Non-communicable diseases prevention and control in Pakistan: recommendations from policy and public health experts

Non-communicable diseases (NCD) represent a significant and growing global health challenge, disproportionately affecting low- and middle-income countries (LMICs) like Pakistan. Despite their profound public health and economic implications, efforts to address NCD remain fragmented and insufficient. Collaborative platforms play a crucial role in fostering innovation and shaping policies to tackle this crisis effectively. Addressing the significant gaps in NCD initiatives and interventions in LMICs, particularly in Pakistan, the Aga Khan University (AKU), organized a one-day symposium, AKUPI NCDs Research Symposium: A Dialogue on NCDs. This symposium convened policy makers and public health experts from both local and international institutions. This paper synthesizes expert recommendations from a national symposium designed to identify actionable strategies for NCD prevention and control in Pakistan.

Five expert panel discussions were conducted on themes critical for Pakistan: cardiovascular health, cancer prevention, mental health, economic perspectives, and sustainable urban design. The discussions were transcribed and analyzed using Braun and Clarke's thematic analysis framework.

The analysis of discussions from over 30 national and international experts yielded 23 distinct themes. Key recommendations included: 1) Legislating a National NCD Act to establish dedicated units; 2) Shifting resources from tertiary to primary prevention, including integrating CVD risk assessment into existing Lady Health Worker programs; 3) Implementing task-shifting for mental health first aid; 4) Launching targeted, community-co-designed anti-stigma campaigns; and 5) Mandating sustainable urban design principles like the '3-30-300' rule. A critical gap was the absence of dedicated NCD units within the health system and a national policy for NCD and mental health.

The symposium achieved a multi-sectoral expert consensus on a prioritized agenda. These insights provide a clear roadmap for policymakers, emphasizing that effective NCD control requires moving beyond siloed healthcare interventions to address broader social, economic, and environmental determinants through concrete, context-specific policies.