NGAWANG JAMPHEL
Paro
Non-Communicable Diseases (NCDs) such as heart disease, cancer, diabetes, and chronic respiratory illnesses are emerging as the biggest health challenge for Bhutan, reflecting a global trend that has alarmed health experts worldwide.
According to the World Health Organization, NCDs are responsible for nearly 80 percent of deaths globally, claiming around 41 million lives every year. Of these, about 77 percent occur in low- and middle-income countries. Bhutan mirrors this pattern, with the Ministry of Health (MoH) reporting that 72 percent of deaths in the country are caused by NCDs. Cardiovascular diseases are the leading contributor, alone accounting for 28 percent of deaths nationwide.
Chief Program Officer at the Ministry of Health, Laigden Dzed, said that the rising burden of NCDs in Bhutan is largely linked to lifestyle changes and unhealthy habits.
“Seventy-two percent of deaths in Bhutan are due to NCDs, and cardiovascular diseases are the leading cause,” he said, pointing out that shifting dietary patterns, reduced physical activity, and the harmful use of alcohol and tobacco are among the main reasons behind this trend.
The data collected by MoH reveals concerning risk factors. Around 31.4 percent of Bhutanese adults consume tobacco, exposing themselves to cancer, heart disease, and respiratory problems. Harmful use of alcohol is even more widespread, with 40.2 percent of the population affected, leading not only to liver disease but also to heart conditions, cancers, and mental health challenges.
Physical inactivity is another worrying factor, with 18.3 percent of adults in Bhutan reporting inadequate exercise, which significantly contributes to obesity, diabetes, and cardiovascular issues.
At the same time, dietary habits remain poor. Nearly 74.6 percent of the population consumes fewer than the recommended five servings of fruits and vegetables per day, depriving the body of vital nutrients. Metabolic risks are also rising, with 30.3 percent of Bhutanese adults living with high blood pressure and 5.6 percent showing elevated blood sugar levels. These conditions heighten the risk of complications such as diabetes, strokes, and kidney disease.
Health officials admit that tackling these issues is not simple, since lifestyle changes are often the most difficult to implement.
Studies suggest that it takes an average of 66 days to form a new habit, and in Bhutan, cultural practices around alcohol consumption, traditional diets, and the challenging mountainous geography make it harder for people to adopt healthier routines. Scattered rural populations often have limited access to health services, fresh produce, and safe spaces for physical activity, further complicating the fight against NCDs.
In response to this growing crisis, the Ministry of Health has launched the Quad 80 strategy, a nationwide initiative designed to strengthen the prevention and management of non-communicable diseases.
The program is built on four interconnected goals, each set at 80 percent. The first target is to ensure 80 percent of the population is screened for hypertension and diabetes, with community-based programs reaching even remote villages.
The second aims at ensuring 80 percent of diagnosed patients receive proper follow-up and monitoring, which will help with medication adherence and timely treatment adjustments.
The third focus is on protocol-based management, which will provide standardized, evidence-based care across the health system.
Finally, the strategy sets a goal of achieving an 80 percent control rate, meaning that patients with hypertension or diabetes will be able to maintain safe blood pressure and glucose levels, reducing risks of severe complications like heart attacks, strokes, and kidney failure.
Health officials note that the Quad 80 strategy is closely aligned with Bhutan’s 13th Five-Year Plan, which prioritizes the health and well-being of its people. It also contributes to Sustainable Development Goal 3.4, a global target set by the United Nations to reduce premature deaths caused by NCDs by one-third by the year 2030.
By taking a comprehensive approach that combines prevention, early detection, treatment, and community engagement, the Ministry of Health hopes to bring down the country’s rising NCD burden.
Despite these efforts, experts acknowledge that challenges remain. Widespread cultural acceptance of alcohol, the limited availability of fresh produce in rural markets, and inadequate recreational spaces are barriers that cannot be overcome overnight.
Moreover, ensuring that patients follow treatment protocols consistently requires sustained community support and strong health systems. Still, the introduction of Quad 80 and ongoing awareness campaigns have given officials confidence that Bhutan can begin to turn the tide against NCDs.
