1. Country presentation: Maldives
Dr Ali Latheef
Focal Point, NCD unit
IGM Hospital

2. Situation analysis
Geographical distribution
1200 island spread over 900 km; 198 islands are inhabited
Population – 350,000 ; more than 1/3rd lives in capital, Male (2 square kilometers)
NCD burden
% of disease burden
% of NCD deaths
All NCDs
52.8 79
Cancer
13.4 7
CVD
11.4
39.4
COPD
4.5
8.4
Diabetes
2.9 2

3. Overall structure of prevention services and resources
CCHDC – Center for Community Health and Disease Control
Non communicable disease unit
Tobacco control unit
Limited staff at central and Atoll (regional) level
Same staffs look after both NCD program & CD programs
Lack of trained staffs leading preventive work
NGOs –
Diabetic society

4. Achievements in tackling NCDs and their risk factors
Maldives have acknowledged NCD as a top priority.
CVD, DM, COPD and selected cancers were identified
Developed the NCD strategic Plan
The biggest achievement – Law on Tobacco (2010)
Took a long time
Tobacco lobby is very strong
Able to increase the tax on tobacco products, restrict advertising etc
STEPS survey in 2004
Tobacco free islands

5. Challenges encountered in Maldives
At present biggest challenge is political and financial crisis
Privatization of health services
Preventive work significantly affected
Geographical distribution of islands
Transport difficulties
Small population in most of the islands
Most of the fruits and vegetables are imported
Expensive
Unavailable in islands

6. Challenges encountered in Maldives
Difficult to bring changes in to existing regulation
Public involvement is less
Many prominent public figure appear to be on the “other side”
High incidence of drug abuse
Implementing rules and regulations is difficult
Implementation and enforcement of policies
Proliferation of fast food joints
Energy drinks very popular
No regulation on advertising except tobacco

7. Main lessons learnt over the last 5 years
NCD and their risk factors are on the increase’
Adequate preventive measures are lacking all over the country
Strong media advertisement has caused significant increase in sales of soft drinks/energy drinks leading to obesity
Fast food industry is rapidly growing
An adequate budget and a stronger commitment needed from all stake holders

8. Main steps for the next five years
Strengthen the NCD units
Developing capacity for implementing the policies and evaluating the program
Establish NCD units at Atoll level for preventive work
Allocation of sufficient budget for preventive activities and ensure that it remains a priority for all sectors
Establish a close relationship with media
Laws and regulation on advertising on products related to nutrition etc
Strengthen the school health program to reduce childhood obesity

9. THANK YOU