A WHO-UNDP team under the United Nations Interagency Task Force on the Prevention and Control of Noncommunicable Diseases (NCDs) has completed a one week mission in Ulaanbaatar on 9 September. During the mission the team of six international experts in epidemiology, health economics and governance, backed up by 25-member strong team of national experts has worked on developing a Business Case in Investing in Noncommunicable Diseases Prevention and Control in Mongolia. The Team has met a whole range of stakeholders including the Head of the Parliamentary Standing Committee on Social Policy, Education, Culture and Sciences, Mr. L.Enkh-Amgalan, representatives of MOH and its agencies, professional and civil society organizations as well as international actors including a number of UN agencies represented in Mongolia.
In its interim reporting to the Vice-Minister of Health, L.Byambasuren, the Joint Team has recommended to complete Mongolia’s new multi-sectoral NCD Programme and Action Plan the Government is committed to develop as soon as possible. Given a challenging economic situation in the country, the Team highlighted the need for the Plan to focus on a “small set of very cost effective priorities”. On an operational level the Joint Team recommended that multi-sectoral coordination mechanisms at ministerial and technical levels to be set up for driving forward the development and implementation of the NCD Programme and Action Plan. The Joint Mission also highlighted the importance of civil society in the national NCD response and the commitment of the United Nations system to support the new Government in tackling NCDs.
The Mission strongly encouraged an urgent implementation of the Government’s commitment to increase tax on tobacco products as tobacco tax levels in Mongolia are much lower than in other countries despite Mongolia being one of the countries with the highest number of people smoking in the world. The Joint Team also highlighted the need to enforce an increase in excise taxes on alcohol.
"Alcohol and tobacco are too cheap in Mongolia. Even high school students can afford these products. Smoking and binge drinking are becoming a problem in Mongolia's schools. Hence setting higher taxes on alcohol and tobacco will not only prevent from acquiring NCDs but also will contribute to health sector budget," said Dr Soe Nyunt U, WHO Representative in Mongolia.
“In addition to alcohol, which is a big problem in Mongolia, we know that diet is not good in this country: people are eating too much animal fat, salt and sugar and not enough fresh fruits and vegetables. With urbanization and aging people should start looking at their diets,” says Dr Nick Banatvala, the mission head and the Senior Adviser to the Assistant Director General on NCDs and Mental Health, WHO.
According to studies, NCDs are the primary cause of premature deaths in Mongolia: 32 percent or 1 in three persons in Mongolia die because of non-communicable diseases before reaching 70 years of age. Over 40 percent of those die because of cardiovascular diseases. Almost half of the Mongolian men and 1/4 of women suffer from hypertension. Risk factors for developing NCDs as consumption of alcohol and tobacco, lack of exercise and unbalanced diets are wide-spread in Mongolia.
Hence the Joint Team recommended scaling up sustained public health campaigns to raise public awareness on diet and physical activity among the urgent policy measures that need to be undertaken by the Government of Mongolia as a priority action. The Team also advised an implementation of evidence-based policies that will reduce levels of salt intake to combat the spread of risk of cardiovascular diseases.
Mongolia is the first country in Asia to undertake this exercise on developing a Business Case in Investing in Noncommunicable Diseases Prevention and Control. The exercise became a logical continuation of the 2015 Joint Mission of the UN Interagency Task Force on Prevention and Control of NCDs. "Many parliamentarians, ministers, officers and experts who we've met during the first mission a year ago pointed to a necessity to work out a business case on NCDs prevention and control to get an idea about return on investment," said Dr Nick Banatvala.
"The case study is developed within the framework of Mongolia's Sustainable Development Concept 2030 and will present an exercise that has a costing element in it," said Dr Soe Nyunt U.
The joint team is expected to release the final report on the Investment Case Study on NCDs in October.