among monks, many of whom are sedentary and consume diets high in fat, salt and sugar.

Following the WHO’s recommendations, the Bhutanese government has granted district authorities more control over health spending, imposed a 100 percent tax on alcohol, and is ramping up promotional campaigns for physical activity. In districts where the plan has been piloted, cases of hypertension fell by half and other conditions, including diabetes, showed improvement as well. “Today, the younger generation of monks are well aware of the need to eat a healthy diet, avoid alcohol use, and be physically active,” says Lopen Pasang, a Buddhist monk and health coordinator of Bhutan’s approximately 12,000-member monastic community. “Their lives have improved.”