NationalNational ControlControl ProgrammeProgramme of of ChronicChronic AirwaysAirways DiseasesDiseases

((AsthmaAsthma –– COPD)COPD)

Dr. Nazan YARDIMDr. Nazan YARDIMMinistryMinistry of of HealthHealth of of TurkeyTurkey

DepartmentDepartment of NCD&CDof NCD&CD

31 May 2008, 31 May 2008, IstanbulIstanbul

CChronichronic diseasesdiseases in in thethe WorldWorld

•• IIn 2005n 2005, , 35 million deaths 35 million deaths outout of 58 of 58 million deaths was million deaths was duedue toto chronic chronic diseases. diseases.

•• IIn most n most of of thethe countries the major cause countries the major cause of adult mortality is chronic diseasesof adult mortality is chronic diseases..

•• TThe mortality rate caused by he mortality rate caused by chronicchronicdiseases is expected to increase by 17 % diseases is expected to increase by 17 % in in nextnext 10 years. 10 years.

ChronicChronic RespiratoryRespiratory DDiseasesiseases(CRD) (CRD) in in thethe WorldWorld

•• More than 500 millionMore than 500 millionss of of ChronicChronicRespiratoryRespiratory DDiseasesiseases (CRD) are seen in (CRD) are seen in thethedeveloping countriesdeveloping countries..

•• 4.9 million people died of CRD in 2005, and 4.9 million people died of CRD in 2005, and this number is projected to increase a great this number is projected to increase a great deal in deal in closeclose futurefuture. .

SourcesSources: WHO : WHO andand WorldWorld BankBank

In 2005, 35 million people died worldwide due to chronic

diseases.

Source: Preventing Chronic Diseases - A vital investment, WHO 2005

HIV/AIDS

2.830.000

deaths

Tuberculosis

1.607.000

deaths

Malaria

833.000 deaths

Cardiovascular

Diseases

17.528.000

deaths

Cancers

7.586.000

deaths

Respiratory

System

4.057.000

deaths

Diabetes

112.500 deaths

Chronic Diseases in the World

Total estimated number of deaths in Turkey is 430.459.

Source NBD-CE Study Turkey

Infectious

Diseases.

38.071 deaths

Injuries 25.025

deaths Cardiovascular

Diseases

205.457 deaths

Cancers 56.250

deaths

Respiratory

System

34.211 deaths

Diabetes 9.549

deaths

Percentage Distribution of The First 10 DiseasesCausing Death in Turkey

Source: NBD-CE Burden of Disease Study, Turkey 2003

DistributionDistribution of of DeathsDeaths byby MajorMajor DiseaseDiseaseGroupsGroups in in TurkeyTurkey

% Distribution of Deaths in the National Level by

Major Disease Groups

Injuries; 5,8

Maternal and

Perinatal Causes;

6,0Respiratory

System Dis.; 8,0

Infectious Diseases

other than

HIV/AIDS; 8,8Cancers; 13,1

Cardiovascular

Diseases; 47,7

Source: NBD-CE Burden of Disease Study, Turkey 2003

Source: NBD-CE Study Turkey

8,9

8,0

5,9

3,9

3,8

3,0

2,9

2,8

2,4

2,1

0 2 4 6 8 10 12 14 16 18 20

Perinatal Causes

Ischaemic Heart Disease

Cerebrovascular Disease

Unipolar Depressive Disorders

Lower Respiratory Infections

Congenital Anomalies

Osteoarthritis

COPD

Road Traffic Accidents

Iron-deficiency Anaemia

%

Percentage Distribution of First 10 Diseases

Causing DALY at National Level

The Comparison of the Number of Deaths Caused byRespiratory System Diseases in Males at National Level in Turkey, Compared by the Number of Expected Death in 2010,

2020, 2030, (NBD-CE Project,Turkey)

The Comparison of the Number of Deaths Caused by Respiratory

System Diseases in Females at National Level in Turkey, Compared

by the Number of Expected Deaths in 2010, 2020, 2030, (NBD-CE

Project, Turkey)

NumberNumber of of DeathsDeaths COPD COPD andand AsthmaAsthma, , AccordingAccording toto SexSex forfor 2000, 2010, 2020 2000, 2010, 2020

COPD Asthma

Male Female Total Male Female Total

2000 18183 6922 25104 1390 1230 2620

2010 30020 10811 40831 1811 1498 3308

2020 47925 15315 63239 2413 1845 4258

COPD COPD DeathDeath NumberNumber accordingaccording toto ageagegroupsgroups in 2000, 2010, 2020 in 2000, 2010, 2020

COPD

0-4 5-14 15-29 30-44 45-59 60-69 70+ Total

2000 0 0 0 154 993 4893 19065 25104

2010 0 0 0 183 1470 6709 32469 40831

2020 0 0 0 191 1939 12001 49107 63239

AsthmaAsthma DeathDeath NumberNumber accordingaccording toto ageagegroupsgroups in 2000, 2010, 2020 in 2000, 2010, 2020

Asthma

0-4 5-14 15-29 30-44 45-59 60-69 70+ Total

2000 69 77 437 747 248 338 703 2620

2010 69 73 370 815 359 460 1163 3308

2020 42 57 305 852 480 797 1724 4258

Prevention of Deaths and DALYs through the prevention of Selected

Risk Factors for Turkey Overall (NBD-CE Project, Turkey)

Prevented Deaths

Risk factor MaleMale FemaleFemale BothBoth

HighHigh bloodblood pressurepressure 47.64347.643 60.82560.825 108.468108.468

HighHigh BMI(>30)BMI(>30) 26.00626.006 31.13631.136 57.14357.143

SmokingSmoking 52.90552.905 1.7941.794 54.69954.699

HighHigh cholesterolcholesterol 26.48726.487 22.54222.542 49.02949.029

PhysicalPhysical inactivityinactivity 22.51522.515 22.60522.605 45.12045.120

LowLow fruitfruit andand vegetablevegetable intakeintake 21.66821.668 17.06617.066 38.73438.734

AlcoholAlcohol useuse 10.85010.850 2.5852.585 13.43513.435

WaterWater andand sanitationsanitation 2.8072.807 2.8122.812 5.6195.619

Prevention of Deaths and DALYs through the prevention of Selected

Risk Factors for Turkey Overall (NBD-CE Project, Turkey)

Prevented DALYs

Risk factor MaleMale FemaleFemale BothBoth

HighHigh bloodblood pressurepressure 443.788443.788 485.162485.162 928.950928.950

HighHigh BMI(>30)BMI(>30) 379.980379.980 407.203407.203 787.183787.183

SmokingSmoking 870.603870.603 61.30661.306 931.909931.909

HighHigh cholesterolcholesterol 345.993345.993 220.688220.688 566.681566.681

PhysicalPhysical inactivityinactivity 254.555254.555 210.072210.072 464.627464.627

LowLow fruitfruit andand vegetablevegetable intakeintake 250.660250.660 166.216166.216 416.876416.876

AlcoholAlcohol useuse 388.526388.526 73.49273.492 462.018462.018

WaterWater andand sanitationsanitation 94.40194.401 88.38188.381 182.781182.781

IncidenceIncidence (100.000)(100.000) PrevalancePrevalance (1000)(1000)

RespiratoryRespiratory diseasesdiseases

malemale femalefemale totaltotal malemale femalefemale totaltotal

TracheaTrachea, , bronchusbronchus andand lunglung

cancerscancers 63,60063,600 5,0005,000 34,70034,700 0,3000,300 0,0000,000 0,2000,200

ChronicChronic obstructiveobstructive

pulmonarypulmonary diseasedisease 76,80076,800 68,50068,500 72,70072,700 8,4008,400 11,90011,900 10,20010,200

AsthmaAsthma 256,200256,200 152,200152,200 204,900204,900 31,10031,100 44,40044,400 38,70038,700

CostCost EffectivenessEffectiveness forfor COPD (COPD (includingincludingasthmaasthma))

Cost/case $ Total cost$ Cost per DALY $

COPD (incAsthma) Treatment at thehealth center

65,58 173,950,269,56 46,18

COPD (incAsthma) Treatment at thehospital

249,48 661,743,111,46 175,70

NumberNumber of of SpecialistSpecialist PhysiciansPhysicians in in TurkeyTurkey

SpecialisationSpecialisationNumberNumber of of MoHMoH ++UniversityUniversity HospitalHospital++PrivatePrivate PhysiciansPhysicians

EmergencyEmergency MedicineMedicine 264264

ChestChest SurgerySurgery 373373

FamilyFamily MedicineMedicine 831831

CardiovascularCardiovascular SurgerySurgery 861861

NeurosurgeryNeurosurgery 11341134

MentalMental DiseasesDiseases andand PPpsychiatry psychiatry 11871187

BiochemistryBiochemistry 12861286

PhysicalPhysical TherapyTherapy andand RehabilitationRehabilitation 13541354

CardiologyCardiology 13761376

RespiratoryRespiratory DiseasesDiseases 14401440

NeurologyNeurology 14881488

RadiologyRadiology 21652165

PediatricsPediatrics 38703870

InternalInternal MedicineMedicine 40054005

Source: Ministry of Health, General Directorate of Personnel, December 2007

Number of health personnel per 1000 persons in Turkey and

OECD European Region Countries*

Source: Human Resources in Health and Policy Dialogue Workshop MoH, Refik Saydam Hygiene Center Presidency,

School of Public Health, 2007.

Ministry of Health Hospitals, 2001Ministry of Health Hospitals, 2001--20062006

20012001 20022002 20032003 20042004 20052005 20062006

General HospitalsGeneral Hospitals 514514 541541 554554 569569 654654 629629

Health Care CenterHealth Care Center 128128 -- -- -- -- --

Maternity and Children Maternity and Children

HospitalHospital 4444 4747 4848 4848 6666 6565

Chest Diseases HospitalChest Diseases Hospital 2323 2323 2222 2222 2222 2222

Chest and Chest and CardiovasCardiovasccularular

Surgery CentersSurgery Centers 55 66 66 66 77 66

Mental Health HospitalsMental Health Hospitals 66 66 66 66 88 99

ChildrensChildrens HospitalsHospitals 66 66 66 77 99 99

OphtalmologyOphtalmology Hospitals.Hospitals. 11 11 11 11 22 22

Oncology HospitalsOncology Hospitals 33 33 33 33 22 22

Total MoH Hospital numbers: 769 (2006).

Source:Ministry of Health Statistics, 2006.

•• ThereThere is is shiftshift betweenbetween thethe Global Global burdenburden of of chronicchronic andand communicablecommunicabledisesesdiseses in in WorldWorld andand TurkeyTurkey

•• MajorityMajority of CRD COPD of CRD COPD andand asthmaasthma in in TurkeyTurkey

CRD causesCRD causes areare PPreventablereventable

•• TTobaccoobacco smoke smoke •• IIndoorndoor air pollution air pollution •• AllergensAllergens•• OOccupationalccupational factorsfactors•• SomeSome diseasesdiseases (e.g. (e.g. schistosomiasisschistosomiasis and and sickle cell anemiasickle cell anemia))

•• 53rd World Health Assembly asked the 53rd World Health Assembly asked the General Director of WHO to launch General Director of WHO to launch works in the field of Cworks in the field of ChronichronicRespiratoryRespiratory DiseasesDiseases, under the , under the leadership of the governments and with leadership of the governments and with internationals support.internationals support.

GARDGARD-- Global Alliance against Global Alliance against Chronic Respiratory Diseases Chronic Respiratory Diseases

•• purpose purpose of GARD of GARD isis::

TTo draw attention to the fact that CRD o draw attention to the fact that CRD is one of the most important health is one of the most important health problems in the world. problems in the world.

GARD aimsGARD aims;;•• improving the surveillance improving the surveillance •• identifying countryidentifying country--focused priorities in focused priorities in prevention and control,prevention and control,

•• increasing the quality of care increasing the quality of care •• improving the trainings of the improving the trainings of the healthcare personnel working in this healthcare personnel working in this fieldfield

WHOWHO’’s goal iss goal is;;

•• to set up collaboration between the countriesto set up collaboration between the countries’’own programs and the programs continuing own programs and the programs continuing under GARD. under GARD.

•• GARD member countries organize country GARD member countries organize country programs for CRD within the framework of programs for CRD within the framework of GARD structure and rules, GARD structure and rules,

•• PProgramsrograms are directed by the country are directed by the country governments themselves.governments themselves.

GARD in GARD in thethe worldworld andand TurkeyTurkey

•• The first steps of this alliance were The first steps of this alliance were taken in 2000 taken in 2000

•• 17 government and non17 government and non--government government organizations participated at the organizations participated at the beginning beginning

•• RecentlyRecently the numbers of member the numbers of member organizations have reached organizations have reached 7979. .

GARD in GARD in TurkeyTurkey

•• Turkish Turkish ThorasicThorasic Society (TTS) became Society (TTS) became a GARD member in 2005 and attended a GARD member in 2005 and attended the plenary assemblies. the plenary assemblies.

•• Turkish Association of Allergy and Turkish Association of Allergy and Clinic Immunology became the second Clinic Immunology became the second Turkish member of GARD in 2007.Turkish member of GARD in 2007.

GARD in GARD in TurkeyTurkey

•• TThe he GARD GARD Project was submitted to Project was submitted to the Ministry of Health for approvalthe Ministry of Health for approval

•• GARD GARD GeneralGeneral Assembly of Turkey Assembly of Turkey was held in Ankara in October 26th, was held in Ankara in October 26th, 20072007..

•• 25 stakeholders 25 stakeholders participatedparticipated toto thetheassemblyassembly. .

StakeholdersStakeholders of GARD in of GARD in TurkeyTurkey

•• Ministry of HealthMinistry of Health•• Ministry of InteriorMinistry of Interior•• Ministry of EducationMinistry of Education•• Ministry of Industry and TradeMinistry of Industry and Trade•• Ministry of Labor and Social SecurityMinistry of Labor and Social Security•• Ministry of Environment and ForestryMinistry of Environment and Forestry•• Department of Religious AffairsDepartment of Religious Affairs•• State Planning OrganizationState Planning Organization•• Social Security InstitutionSocial Security Institution•• WHO Representative in Turkey WHO Representative in Turkey •• RRelevantelevant associationsassociations andand NGOsNGOs..

•• During GARD During GARD GeneralGeneral Assembly of Assembly of Turkey, the roles and responsibilities of Turkey, the roles and responsibilities of all stakeholders were defined, and all stakeholders were defined, and action plans were made for short, action plans were made for short, medium and long terms. medium and long terms.

GARD in GARD in TurkeyTurkey

Ministry of HealthMinistry of Health’’s Approaches to s Approaches to

Chronic Disease PreventionChronic Disease Prevention

•• TurkeyTurkey’’s Program for Preventing and Controlling s Program for Preventing and Controlling RespiratoryRespiratoryDiseases, Strategic Plan and Action Plan for the Risk FactorsDiseases, Strategic Plan and Action Plan for the Risk Factors--DraftDraft

•• National Program for Transformation in Health and Second National Program for Transformation in Health and Second FiveFive--Year Action PlanYear Action Plan

•• Tobacco Control Program Tobacco Control Program --PublishedPublished•• TurkeyTurkey’’s Program for Preventing and Controlling s Program for Preventing and Controlling

Cardiovascular Diseases, Strategic Plan and Action Plan for the Cardiovascular Diseases, Strategic Plan and Action Plan for the Risk FactorsRisk Factors--PublishedPublished

•• TurkeyTurkey’’s Program for Combating Obesity and National Action s Program for Combating Obesity and National Action PlanPlan--DraftDraft

•• The The aimaim of this of this NationalNational ActionAction PlanPlan isis;;TTo reduce the asthma and COPD o reduce the asthma and COPD related morbidity, mortality and the related morbidity, mortality and the accompanying economic burden. accompanying economic burden.

Chronic Airway Diseases Prevention Chronic Airway Diseases Prevention and Control Program National Action and Control Program National Action Plan Plan ofof TurkeyTurkey”” waswas preparedprepared..

•• C.1. The establishment of prevention/ C.1. The establishment of prevention/ control program and action plan control program and action plan against chronic airway diseaseagainst chronic airway disease

• C.2.Advocacy and awareness• C.2.1. Defining the goals and principles of theprogram

• C.2.2. Introducing the program to healthprofessionals by these principles

• C.2.3. Introducing the program toeducational units by these principles

• C.2.4. Introducing the program to publicby these principles

• C.3. Preventing the development of disease• C.3.1. Reducing Smoking• C.3.2. Reducing enviromental smoking• C.3.3. Reducing indoor air pollotion• C.3.4. Reducing outdoor air pollotion• C.3.5. Reducing occupational risk factors• C.3.6. Reducing allergen exposure• C.3.7. Prevention ant management of childhood infections

• C.3.8. Generalizing physical activities and healthynutrition

• C.4. Early detection of diseases and prevention of progress • C.4.1. Increasing awareness of early detection among public and

health professionals• C.4.2. Supplying and expanding the usage of spirometry• C.4.3. Easy access to healthcare services• C.4.4. Eliminating the risk factors

(smokin,infection,occupational) • C.4.5. Easy access to medicine and treatment equipment• C.4.6. Proper recording and monitoring • C.4.2. Decreasing allergen burden

• C.5 .Effective treatment of the diseases and prevention of complication development

• C.5.1. Education of patients and health care professionals about appropriate treatment

• C.5.2 Expanding home care services • C.5.3. Expanding pulmonary rehabilitation services

• C.5.4. Easy access to medicine and treatment equipment

• C.5.5. Proper recording and monitoring

• C.6. Monitoring the chronic diseases and the control program evaluation

• Goal 1. (C.6.1) Monitoring the disease burden and risk factors, developing standardized methods for obtaining proper data andcollect data with these methods

• Strategies:• C.6.1.1. Collection and evaluation of current national and international

data• C.6.1.2. Collection of COPD and Asthma spesific prevalance and

incidence data• C.6.1.3. Defining the methods for obtaining reliable and

comparable data• C.6.1.4. Monitoring the disease burden by defined intervals• C.6.1.5. Establishment of a unit for collecting, analysing and reporting

data within MoH

• Goal 2. (C.6.2.)Monitoring, yearly evaluating andreportingof the program

• Strategies:• C.6.2.1. Defining the survey and outcomes of theprogram

• C.6.2.2. Preparing data collection/investigationprotocols for routine use.

• C.6.2.3. Collection and evaluation of the data • C.6.2.4 Preparing Annual National Report

HealthHealth TransformationTransformationProgrammeProgramme

•• Program for Transformation in Health, which has been Program for Transformation in Health, which has been launched in 2003 in our country, is a comprehensive program launched in 2003 in our country, is a comprehensive program aiming at generating the most suitable solutions with aiming at generating the most suitable solutions with participatory and democratic decision processes taking all the participatory and democratic decision processes taking all the works carried out so far into consideration. The objective is toworks carried out so far into consideration. The objective is toorganize the health services in an effective, efficient and justorganize the health services in an effective, efficient and justmanner and to ensure their financing and delivery. manner and to ensure their financing and delivery.

HealthHealth TransformationTransformationProgrammeProgramme

•• While implementing the Program for Transformation While implementing the Program for Transformation in Health, significant progress was made in issues in Health, significant progress was made in issues such as mothersuch as mother--child health, vaccination activities, child health, vaccination activities, and prevention of communicable diseases. and prevention of communicable diseases.

StretegicStretegic ActionAction Plan Plan forfor20082008--20122012

•• the second fivethe second five--year Action Plan period year Action Plan period of the Program for Transformation in of the Program for Transformation in Health, the focus will be on the Health, the focus will be on the incentive works for promoting a incentive works for promoting a healthy life, and activities will be healthy life, and activities will be implemented for raising consciousness implemented for raising consciousness and awareness in addition to and awareness in addition to information and for making behavioral information and for making behavioral changes that will positively affect changes that will positively affect health.health.

Ministry of HealthMinistry of Health’’s Approaches to s Approaches to

Chronic Disease PreventionChronic Disease Prevention

•• Department of Department of NonNon-- CommunicableCommunicableandand Chronic Diseases Chronic Diseases

•• Department of Health Promotion Department of Health Promotion

have been established have been established in 2008 in 2008 under the under the General Directorate of Primary General Directorate of Primary Healthcare Services. Healthcare Services.

National Tobacco Control National Tobacco Control ProgramProgram

•• National Tobacco Control Program is a road map and National Tobacco Control Program is a road map and a commitment document.a commitment document.

•• Republic of Turkey has signed the WHO Framework Republic of Turkey has signed the WHO Framework Convention on Tobacco Control in an early period. Convention on Tobacco Control in an early period. The activities for the Framework Convention on The activities for the Framework Convention on Tobacco Control are carried out by the ministries of Tobacco Control are carried out by the ministries of health in all countries. health in all countries.

•• . . •• 20082008--2012 National Tobacco Control Action 2012 National Tobacco Control Action Plan has been introduced on 12.12.2007. Plan has been introduced on 12.12.2007. European Heart Health Charter was signed in European Heart Health Charter was signed in Ankara in December 25th, 2007 with the Ankara in December 25th, 2007 with the participation of Nonparticipation of Non--Governmental Governmental Organizations and the Ministry of Health.Organizations and the Ministry of Health.

•• After signing this convention, the After signing this convention, the National Tobacco Control Program was National Tobacco Control Program was established in our country, and the Law established in our country, and the Law no. 5727 on Amending the Law on no. 5727 on Amending the Law on Preventing the Harms of Tobacco Preventing the Harms of Tobacco Products was accepted on 3/1/2008, Products was accepted on 3/1/2008, and the first step for combating tobacco and the first step for combating tobacco was thus taken. was thus taken.

National Tobacco Control Program

National Tobacco Control National Tobacco Control ProgramProgram

•• NationalNational anti anti smokesmoke campaigncampaign is is goinggoingbyby thethe endend of of yearyear

•• CampaignCampaign conceptconcept is is

KeepKeep youryour airair, ,

smokesmoke freefree zonezone

TurkeyTurkey’’s Program for Preventing and Controlling s Program for Preventing and Controlling Cardiovascular Diseases, Strategic Plan and Action Cardiovascular Diseases, Strategic Plan and Action

Plan for the Risk FactorsPlan for the Risk Factors•• Our Ministry has prepared Our Ministry has prepared ““TurkeyTurkey’’ssProgram Program forfor CardiovascularCardiovascular DiseasesDiseasesPreventionPrevention andand ControlControl -- StrategicStrategic Plan Plan andandActionAction Plan Plan againstagainst thethe Risk Risk FactorsFactors”” in in collaboration with the relevant Noncollaboration with the relevant Non--Governmental Organizations.Governmental Organizations.

•• The aim of Plan is; to prevent and control The aim of Plan is; to prevent and control cardiovascular diseases by reducing the cardiovascular diseases by reducing the major risk factors in combat against the major risk factors in combat against the cardiovascular diseases for a healthier cardiovascular diseases for a healthier Turkey.Turkey.

TurkeyTurkey’’s Program for Preventing and Controlling s Program for Preventing and Controlling Cardiovascular Diseases, Strategic Plan and Action Cardiovascular Diseases, Strategic Plan and Action

Plan for the Risk FactorsPlan for the Risk Factors

•• The scope of the Plan has been developed within the The scope of the Plan has been developed within the framework of reducing the use of cigarette and other framework of reducing the use of cigarette and other tobacco products, preventing unhealthy dietary tobacco products, preventing unhealthy dietary habits and obesity and eliminating physical inactivity habits and obesity and eliminating physical inactivity for reducing the risk factors of cardiovascular for reducing the risk factors of cardiovascular diseases in Turkey. diseases in Turkey.

•• The objectives of the Plan are; to inform the public The objectives of the Plan are; to inform the public about the cardiovascular diseases, to increase about the cardiovascular diseases, to increase community awareness, to promote positive and community awareness, to promote positive and lifelong behavioral changes with respect to major risk lifelong behavioral changes with respect to major risk factors, and thus to enable people to live a qualified factors, and thus to enable people to live a qualified life in terms of health. life in terms of health.

TurkeyTurkey’’s Program for Preventing and Controlling s Program for Preventing and Controlling Cardiovascular Diseases, Strategic Plan and Action Cardiovascular Diseases, Strategic Plan and Action

Plan for the Risk FactorsPlan for the Risk Factors

•• TheThe preparationspreparations forfor TurkeyTurkey’’ss Program Program forforPreventingPreventing andand ControllingControlling CardiovascularCardiovascularDiseasesDiseases, , StrategicStrategic Plan Plan andand ActionAction Plan Plan forforthethe Risk Risk FactorsFactors havehave beenbeen completedcompleted andand it it is in is in printingprinting processprocess. .

•• TheThe otherother approachesapproaches forfor thethe secondarysecondary andandtertiarytertiary protectionprotection againstagainst thethe CardiovascularCardiovascularDiseasesDiseases willwill be be developeddeveloped separatelyseparately andand be be includedincluded underunder thethe nationalnational program program

TurkeyTurkey’’s Program for s Program for Combating Obesity and Combating Obesity and National Action Plan National Action Plan

•• In recent years, the prevalence of obesity in In recent years, the prevalence of obesity in the whole world has been gradually the whole world has been gradually increasing, and WHO European Region increasing, and WHO European Region organized a organized a ““Ministers ConferenceMinisters Conference”” aiming at aiming at taking senior level measures against this taking senior level measures against this increasing global threat on the part of increasing global threat on the part of member countries. member countries.

•• The Conference was organized in Istanbul in The Conference was organized in Istanbul in November 15November 15--17, 2006 with Ministry of 17, 2006 with Ministry of Health of the Republic of Turkey as the host. Health of the Republic of Turkey as the host.

European Charter on European Charter on Counteracting Counteracting

•• Minister of Health of the Republic of Minister of Health of the Republic of Turkey, Professor Dr. Turkey, Professor Dr. RecepRecep AKDAAKDAĞĞ, ,

•• WHO European Region Director Dr. WHO European Region Director Dr. Marc DANZON signed the European Marc DANZON signed the European Charter on Counteracting ObesityCharter on Counteracting Obesity

•• ..

TurkeyTurkey’’s Program for Combating s Program for Combating Obesity and National Action PlanObesity and National Action Plan

•• The combat against obesity is a long and The combat against obesity is a long and widewide--ranging combat covering health, ranging combat covering health, education, transportation, urbanization, food, education, transportation, urbanization, food, sports etc. Therefore, for succeeding in this sports etc. Therefore, for succeeding in this combat, combat, ““TurkeyTurkey’’s Program for Combating s Program for Combating Obesity and National Action PlanObesity and National Action Plan”” has been has been prepared with a multiprepared with a multi--sector approach in sector approach in addition to the existing policies of the addition to the existing policies of the Ministry of Health. Ministry of Health.

•• PlanningPlanning toto conducedconduced activitiesactivities whichwhichareare in in thethe actionaction plansplans step step byby stepstep

EE--healthhealth andandsurveillancesurveillance

•• InIn thethe ee--healthhealth studiesstudies, , surveillancesurveillance systemsystem is is beingbeing improvedimproved andand reorganisedreorganised..

•• ImplementationImplementation of of familyfamily medicinemedicine systemsystemwillwill be be completedcompleted in 21 in 21 provincesprovinces at at thethe endendof of thethe yearyear..

•• ElectronicElectronic data transfer data transfer fromfrom hospitalshospitals willwill be be completedcompleted byby OctoberOctober in in thethe statestate hospitalshospitalsandand byby JanuaryJanuary in in universityuniversity hospitalshospitals. .

NCD NCD andand HealthHealth PromotionPromotionSymposiumSymposium

•• NCD NCD andand HealthHealth PromotionPromotion SymposiumSymposium willwillbe be heldheld on 13on 13--14 14 NovemberNovember 2008 in Ankara 2008 in Ankara withwith internationalinternational participantsparticipants..

•• AimAim is is •• toto createcreate awarenessawareness aboutabout NCD &HPNCD &HP•• ToTo shareshare scientificscientific approachesapproaches•• ToTo shareshare MoHMoH studiesstudies•• ToTo improveimprove intersectoralintersectoral collaborationcollaboration

THANK YOU!THANK YOU!