The Ministry for Health launched its Non-Communicable Diseases Prevention Framework on Friday morning. This strategy sets out how national health authorities can work to reduce the impact of such diseases via prevention, early diagnosis, effective treatment, care management, and promoting general wellbeing.

Non-Communicable Diseases (NCDs) are defined as chronic diseases, typically of long duration, that are not infectious and arise from a combination of genetic, physiological, environmental, and behavioural factors. Common examples of NCDs are cardiovascular diseases like strokes or heart attacks, cancers, chronic respiratory diseases, e.g., asthma, diabetes, obesity, and mental health disorders.

This policy framework outlines measures for the coming decade, till 2035, with the goal of preventing NCDs, and thereby reducing morbidity and mortality rates.

Analysing the Maltese context, statistics indicate several areas where this framework can improve the situations of NCDs around the Maltese islands. For instance, people in the country have a 10.2% of dying between 30-70 years of age due to any cardiovascular disease, cancer, diabetes, or chronic respiratory disease; 31.1% of 16+ year olds have a longstanding illness or health issue; a quarter of all 15+ year olds (25.1%) were tobacco smokers, as of 2019; 13.9% of people over 14 years of age had poor mental wellbeing, also as of 2019; and 63.8% of 15+ year olds are overweight while 28.1% are obese.

While the actual prevalence of NCDs is difficult to quantify, data from 2019 indicates that NCDs accounted for 90.9% of all deaths that year. Conservative estimates from 2016 suggest that obesity that year cost the country some €36.3 million.

This NCD Prevention Framework (2025-2035), according to the Superintendent of Public Health, Charmaine Gauci, will help boost quality of life and help make the country’s healthcare system more sustainable.

The measures in this strategy focus on addressing the root causes of NCDs by promoting healthy behaviours and reducing risk factors across the population, preventing the onset of disease via vaccinations and lifestyle adjustments, and by pushing screenings for the early detection and treatment of NCDs to halt their progression and reduce complications.

Health Minister Jo Etienne Abela said that as this prevention framework has been launched, the government will retain its focus on investing in treatment. He said that “if we don’t focus on prevention, treatment services we are providing will surely become unsustainable” and that “the key to the future is prevention.”

“I am very hopeful that this framework will prove very beneficial to our country, to our population. I am sure of it,” Health Minister Abela said.

Minister Abela observed that in today’s digital age, it is vital for health authorities to look towards data to analyse how if and to what extent preventative efforts are working. He added that data collection within these decision-making processes must include artificial intelligence to fully evaluate such information on general public health on a national scale.

Minister Abela remarked that health authorities, through this decade-long framework, will have certain key performance indicators (KPIs) to stick to, “and only those KPIs will prove that our efforts will not be in vain.”

The Health Minister stated that with the nature of this framework, results will not be seen immediately and that “we should not be discouraged if we do not see results by the end of this year.”

This framework lists eight priority areas, each featuring policy recommendations, to support NCD prevention. These priority areas are to reduce tobacco use; to reduce alcohol use; decrease obesity and overweight rates; improve access to a healthy diet; increase physical activity while lowering physical inactivity and sedentary time; promoting early diagnoses through opportunistic screenings; promoting mental health and wellbeing; and promoting environmental health.

This framework also lists several enablers of NCD prevention, with each one also including its own set of policy recommendations.

The first enabler pertains to governance and accountability and discusses having a strengthened will to prioritise NCD prevention at a national level, as well as provide training to the public service and sector on good governance.

The second enabler is about putting data into action and lists points to promote surveillance, monitoring and evaluation, and research. Among the listed policy recommendations were for health authorities to have a clearer idea on the population’s burden of diabetes, hypertension and dementia and other relevant data, as well as to identify any research gaps and prioritise research needs.

The third one is to address health determinants and health inequities and pushes to strengthen Health in All policies through continued awareness campaigns; advocates for proportionate universal policies and services; and for the Health Ministry to keep in touch with other Ministries and entities to help the holistic implementation of this strategy.

The fourth NCD prevention enabler is to re-orient health systems for prevention. As of 2021, only 1.2% of all healthcare expenditure went towards preventative care. It is suggested for screening and brief interventions (SBIs) and motivational interviewing (MI) to be integrated for NCDs, as well as for NCD risk factors and community-based mental wellbeing services to be integrated into healthcare settings. SBIs and MI will also be included in undergraduate curricula for all healthcare professionals as healthcare systems work to re-orient themselves in this way.

The final two enablers are health literacy and emergency preparedness. Among the recommendations here include developing and implementing a comprehensive national health literacy strategy and ensuring that health systems are prepared to continue catering for NCDs in during emergency periods like the pandemic or major summer heatwaves. Health authorities plan on integrating NCDs as part of emergency preparedness and response planning.