World Health Organization - Regional Office for the Eastern Mediterranean
WHO Country Office in Lebanon

WHO Collaborative Programme

Non Communicable Diseases

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Cancer Control Programme

Situation Analysis:

The issue of cancer has been given attention over the past years. In fact, a consensus workshop held in 1995, resulted in the development of national plan, which defined the priority activities. Following that, a national committee for cancer registry was created and a hospital based cancer registry was proposed but is still not operational.
During this year, a proposal on operating the cancer registry was submitted to the WR and the Italian Cooperation that will fund part of it. An advisory board for preparing plan of action for primary and secondary prevention was also established following the mission of the Regional Advisor, Dr. Oussama El khatib. The cancer registry will be launched next month.

Progress achieved:

- During the period under review, efforts to integrate non-communicable diseases with primary health care continued, and need to be maintained and intensified.
- Revision and approval of proposals for breast cancer awareness campaigns.
- Regular meetings with the concerned societies and the office of the Minister to initiate the cancer registry in Lebanon.

Objectives:

1. Develop and implement a national programme for cancer control.
2. Improve cancer surveillance.

Cardiovascular Diseases Control Programme

Situation Analysis:

Over the past few years, attempts at determining prevalence of risks for CVD were made in Lebanon; the studies conducted on this issue revealed that 20-25% of the adult population suffers from high BP (over 165/95). Moreover, it was found that around 9% of the young adolescents (age 10-14) had elevated BP, and 18% were hypercholesterolimic (1992). This data remains insufficient for decisions on interventions, despite the fact that the MOH has already initiated drug subsidy programmes in several dispensaries across the country for 1998/1999. Cardiovascular disease activities were focused on the promotion of coronary heart diseases, and hypertension control, and on prevention based on risk factors related to non-communicable diseases. Within this context, a pilot project was initiated by leading doctors from the American University of Beirut-Medical Center in Aicha Bakkar area in Beirut; this project is supported by the EU and WHO and aims at determining the level of awareness among the general population and the effect of increasing awareness on the behavior and practice of the community. Besides this, all efforts and resources are still high technology care oriented.

Progress achieved:

Efforts focused on the promotion of hypertension control in the country and its integration with primary health care, as well as public and community awareness for control of risk factors, materialized into two national campaigns. Training of paramedicals and physicians for promotion of guidelines on hypertension control at the PHC level was implemented in the areas of Akkar as a pilot effort. A national expert was recruited for the development of national protocols for hypertension control. This expert was followed during this period through regular meetings and the first draft of the above-mentioned guidelines is expected to show up by end of November 2001. Besides, efforts have been made to launch a national campaign starting on the occasion of the "World Heart Day", September 30, 2001 and it extends for the whole month of October. This campaign involves: Press conference, mass media sessions and seminars in Mohafazat. All concerned parties are involved.
In addition, an advisory board was established after contacting the professionals in these fields to support the Program and to work on the major activities for prevention and control.

Objectives:

1. Reduce mortality and morbidity from CVDs.
2. Develop and implement a national plan for CVD control.
3. Implement a national programme for CVDs.

Diabetes Control Programme

Situation Analysis:

Epidemiological studies done in Lebanon over the past few years have shown that, among other countries in the area, Lebanon has a prevalence of non-insulin dependent diabetes mellitus that is almost double of that of industrialized countries, reaching around 13% in the adult population. These studies have also shown that there is around 6% prevalence of impaired glucose tolerance.

Ministry of Health is trying to ensure availability of drugs at several dispensaries through a collaborative project run by YMCA, a Lebanese NGO, but insulin is still not included. A non-governmental center for management, counselling and education of children with diabetes and their families (the chronic care center) was created a few years ago and is actually considered a model center for children with diabetes. Moreover, two recent studies were conducted regarding the epidemiology of diabetes and cardiovascular disease risk factors and a study on evaluation of health professionals about knowledge in diabetes management.

Efforts to address the problems of diabetes have been displayed; these include a consensus workshop held in 1995 with WHO support, which came out with recommendations and a plan of action. On the other hand, two workshops were conducted for the NGOs on basic concepts regarding diabetes education and management. Nevertheless, these efforts remain insufficient and scattered, and need to be complemented with further interventions.

Efforts focused on general public awareness, materialized into National Diabetes day media campaign. An ad hoc committee was established during this year to work on the preparation of an awareness plan for diabetes. 

Progress achieved:

Preparation of national guidelines for the management of diabetes patients and preparation of training programme for care and management of diabetes is currently being finalized following two consensus meetings prepared and organized by the NCDP and the concerned parties; also, the NCDP organized a very successful campaign to introduce the U-100 insulin, and transfer to U-100 in the Lebanese market was very smooth.
One meeting for the ad hoc committee was organized by the program to define its tasks and to identify priorities for its work.

Objective:

Reduce mortality and morbidity from diabetes.

Genetics and other Non-communicable Diseases Control Programme

Data related to genetic diseases in Lebanon is scattered and insufficient. The results of the research at the Chronic Care Center are being finalized to study thalassemia among military recruits. This serum collected could be used at further stage, to study other genetic diseases. The recommendations, at this level, are to continue improving the database on the genetic disease in the country and interventions will be planned further on accordingly. Further contact with the Chronic Care Center has resulted in submitting a proposal to the NCDP, whereby the programme can benefit from the data generated in the Center on Diabetes and Thalassemia.