Non-communicable diseases (NCDs) account for 73 percent of all deaths in Nepal, highlighting the urgency of the situation. Though, the allocated budget falls significantly short of the Rs35 million budget ceiling proposed for the upcoming fiscal year 2025-26. In the current fiscal year, approximately Rs47 million was allocated for mental health and NCDs combined.

“We had planned several preventive measures against the growing burden of non-communicable diseases, but the allocated budget does not allow us to move forward,” said Dr. Pomawati Thapa, chief of the Non-communicable Disease and Mental Health Section of the Epidemiology and Disease Control Division. “We cannot reduce the rising burden of non-communicable diseases without effective preventive measures.”

The rise in NCDs has been alarming. The Nepal Burden of Disease 2017 report indicated that two-thirds (66 percent) of total deaths were attributable to NCDs.This figure increased to 71.1 percent in the 2019 report.

“The Global Burden of Disease 2021 has shown that non-communicable diseases are responsible for 73 percent of total deaths, and the ratio coudl be even higher now,” said Dr. Meghnath Dhimal, chief researcher at Nepal Health Research Council. “Despite the rising burden of non-communicable diseases, we have not invested much in preventive measures.”

Budget Constraints and Mental Health Programs

The allocated Rs 21.1 million must also cover mental health programs, a situation complex by a recent Supreme court directive.The court ordered on December 2 last year that mental health and NCD programs should be run separately, necessitating additional funding.

“Early diagnosis of ailments and timely,quality care should be ensured.”

The Supreme Court’s directive encompasses budgetary commitments, mental health legislation, multidisciplinary workforces, awareness campaigns against stigma and discrimination, community integration for individuals with mental health issues, and the promotion of alternative therapies.

Preventive measures for NCDs and mental health involve addressing risk factors, promoting healthy lifestyles, discouraging tobacco and alcohol use, encouraging healthy diets and physical activity, managing weight, and promoting mental relaxation techniques. Studies reveal increasing consumption of alcohol, tobacco, salt, and processed foods, coupled with insufficient intake of fruits and vegetables, contributing to cardiovascular diseases.

Doctors emphasize the need for investments in behavior change to reduce the burden of NCDs and mental health issues.

“Early diagnosis of ailments and timely, quality care should be ensured,” said Dr. Basudev Karki, a mental health expert. “I don’t think the budget allocated for the non-communicable diseases and mental health programmes is enough to carry out preventive measures extensively.”

The government has also allocated funds for financial assistance to individuals facing financially burdensome conditions such as cardiovascular disease, cancer, renal failure, Alzheimer’s disease, Parkinson’s disease, head and spinal injury, sickle cell anemia, and stroke.

While financial relief addresses immediate needs, doctors note that it is a curative measure and does not reduce the overall disease burden.

Public health experts advocate for increased focus on NCDs, emphasizing that free testing could save many lives. they also stress the importance of behavioral changes, including improved eating habits and increased physical activity.

“To address the existing burden of non-communicable diseases and mental health, investments should also be made in preventive measures,” said Dr. Karki.