Taking action on prevention and control of noncommunicable diseases in Bhutan by strengthening gross national happiness

  • Gyambo Sithey Centre for Research Initiatives, Changangkha, Thimphu, Bhutan.
  • Anne Marie Thow Menzies Centre for Health Policy, The University of Sydney, NSW, Australia.
  • Jayendra Sharma Policy and planning division, Ministry of Health, Bhutan.
  • Karma Lhazeen Department of public health, Ministry of Health, Bhutan.
  • Mu Li Sydney School of Public Health, The University of Sydney, NSW, Australia
Keywords: Health policy; Global NCD action plan ;Gross national happiness; Noncommunicable diseases; Shared agenda.


Introduction: Noncommunicable diseases (NCDs) are major public health problem in Bhutan, accounting for 68% of total deaths.
The growing epidemic of NCDs threatens the achievement of Gross National Happiness (GNH). NCDs are the results of complex
interaction of social and economic risk factors and change in diet and lifestyle. Effective action to prevent and control these
diseases requires a whole-of-government approach.In this paper we review new evidence to support political priority for NCDs
in Bhutan. One third of the Bhutanese are overweight (33%) and hypertensive (35.7), and 6.4% are diabetic. The prevalence of
modifiable risk factors is also very high. We also present the analysis of strategic policy opportunities for health sector to integrate
the ‘Multisectoral national action plan for the prevention and control of NCDs, 2015-2020’ into policies across all relevant
sectors. Our analysis has identified three specific opportunities for the health sector to engage strategically to strengthen action on
NCDs and GNH, concurrently: 1) raising priority actions on NCDs within the existing GNH multisectoral committee, to achieve
both health and happiness objectives; 2) identifying shared agenda between NCDs and GNH to achieve both health and happiness
objectives; and 3) identifying shared GNH determinants between NCDs and GNH to enhance action on NCDs. Addressing NCDs
aligns with the optimization of Gross National Happiness. It is imperative that the Government of Bhutan recognize that action
on NCDs is an integral element for achieving GNH.


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