The Rise of NCDs Necessitates a Range of Adjustments by Health Systems in Australia

The rise of non-communicable diseases (NCDs) in Australia has led to adjustments in the healthcare system. This essay analyzes the changes made by the Australian government to cope with the increase in NCDs, including the WHO global action plan, tobacco, alcohol, unhealthy diet, physical inactivity, and more. The essay also discusses the implications of NCDs for medical practice and workforce planning and management.

Running head: NON-COMMUNICABLE DISEASES
The Rise of NCDs Necessitates a Range of Adjustments by Health Systems in Australia
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Introduction
Prevention and control of infectious disease, financial improvements and
technological advancement in the healthcare domain have contributed to the overall increase
in the life expectancy and improved quality of life of the people. This in turn has increased
the likelihood of living up to the age of 60 years and beyond. Apart from this notable
achievement, there are lifestyle-related shifts, epidemiological changes. This modification in
the socio-demographic structure has increased the burden of non-communicable diseases
(NCDs) (Chaker et al. 2015). Non-communicable diseases (NCDs) are chronic conditions
which manifests with slow progression and are difficult to cure. The four most common
NCDs include cancers, cardio-vascular disease diabetes and chronic respiratory disease
(Kroll, Phalkey and Kraas 2015). In Australia, NCDs account to 91% of the total deaths. This
increase in the rate of occurrence and mortality of non-communicable disease in Australia is
attributable to the increase in total percentage of aged population, rapid urbanization and
lifestyle changes.

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Figure: Australian Statistics of NCDs
(Source: WHO 2017)
According to the World Health Organisation [WHO] (2017), prevalence of NCDs is
overburdening the healthcare system which is further aggravating the impact of NCDs. It is
estimated that the NCDs as cast a cumulative economic loss of 13.2 billion USD per year in
Australia during the tenure of 2011 to 2015 (Chaker et al. 2015). This rising economic and
health burden of NCDs necessitates the certain adjustments in the health care system along
with proper institutionalization surveillance system to track the trends of NCDs along with
the evaluation of the outcomes (Chaker et al. 2015). The following essay aims to analyse the
change in the healthcare system undertaken by the Australian government in order to cope up
with the increase rate of occurrence of the NCDs.

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Global Action Plan: WHO
The World Health Organization (WHO)'s Global Action Plan for the Prevention and
Control of Noncommunicable Diseases (2013–2020) is mainly based on the modifiable risk
factors that are associated with the course of development of the NCDs. The government of
Australia has made adjustments in their healthcare system based on the global action plan
drafted by WHO.
Tobacco
One of the prime targets towards reduction of the premature deaths arising out of the
non-communicable disease includes tobacco smoking. Smoking of tobacco accounts for
about majority of the casualties arising out of the non-communicable diseases like
cardiovascular diseases, chronic respiratory diseases, diabetes and cancer (Glantz and
Gonzalez 2012). Lowering the consumption of tobacco reduces the susceptibility of
developing NCDs, delayed onset and decrease in the overall healthcare cost (Glantz and
Gonzalez 2012). The WHO Convection of Tobacco Control is mainly based on reducing the
affordability of the tobacco, banning smoking in public, banning advertisements related to
tobacco and banning sales of tobacco to and by the children via effective monitoring and
enforcement. Apart from these changes in the administrative and the policy level, WHO has
also drafted change in the health care system in order reduce the threats coming from the
tobacco smoking in the development of NCDs. The WHO proposed to implement affordable
treatment for tobacco dependence along with supporting interventions for smoking cessation
in primary care and affordable pharmacological therapies (Magnusson and Patterson 2015).
The Government of Australia has implemented special smoking cessation therapy in order to
decrease the rare of tobacco dependence and this includes Nicotine Replacement Therapy.
Nicotine Replacement Therapy or bupropion slow release is considered as an effective aid to
motivate the smokers to quit smoking. This therapy is devoid of significant contradiction and

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thus is considered to be helpful interventions for decreasing tobacco dependence. Australian
Government mainly offers NCT to people who smoke more than 10 cigarettes per day at
affordable rates. However, there are certain contradictions in offering NCT which the
Australian government abides by while procuring care to patients who fall under the category
of adolescent smokers, pregnant women, cardiovascular patients and women who are breast-
feeding (Australian Government Department of Health 2017). In order to reduce the rate of
smoking and the development of the NCDs among the Australian aboriginals the government
of Australia has special program targeted towards indigenous population under the regional
grants (since 2011). This program is further supported by the complementary role of the
primary health care services in procuring interventions directed towards aboriginals and
Torres Strait Islanders (Australian Government Department of Health 2017a). The target
towards change in the healthcare system in controlling addiction has been found to procure
effective results towards the possible prevention of NCDs in Australia (Australian
Government Department of Health 2017).
Alcohol
According to Parry, Patra and Rehm (2011) alcohol is another leasing cause behind
the development of the NCDs like the coronary heart disease and cancer. The ill-effects of
alcohol are more prominent among the people who belong from low to middle income
families and the aboriginals. Towards the reduction of the effects of alcohol over the the
development of the NCDs, the government of Australia abides by the WHO global Alcohol
Strategy. This strategy main promotes the increase in the tax over the alcoholic beverages,
implementation of high penalties against smuggled or informal alcohol and restrictions on
alcohol advertising and promoting through the audio-visual media and print media. The
WHO also vouches for health warnings on the alcohol products and strict drink driving
measures (like random breath testing) (Australian Government Department of Health 2012).

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Australian Government Department of Health has special commonwealth funding for alcohol
and drug related activities and this encompass a range of prevention activities guided by the
National leadership (Australian Government Department of Health 2012b). One of the main
preventive activities undertaken for the reduction in the use of the alcohol consumption
among the Australian population includes family based protective programs, school based
protective programs and community based approach. Under these protective programs, the
government of Australia aims to increase the sense of awareness against the harmful effects
of alcohol and its consequences among the target population and thereby plans to reduce the
consumption of alcohol (Australian Government Department of Health 2012a). The
government of Australia, Department of Health has special alcohol prevention programs
directed towards the aboriginals and this includes National Drug Strategy (NDS) and the
National Drug Strategy Aboriginal and Torres Strait Islander Peoples Complementary Action
Plan (CAP). However, Australian Government is planning to replace CAP by the National
Aboriginal and Torres Strait Islander Peoples Drug Strategy, which is based on broad
strategic planning framework for the provision of alcohol, tobacco and other drugs treatment
services Australian Government Department of Health 2012a).
Unhealthy diet
According to Melaku et al. (2018), dietary risk factors are the major contributors
towards the morbidity and mortality associated with the NCDs. Despite these findings, the
food consumption in the developed or developing countries are mainly dominated by the
intake of unhealthy diet. Melaku et al. (2018) is of the opinion that the improvement of the
dietary consumption can be effectively done via the effective involvement of the
stakeholders. Promotion of the healthy diet will help to decrease the overall rate of the
premature death by the end of 2030. However, the information and contribution in the
domain of the dietary risk factors behind the development of the NCDs is limited. Melaku et

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al. (2018) further reported that the despite a decrease in the diet associated NCDs burden
during the last 25 years in Australia, there still exists significant dietary risks behind the
development of NCDs. Interventions directed towards reducing NCDs should be focused
over the dietary behaviours of the individuals and the population groups (Melaku et al. 2018).
According to the report published by WHO, over NCDs, the metabolic risk factor associated
with development of NCDs include over-weight/ obesity, hyperglycemia, hyperlipidemia and
raised blood pressure. In order to promote healthy diet among the overall population as a
whole, the government of Australia has special dietary guidelines known as Australian
Dietary Guidelines. Guideline-1 promotes consumption of nutritional food, Guideline-2
encourage the intake of specific five groups of food each day and this includes adequate
vegetables, whole grains, lean meats, egg and fish, fruits and milk. Guideline-3 mainly limits
the intake of saturated fats, sugar and alcohol. Guideline-4 and Guideline-5 do not directly
promote any specific diet plan but encourage breastfeeding and proper storage of food. Thus
Australian dietary pattern mainly promotes the consumption of food and drinks and simply
not nutrition. The main dietary choices include vegetables, fruits, grains, cereals, milk, meat,
fishes, eggs and nuts along with high intake of water (Australian Government Department of
Health and Ageing 2013). Health care department of Australia via the regulation of specific
diet plan aims to reduce the chances of occurrence of NCDs.
Physical inactivity
Physical inactivity is another risk factor behind the development of NCD and thus
falls under the global action plan of WHO towards preventing the NCDs. Proper level of
physical activity is associated with 30% decrease in the overall risk of ischemic heart disease
along with 27% reduction in the risk of developing diabetes and 21% reduction in the
vulnerability of colon and breast cancer. The government of Australia in order to promote
practice of physical activity among the Australian population have undertaken

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communication strategies, fiscal measures and other regulatory measures for communication
and marketing of the health information that promotes healthy eating and physical activity.
This has found to yield substantial along with cost effective health gains (Lachat et al. 2013).
Australian Institute of Health and Welfare (2017) has national guidelines that outline the
minimum level of physical activity that is required to promote health benefits among the
children between the age group of 5 to 12 years. These guidelines include minimum of 60
minutes to moderate to vigorous physical activity per day, engagement of muscle
strengthening activity 3 days per week, reduction in the sedentary mode of life via reducing
the use of social and electronic medium less than 2 hours per day. For adults who are aged
between 18 to 64 years, minimum level of physical activity will be helpful in securing the
health benefits and thereby reducing the chance of occurrence of NCDs include 75 minutes of
vigorous physical activity or 15 minutes of moderate physical exercise per week. Adults are
also encouraged to undertaken muscle strengthening activities for 2 days per week
(Australian Institute of Health and Welfare 2017).
Non-Communicable Diseases global monitoring framework
One of the principal adjustments undertaken by the Australian healthcare system is
joining the NCDs global monitoring framework. This framework helps to target the venerable
group of population who are at an increased risk of developing NCDs. The main
classification of the framework is mainly based on the level of physical activity,
hypertension, tobacco smoking, and dietary intake of salt, obesity, diet plan and inclusion of
palliative care (Australian Government Department of Health 2012).
Non-communicable disease implications for medical practice
Apart from the healthcare system, the prevalence of NCDs has also caused a transition
in the medical practice in Australia (McNab, Schneider and Leeder 2014).

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Technological advancement and training
The Australian healthcare system has experienced significant technological advances
in order to skilfully manage the NCDs. For example, increase in the prominence of
cardiovascular disease during the later part of the 20th century has promoted innovative
technological advances like electrocardiography. Further advancement during the beginning
of the 21st century include imaging and scanning technologies like stents in order to
effectively diagnose and treat NCDs like cardiovascular complications. In the field of cancer
therapy there are innovations like chemotherapy and radiation therapy. Moreover, rapid
technological advancement also prompted training of the medical professionals in order to get
accustomed with the technological application of NCDs. In the domain of treating diabetes,
the use of insulin spread throughout Australia along with urine and blood sugar testing
(McNab, Schneider and Leeder 2014). The review of the Health Technology Assessment
(HTA) in Australia has lead to the elucidation that the government of Australia apart from
implementing new policies towards the control of the healthcare system and reviews the
effectiveness of the approaches in order to make stringent modifications (Australian
Government Department of Health 2014).
Change in the workforce planning and management
The most predictable change in the health workforce during 20th century is increase in
the number of specialised doctors. In order to manage various components of treatment, new
levels of co-ordination between the generalists, specialists and allied healthcare professionals
were developed. The nurses and their role in health workforce gradually gained prominence
in the domain of successfully managing respiratory problems, cardiac complications and high
blood sugar level. Apart from the role of the nursing professionals, there also occurred
increase in the popularity of the concepts like multidisciplinary team in successful
management of the disease. The main members of the multidisciplinary team include

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physiotherapists, dieticians, and occupational therapists, community health nurse and
psychologists (McNab, Schneider and Leeder 2014). According to Atun et al. (2013), the
healthcare professionals who are under the multidisciplinary team plays an important role in
effectively regulating NCDs. Atun et al. (2013) further opined that the introduction of the
multidisciplinary team in managing NCDs helped in improving disease responsiveness.
Other changing modes in the healthcare system
The health workforce of Australia responded to the increase in the prevalence of
NCDs via conceptualising the diseases in an innovative way and via changing and defining
the roles of the healthcare professionals. These changes not only had implications for the
patients but also for the overall healthcare systems. During 20th century, like most other
western countries, Australia established health insurance coverage for its citizens along with
greater integration of multiple services via co-ordination, flexibility, continuity along policy
change in order to manage the outbreak of the NCDs (McNab, Schneider and Leeder 2014).
In the domain of policy towards prevention and effective control of NCDs, the
government of Australia have Australian National Preventive Health Agency Act which was
established in the year 2010 (Australian Government Federal Register of Legislation 2011).
The main objective of the Act is establishment of an Agency in order to advise on and
critically manage the national health programs (Australian Government Federal Register of
Legislation 2011). The National Preventive Health Agency Act also has numerous other
objectives. First and foremost is effective monitoring and evaluation of the preventive health
strategies. The second is facilitation of the national health prevention research infrastructure
in order to elucidate more innovative interventions in the successful management of the
NCDs. The third objective includes development of partnership for workplace, school and
community based interventions. Fourth objective include proper assistance in developing
sound and nimble health prevention workforce and co-ordination and implementation of

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national approach towards social marketing for the generation of preventive healthcare
programs (Australian Government Federal Register of Legislation 2011).
According to Vision 2020 – The Right to Sight Australia (2018), 80% of the vision
loss arising out of diabetic retinopathy is either treatable or preventable. The organisation in
Australia like Fred Hollows Foundation provides global leadership in tackling the vision loss
arising out of diabetes. During the 2008, the government of Australia have recognised the
common sense in funding blindness prevention programs and acknowledging that limited
sum of money can cast dramatic impact in disease control. This has lead to the origination of
the Global Consortium of Australian eye care organisation which work in association with
the Australian government and other stakeholders across the region and share experience and
expertise sho that the raised fund is spent as efficiently as possible.
Special framework legislation for NCDs control
Framework legislation is important but neglected tools used to improving the health
governance in country. Framework legislation is defined as a set of legislation that sets out a
series of executive deliberations and government actions in order comprehensively guide the
decision making process. Framework legislation helps to create an enabling environment for
improved decision making process in the control and management of the NCDs. Australian
Government has a versatile framework legislation model in its different province in order to
control and co-ordinate the NCDs (Khan, Kalsoom and Khan 2017). Australian State of
Queensland has special legislation in order to crate Healthy Futures Commissions. The role
of these commissions is to support the families and the children towards adopting a healthy
lifestyle and contributing towards reduction in the in the health inequalities. The legislation
also promotes commission to spend at least 55% of its budget over the grants to community
and industry organisations and local government bodies in order to support the functions of

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commission (Khan, Kalsoom and Khan 2017). Australia also has special National Preventive
Health Agency which encourages prevention of NCDs under active partnership with industry,
community sector and non-government organisations. This active collaboration between
different sectors help in generating effective community based approach towards the
prevention of the NCDs. The State of South Australia empowers the ministry of health to
announce the a particular medical condition or disease is entitled under the non-
communicable disease and thereby issuing special code of conduct in order decrease or
reduce the rate of occurrence of that particular NCD (Khan, Kalsoom and Khan 2017).
Conclusion
Thus from the above discussion, it can be concluded that in Australia at least 91 % of
death that rise from the development of NCD. These NCDs also cause increase in the rate of
premature death. Some of the common NCDs include diabetes, cancer, cardio - vascular
diseases and respiratory diseases. So in order to fight against the outbreak of the NCDs at an
explosively high rate, the government of Australia abide by the the Global Action Plan
proposed by WHO. This plan promotes restriction over tobacco and alcohol use along with
the promotion of healthy diet and physical activity. The governent of Australia, Department
of Health also work in favour of proper health work force management and education along
with the promotion of the technological advancement in order to reduce the chance of
occurrence of NCDs. WHO is of the opinion that change in the lifestyle factors help in the
successfully prevention of non-communicable disease and this what the Australian
Government is abiding bide. The Australian government also has their own National Health
Prevention Program to bring changes in the healthcare system, especially financially via
raising and proper utilization of funds.

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