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(1)

Total population (in 000s)

a

:

1318

GDP per capita (in US$)

b

:

1294.2 Total deaths (2016)

c

: 7200

Total NCD deaths (NCD deaths as

% of total deaths)

c

: 3300 (46%)

TIMOR-LESTE

National capacity for prevention and control of NCDs in SEA Region 2019: Country profiles

Off track

1

Premature

mortality (probability of dying before the

age of 70, %) Tobacco use (%)

Heavy episodic drinkers

(%)

Physical inactivity

(%) Obesity

(%) Hypertension (%)

Per capita salt consumption

(g)

Population that use solid fuels as primary source for

cooking

d

(%) Incomplete data

On track

2

Global targets

d

(in terms of relative

percentage reduction) 25 30 10 10 Halt the

rise 25 30 50

(Regional goal only) Country targets

(in terms of relative

percentage reduction) 20 20 10 10 Halt the

rise 25 Not set Not set

Baseline

e

23.2

(2010)

44.3

(2010) NA NA

0.8

(2009)

NA 11.2

(2010)

95.0

(2010)

Current status

f

19.9

(2016)

36.9

(2018)

14.5

(2014)

16.7

(2014)

1.5

(2016)

39.3

(2014)

NA 88.0

(2018)

National targets

(Absolute) (2025) 18.6 35.4 NA NA 0.8 NA Not set Not set

I. Public health infrastructure, partnerships and

multisectoral collaboration for NCDs and their risk factors

An exclusive organizational unit for NCDs Total number of staff

Yes 11 or more Multisectoral mechanism

(Year of establishment)

Under-development (Informal) (2018)

Chair of multisectoral mechanism Coordinated by NCD department Dedicated funding for NCDs Yes Earmarking of taxes from tobacco and alcohol for health

Tobacco (None) Alcohol (None)

II. Plans, policies and strategies

Integrated multisectoral action plan

addressing all risk factors & diseases Multisectoral action plan for the prevention and control of noncommunicable diseases in Timor-Leste (2018–2021)

Is the plan costed No

Operational tobacco control law/

regulation Decree Law No. 14/2016 on

Tobacco Control Regime Operational alcohol control law/regulation

for comprehensive ban No (under development)

Tobacco taxes as percentage of price of 20 most sold brand of cigarettes (2018)

g

21.8%

Affordability in 2018 of cigarettes – less

since 2008

g

Yes

Guidelines for physical activities with recommended level for children, adolescents and adults

No

Implementation of national public awareness campaigns for physical activity

Yes

Availability of food-based dietary

guidelines Yes

Front-of-pack labelling for packaged foods to indicate high level of sugar, salt, saturated fats or transfat

No

Salt control policy – on reformulation of

food No

Salt control policy – front-of-pack labelling No Implementation of public campaigns for

salt No

m-health interventions for NCD risk

factors & NCDs No

(2)

III. Capacity for NCD early detection, treatment and care within the health system

Availability of evidence-based guidelines/protocols in primary care settings by public authorities for the management of

NCDs (Cardiovascular disease, diabetes cancer,

chronic respiratory disease) Yes

Alcohol dependence, tobacco dependence,

overweight/obesity & physical inactivity Yes (except for alcohol dependence) Availability of basic technologies in 50% or more health-care facilities in the public sector

Equipment for measurement of height and weight Yes

Blood glucose measurement Yes

Oral glucose tolerance test No

HbA1c test No

Dilated fundus examination Yes

Foot vibration perception by tuning fork Yes Urine strips for glucose and ketone measurement No

Blood pressure measurement Yes

Total cholesterol measurement No

Urine strips for albumin assay No

Peak flow measurement spirometry Yes

Availability of essential medicines for prevention and control of NCDs in primary care facilities

Anti-diabetic medication Metformin (Yes), sulphonylureas (No), insulin (Yes)

HPV vaccination No

Anti-hypertensive drugs Thiazide diuretics (Yes), ACE inhibitors (Yes), ARBs (Yes), calcium channel blockers (Yes), beta blockers (Yes)

Cardiovascular disease drugs Aspirin 75/100 mg (Yes), statins (Yes) Chronic respiratory disease

drugs Bronchodilator (Yes),

Steroid inhaler (Yes)

Oral morphine No

Benzathine penicillin injection Yes Nicotine replacement therapy No Screening for cervical cancer

(Program, Method, Coverage)

Opportunistic, VIA, ≤10%

(1.1% in 2014 STEPs survey) Proportion of health facilities

offering CVD risk stratification <25%

IV. Health information systems and surveillance

Exclusive dedicated staff/office/department/division No

h

A functional system (either CRVS or SRS) that provide national reliable estimates of mortality from main NCDs Yes

% of deaths registered in CRVS 20%–49%

Time lag in availability of mortality data from CRVS/SRS

(latest year of data available) 2 years (2017)

Risk factor data among adolescents (with latest year of data available):

An integrated risk factor survey within last 5 years Availability of at least two data points for most risk factors in last 10 years

Yes (2015) No (only in 2015) Risk factor data among adults (with latest year of data available):

An integrated risk factor survey within last 5 years Availability of at least two data points for most risk factors in last 10 years

Yes (2014) No (only in 2014) Time lag in publication of data from (with latest year of data available):

Most recent integrated risk factor survey Cancer registry

Diabetes registry

1 year (2014) Started in 2019 None

a. United Nations, Department of Economic and Social Affairs, Population Division (2019).

World Population Prospects 2019, Online Edition.

b. World Bank national accounts data (2019).

c. WHO Global Health Estimates (2016) as downloaded from GHO (https://apps.who.int/gho/

data/node.searo.A860).

d. The regional targets set in “Action plan for the prevention and control of noncommunicable diseases in South-East Asia, 2013–2020” are the same as the global targets set in 2013 in “Global NCD monitoring framework” for all indicators except for an additional regional target of “50% relative decrease in households using solid fuels as primary source for cooking between 2010 and 2025”. Though the indicator in the Regional plan and national plan refer to the percentage of “households” using solid fuel, data on the percentage of the

“population” using solid fuels is presented here. Timor-Leste did not use this indicator or set a target for it in their national plan.

e,f Sources of data:

Premature mortality (Probability of dying before age 70): Both the baseline and current situation data are based on WHO Global Health Estimates (2016) as downloaded from GHO (https://apps. who.int/gho/data/node.searo.A857)

Tobacco use (Percentage of population using any tobacco product-smoked or smokeless):

Both the baseline and current situation data are from WHO estimates of prevalence published in 2019, taking into account all the population-based surveys conducted between 1990 and 2018. https://apps.who.int/gho/data/view.searo.GSWCAH20v as downloaded on June 25, 2020. The last National NCD risk factor survey (STEP survey) that measured tobacco prevalence was conducted in 2014 and tobacco use prevalence (18–69 years) was 56.1% (https://www.who.int/ncds/surveillance/steps/timor-leste).

Heavy episodic drinking (alcohol): No baseline data are available. The current situation data are from the NCD STEP surveys 2014. GIASH estimated 9.7% in 2016 (http://apps.

who.int/gho/data/node.gisah-searo.A1046).

Physical inactivity (Percentage with <150 minutes of activity per week): No baseline data are available. The current situation data are from the NCD STEP surveys 2014.

Obesity (BMI≥30 Kg/m2): The baseline and current situation data are from “Demographic and Health Survey for women 15–49 years old. The National NCD risk factor survey 2014 measured obesity prevalence at 0.9%. DHS 2016 also estimated obesity prevalence among 15–59 years old men at 0.7%.

Hypertension (Percentage with raised blood pressure (SBP≥140 and/or DBP≥90 mmHg) or currently on medication for raised blood pressure): Same data source as physical inactivity.

Per capita salt consumption: The baseline estimate was from Powles (2013) https://

bmjopen.bmj.com/content/bmjopen/3/12/e003733.full.pdf. No other nationwide estimates are available. Timor-Leste did not use this indicator or set a target for it in their national plan.

Percentage of population that use solid fuels as primary source of cooking: the data are from Global Household Energy Database, 2020 update. (https://apps.who. int/

gho/data/node.searo.SDGFUELS712). The percentage of households using solid fuels is estimated as (100 - percentage of population with primary reliance on clean fuels and technologies).

g. WHO report on the global tobacco epidemic 2019. https://apps.who.int/iris/bitstream/han dle/10665/326043/9789241516204-eng.pdf

h. An office/dept./administrative division within the MOH not exclusively dedicated to NCD surveillance.

1. On track: The rate country has made sufficient progress between 2010 and the year for which data are available and are either ahead or less than 2 years off track to achieve the goal by 2025. If the country continues to make the progress at the same or slightly higher rate, it will be able to achieve the 2025 target.

2. Off track: Country may have made progress on the indicator, but the rate of progress made is not sufficient to achieve the 2025 target. As of the current year for which data are available, the country is behind by at least two years equivalent to the annual decline needed between 2010 and 2025 to achieve the target. The country needs to accelerate the rate of progress to achieve the 2025 target.

For full report refer to https://apps.who.int/iris/handle/10665/333806 For technical information, please contact: Dr Manju Rani, Regional Adviser (NCD Governance, Policy, and Surveillance), Email: ranim@who.int; Mr Naveen Agarwal, Surveillance Management Associate, Email: agarwaln@who.int

TIMOR-LESTE

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