Domestic Activities

Combating the rise in heart disease

While mortality from cardiovascular disease (CVD) has been falling at an annual rate of 2% in Western Europe, it has been increasing by as much as 6% each year in the Eastern and Central European countries. In Yugoslavia and in the Republic of Srpska(Entity in Bosnia and Herzegovina), after decreasing between 1980 and 1990, by 1996 the trend had reversed and CVD mortality was up and increasing. Reversing this disturbing trend is the prime goal of Bosnia and Herzegovina Foundation of Health and Heart.

Plan to stop CVD at national and local level

Entity Republic of Srpska-Bosnia and Herzogovina's Strategy of Health Protection Development sets stopping the increase in mortality from CVD as one of its priorities. In early 1999 the Cardiovascular Diseases Prevention Programme was drafted, amended by the Sector for Reform and Reconstruction of the Health Ministry and the Health Insurance Fund and promotion began. The relevant ministries are both defining and tackling the problems, while also seeking outside funding, including European Union funding, to help meet the challenges.

An advisory body called the National Committee for Cardiovascular Diseases was formed in 2000 to give advice to the Ministry of Health and Social Protection. The committee will conduct inter-sector analyses of activities already carried out and define guidelines and recommendations for future work.

A pilot project drafted by the committee proposes a unique programme for monitoring CVD. Initial results show that patients suffering from coronary diseases present modifiable risks. Of the 430 patients studied, 40.5% were smokers, 74.3% suffered from hypertension, 28.4% had hyperlipidaemia, while 25.7% were obese. Nearly one-quarter of the patients were diabetic. These figures confirmed the direction that CVD prevention should take in Bosnia-Herzegovina.

One of the first goals locally is to improve the training that physicians receive in primary health care. European recommendations have been translated into the local language, printed and are being distributed to practising physicians. Doctors are coming together for training in the latest recommended treatments in seminars, while learning about the

importance of advising their patients on CVD prevention. In August 2002, for example, 180 physicians were trained in regional seminars, and then delivered public speeches, lectures in schools and programmes in the local media to educate the general public.Smoking is being attacked at the national level, with a special programme and the enactment of legal regulations restricting smoking in public places.

The Diabetes Development Project started in 2002. It established the Health and Diabetes Foundation whose aim is to review the diagnosis and the treatment of patients suffering from diabetes with a view to reducing cardiovascular complications.

The Ministry of Health and Social Protection formed a National Committee which is in charge of drafting a food and nutrition policy including a food and nutrition action plan in accordance with the World Health Organization's European action plan for food and nutrition.

Cooperation at a European level

The Bosnia and Herzegovina Foundation of Health and Heart observes the activities that take place in the framework of the EU-supported European Heart Health Initiative and has subscribed to the Winning Hearts' declaration in a slightly adapted version to day that every child born in the XXI century should not suffer from cardiovascular diseases before the age of 70.