Prevention and control of chronic chest diseases: National Action Plan for NCD Prevention, Control and Health Promotion in Pakistan.

The National Action Plan for Non-Communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD) does not include surveillance of Chronic Respiratory Diseases (CRDs) into the integrated NCD surveillance model due to issues with assessing the magnitude of the burden of CRD in general and chronic obstructive pulmonary disease (COPD) in particular, within populations. Tobacco has been used as a proxy for the magnitude of COPD in the population. However, it stresses on the need to develop acceptable criteria for the diagnosis of CRDs and methodologies to monitor CRDs. The CRD component of the NAP-NCD integrates prevention of CRDs with a comprehensive NCD prevention and control framework with specific emphasis on tobacco as a cross-cutting theme. It prioritizes the examination of trends in outdoor air pollution levels and their determinants in order to develop appropriate public health interventions. Other priority areas include research to quantify the magnitude and determinants of chronic lung diseases attributable to indoor air pollution both in the rural and urban areas; the development of appropriate public health strategies to reduce risks in such settings and the integration of guidance on CRD prevention with an NCD behaviour change communication strategy. The cross-cutting theme of environmental pollution and occupational exposure to toxins develops common action areas for CRD and cancer prevention.