ISLAMABAD The greater disease burden in Pakistan is generally regarded as that of non-communicable diseases (NCD), so the governments plan was to establish a Commission on NCD. But this has hit snags owiing to lack of political will. According to Pakistan Demographic Survey, the burden of NCDs including cardiac conditions, cancers, respiratory illnesses, mental ailments and other diseases have increased over the years while the percentage of deaths attributed to communicable diseases has decreased. Earlier in 2003, the Ministry of Health in consensus with the stakeholders launched a National Action Plan for Prevention and Control of Non-Communicable Diseases and Health Promotion in Pakistan (NAP-NACD). Later, the plan could not be implemented in letter and spirit and the health managers decided to establish a commission on NCDs. The Commission was supposed to address this gap in its programmes by devising sustainable prevention strategies. As per consensus, it was suggested that the Commission should be empowered to enter into agreements with international organisations for financial and technical support. It was decided that the Commission should have its own core staff and core annual budget in order to be sustainable and effective. The proposed National Commission was supposed to be a high-powered Commission to bring together and guide all the efforts to achieve the desired goals. A well-planned and vigorous effort was undertaken by the Ministry of Health to achieve this target of formation of the Commission in shortest possible time but to no avail. To make the process more representative and inclusive, even a series of meetings was carried out with the relevant national stakeholders in the field of NCDs, keeping in mind representation from all the regions, professional associations and key institutions. The outcome of these meetings was a consensus document, defining a course of action for each stakeholder delineating their role in the larger national framework, thus integrating and harmonising their individual strengths for contributing towards combating NDCs in Pakistan. It was suggested that the government would support the initiative by seed money. Subsequently it should be empowered to generate its own resources on recurrent basis through government international organisations and donors. The Commission was also supposed to adopt a mechanism to reach out to provinces and districts in order to guide and monitor the implementation of the national policies. But at the end of the day nothing substantive has happened yet again on a good idea.