1. Progress in NCD reduction in Russian Federation
Boytsov S.
National Research Center for Preventive Medicine,
Мoscow

2. High level of cardiovascular mortality in Russian Federation (2010 г.)
Life expectancy
Despite the reduction the gap is still very large: 7 years - Estonia, 8 years - of the
"new" EU member states, 12 -years from the "old" members EU

3. 646,7
811,7
801,0
835,5
621,0
769,1
836,2
790,7
757,8
749,8
746,8
813,1
846,1
864,6
907,0
927,5
895,4
908,0
864,8
834,0
400
450
500
550
600
650
700
750
800
850
900
950
1000
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
729,3
2011
Rosstat, 2013
21%
2012
Steady decline in the mortality of the Russian population from
cardiovascular diseases in 2003
number of deaths/
100 000

4. Rising health care costs (per capita) and the reduction in mortality
from CVD
•Primary care improvement
•Centers of high
technologies
•Centers for stroke and ACS
care
•Actions for decrease in
abuse by alcohol and
alcoholism prevention,
reduction of consumption
of tobacco, healthy lifestyle
r=-0,79 p=0,036
r=-1,0 p=0,0001
Spearman rank correlation coefficient

5. Сопоставление среднедушевых доходов
населения и смертности населения от БСК
The growth of per capita income and reduction in mortality from
diseases of the circulatory system
r=-0,79 p=0,036
Spearman rank correlation coefficient

6. Growth in sales of statins and reduced mortality from CVD
packs per year Statins sells
r=-1,0 p=0,0001
Spearman rank correlation coefficient

7. Growth in sales of ACEI and reduced mortality from CVD
ACEI sellspacks per year
r=-1,0 p=0,0001
Spearman rank correlation coefficient

8. The decrease in cigarette sales and reduced mortality from
cardiovascular diseases
R=1,0 p=0,0001
R=0,8 p=0,2
Spearman rank correlation coefficient

9. NCD risk factors input in population mortality in RF
NCD risk factors prevalence in RF
P. Marques Dying Too Young, World Bank, 2005
%
%

10. 59,6%
Reduction in the prevalence of risk factors resulted in 60% reduction in
CVD mortality in Russia in 2003-2009
Shalnova S ., Deev А., 2012
IMPACT

11. The simultaneous implementation of the three strategies for the
prevention of NCDs as the main guarantee of accelerating decline of
mortality
Strategy Implementation Target
part of
population,
%
Input in
NCD
mortality
decrease, %
Time to
result,
years
Part of
expenditures,
%
Population - healthy life style
(programs)
100 50 5-10 10
High risk -population screening and RF
correction
20-30 20 4-5 30
Secondary
prevention (NCD
patients)
-good clinical practice
-improving patients'
adherence to treatment
--RF correction
20-30 30 4-5 60

12. Prevention and control of NCDs require regulation at all levels and the
implementation of a wide range of multi-level and cross-sectoral
measures to the full range of determinants of NCDs (from the
individual to the structural level) in order to create the conditions
necessary for a healthy life
The Moscow Declaration
Adopted at the First Global Ministerial Conference
on Healthy Lifestyles and NCD, April 2011
The Government Commission for the Protection of the health of
citizens of the Russian Federation
multi-level and cross-sectoral cooperation

13. National and regional of NCD prevention programs
•motivation to HLS
•condition for HLS
•-elements of NCD prevention
system
•stuff education
•population screening
•epidemiological monitoring
National program of NCD prevention
Regional program of NCD prevention
Municipal program of NCD prevention
Regional program of NCD prevention
Municipal program of NCD prevention Municipal program of NCD prevention

14. National and regional of NCD prevention programs
•motivation to HLS
•condition for HLS
•-elements of NCD prevention
system
•stuff education
•population screening
•epidemiological monitoring
National program of NCD prevention
Regional program of NCD prevention
Municipal program of NCD prevention
Regional program of NCD prevention
Municipal program of NCD prevention Municipal program of NCD prevention
83regions – 83 programs

15. Participants of cross-sectoral cooperation in NCD prevention
The Government Commission for the Protection of the health of citizens
of the Russian Federation
Legislative and policy structures
State,
municipal and
private health
care
Ministries and
departments
Social,
business and
religious
structures

16. Distinctions in a death rate from CVD between regions of
the Russian Federation

17. Воронеж Томск Санкт-Петербург Оренбург АланияВладивосток
Красноярск Ростов Самара Иваново ТюменьВологда
Cкрининг в 12 регионах по 1200+400 человек
Общий анализ полученной информации
Углубленное обследование в 5 регионах
Санкт-Петербург Томск Ростов Иваново Тюмень
Epidemiological monitoring of risk factors for NCD
in the Russian Federation (ESSE-RF)
Рязань, Кемерово, Хабаровск
Screening in 15 regions of 1600 (1200 + 400) people
Differences
in demographic, economic, climatic, geographical, ethnic
characteristics

18. Information activities in healthy lifestyle modification
(population strategy)
- PSAs on federal and regional TV channels in prime time
- Internet
- FM radio advertising
- School
- Printed matter
- Outdoor advertising
- Telephone inquiry service
- Mass actions

19. Conditions for healthy lifestyle modification
(population strategy)
-Improvement of the regulatory framework
-Excise tax and regulate the production of tobacco, alcohol and food products
-Ensuring the availability of healthy food (production of sufficient quantities of fruits
and vegetables products with reduced fats, trans fats and salt, placing easy to read
information about calories, fat, carbohydrates and salt in foods)
- Creating conditions for daily physical activity (parks within walking distance, bike
paths, accessible sports facilities, stadiums, etc.)

20. A large part of the population with coronary artery disease
and high-risk
Clinical examination (screening):
identify people with CAD and at high risk and to
have them treated and corrected FR

21. Coverage of the population, ranging
from 21 years 1 every 3 years (up to
20 million people/ year)
Correction of risk factors in the
clinical examination
The purpose - early detection NCD
and their risk factors
The precinct-territorial principle of
organization
A differentiated approach to
evaluation by gender and age
Free
Without interfering with the ongoing
work of clinics
Medico-economic assessment
methods
The main features of modern medical examination (screening)
(high risk strategy)
Two-stage

22. More than
24%
Per 100 000
NCD detection increased на 25%
(high risk strategy)

23. 23
The increase in life expectancy
Increasing the number of years of healthy life
Present:
Future:
Prevention
Prevention
Treatment
Treatment
Health Illness
Health Illness
The real shift in priorities in public health from the treatment of
disease to prevention and health maintenance

24. 24
The prevalence of tobacco use in the
adult population,%
The prevalence of salt intake in the
adult population,%
The prevalence of inadequate fruit and
vegetable consumption among adults,
%
The prevalence of hypertension in the adult
population,%
The prevalence of high cholesterol in adults,%
Indicators project of the National Program on NCD prevention
(2013-2020)

25. Actual and forecasted trends of mortality
from the CVD, CHD, and cerebro-vascular diseases
in the Russian Federation
-30,4%
-26,8%
-23,3%
CVD
CHD
Cerebro-vascular
(per 100 000)
WHO target 2013-2020:
“A 25% relative reduction in overall
mortality from cardiovascular diseases,
cancer, diabetes, or chronic respiratory
diseases”