Longevity Campaign, the “Silkroute-to-health” initiative

Longevity Campaign, the “Silkroute-to-health” initiative

Syed Mahboob Ali Shah, MBBS, MPH, PHD

NCDs Surveillance Specialist for WHO Emro Countries

World Heart Federation Emerging Leader for NCDs Prevention

Co-founder Silkroutetohealth

People in Gilgit Baltistan, like many developing countries, are suffering from the “double burden” of disease where they have not overcome the infectious diseases and maternal and child health issues, are now being affected by rising non-communicable or life style related illnesses such as hypertension, cardiovascular diseases, diabetes and cancer impacting the quality of their lives.
Geographical isolation of the region, lack of awareness, loss of harmony between man and nature, poor diet and hygiene and issues of availability and access to the health care services are few among the host of factors further compound the health situation.
Silkroutetohealth (www.silkroutetohealth.org) is a volunteer-centered, civil society initiative, dedicated to improve health, education and environment in Gilgit Baltistan. It aims to encourage partnerships between professionals and organizations with expertise in health, education and environment in the village and out of the village (in country or overseas) to contribute towards healthy, literate and safe villages.
The health team of silkrouetohealth has launched its longevity campaign in collaboration with local government and non-governmental organizations working to improve health in the region. The major target has been in the area of non-communicable diseases.
Non-communicable diseases (NCDs) are emerging as a major threat for survival of human life across the globe, particularly in developing countries. Based on the scientific evidence four types of NCDS, including cardiovascular diseases, cancers, chronic respiratory diseases and diabetes account for 80% of mortality in adults.
2

In May 2013 the 66th World Health Assembly adopted the comprehensive global monitoring framework (GMF) for the prevention and control of NCDs. The Global Monitoring Framework included a set of indicators capable of application across regions and country settings to monitor trends and assess progress made in the implementation of national strategies and plans on non-communicable diseases. With the aim of reducing premature death and improve the quality of life, the action plan of the Global Strategy for the Prevention and Control of NCDs addresses surveillance as a key component in monitoring NCDs. The WHO Global Action Plan (2013-2020) and its related resolution (WHA66.10) urges countries to strengthen surveillance and monitoring systems for the prevention and control of non-communicable diseases (NCDs). It consists of three major components:
a) monitoring outcomes (mortality and morbidity);
b) monitoring exposures (NCD risk factors); and
c) assessing national health system capacity and response.
World Heart Federation agrees that if we control three important risk factors i.e. high blood pressure, dyslipidemia (low HDL-cholesterol, high total cholesterol, high LDL-cholesterol and triglycerides) and tobacco consumption and exposure, we can prevent 80% of cardiovascular disease associated mortality. Under the WHO Global Monitoring Framework, the following nine areas have been selected to be targets by WHO member countries in Emro region, including Pakistan, to be achieved by the year 2025.
3
WHO targets for developing countries including Pakistan include one mortality target (a 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases) and six risk factors targets (alcohol use, physical inactivity, dietary sodium intake, tobacco use, raised blood pressure, and diabetes and obesity), and two national systems targets (drug therapy to prevent heart attacks and strokes, and essential NCD medicines and technologies to treat major NCDs.
Putting NCDs on Surveillance Screen in Gilgit Baltistan
Introduction and Methods
Population-based surveillance of NCDs is the cornerstone to respond to the NCD challenge of epidemic proportion in any country or region. The surveillance includes estimation of major risk factors in representative samples of population aged 18 to 70 years, estimate the current burden and recent trends in NCD mortality and the national systems capacity to respond to the NCD challenge of epidemic proportions.
Our team of researchers, under the supervision of Dr. Syed Mahboob Ali Shah, conducted NCD surveillance studies in collaboration with local government and Aga Khan Health service, A dedicated team of medical students from Gilgit Baltistan, contributed significantly in partnership with research team to conduct population-based studies in Hunza, Nagar and Ghizar districts to collect data on NCDs and risk factors for NCDS.
Methods:
The study was completed in adults aged ≥ 18 years in a random sample of 1000 households. The questionnaire comprised an adapted version of WHO STEPwise approach to Surveillance, “STEPS”, developed by WHO for the measurement of NCD risk factors at the country level. The
4
questionnaire interview collected information that included demographic characteristics, personal and family and disease history, history of current and past consumption of cigarettes, alcohol, other forms of tobacco (history of exposure to second hand tobacco), and physical activity. Information related to the diagnosis and treatment history of hypertension and diabetes was also collected.
Information on physical activity was obtained using the International Physical Activity Questionnaire (IPAQ-short version) which measures the frequency (days per week), and duration (minutes per day) of moderate- and vigorous-intensity physical activity, in bouts of at least 10 minutes during the past 7-day period. We also measured nutritional status measuring height, weight. Waist, hip circumference using standard equipments (SECA Hamburg, Germany). The WHO cut-offs were used to classify subjects as overweight (25.0-29.9 kg/m2) or obese (30.0 kg/m2) [21]. Waist circumference and waist-to-hip ratio was used to define central obesity. Fasting blood samples were taken to measure lipid levels and blood sugar. American Diabetes Association criteria used to define prediabetes and diabetes.
We used calibrated automated sphygmomanometer (Omron HEM-705cp Intellisense Blood Pressure Monitor). We classified participants as hypertensive if they had a measured systolic blood pressure above 140, diastolic blood pressure above 90, or if they reported taking medications that treat hypertension.
RESULTS: Hunza & Nagar Districts at page 5

5
HUNZA DISTRICT
N
95.8
82.5
57.7
82.4
55
13.4
0
20
40
60
80
100
120
18-35
36-49
≥50 ≥50
Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & Participants having formal schooling (%) by age & gendergender gendergender
Male Male
FemaleFemaleFemale
40
36.1
23.9
50
25
25
0
10
20
30
40
50
60
Under secondary Under secondaryUnder secondaryUnder secondary Under secondaryUnder secondaryUnder secondaryUnder secondaryUnder secondaryUnder secondary
SecondarySecondarySecondarySecondarySecondarySecondarySecondary
College/University College/UniversityCollege/UniversityCollege/UniversityCollege/UniversityCollege/UniversityCollege/University College/UniversityCollege/University College/University College/UniversityCollege/University
Level of formal schooling (%) among participants Level of formal schooling (%) among participantsLevel of formal schooling (%) among participants Level of formal schooling (%) among participants Level of formal schooling (%) among participantsLevel of formal schooling (%) among participantsLevel of formal schooling (%) among participants Level of formal schooling (%) among participantsLevel of formal schooling (%) among participants Level of formal schooling (%) among participants Level of formal schooling (%) among participants Level of formal schooling (%) among participants Level of formal schooling (%) among participantsLevel of formal schooling (%) among participantsLevel of formal schooling (%) among participants Level of formal schooling (%) among participants Level of formal schooling (%) among participants Level of formal schooling (%) among participantsLevel of formal schooling (%) among participants Level of formal schooling (%) among participants Level of formal schooling (%) among participantsLevel of formal schooling (%) among participants
Male Male
FemaleFemaleFemale
6
12.5
41.3
63.1
9.5
28.7
61.4
0
10
20
30
40
50
60
70
18-35
36-49
≥50 ≥50
Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age Prevalence of hypertension (%) by age
Male Male
FemaleFemaleFemale
7
56
28.5
8.5
3.4
48
34.2
14.5
0
10
20
30
40
50
60
Underweight UnderweightUnderweightUnderweight UnderweightUnderweightUnderweight
NormalweightNormalweightNormalweight NormalweightNormalweightNormalweightNormalweightNormalweightNormalweight
OverweightOverweight Overweight OverweightOverweightOverweight
ObeseObeseObeseObeseObese
Nutritional Status (%) by genderNutritional Status (%) by genderNutritional Status (%) by gender Nutritional Status (%) by gender Nutritional Status (%) by genderNutritional Status (%) by gender Nutritional Status (%) by gender Nutritional Status (%) by genderNutritional Status (%) by gender Nutritional Status (%) by genderNutritional Status (%) by genderNutritional Status (%) by gender Nutritional Status (%) by genderNutritional Status (%) by gender Nutritional Status (%) by genderNutritional Status (%) by gender
Men Men
WomenWomenWomen Women
7
33.5
65.4
66.7
37.1
45.1
48.9
0
10
20
30
40
50
60
70
80
NormalweightNormalweightNormalweight NormalweightNormalweightNormalweightNormalweightNormalweightNormalweight
OverweightOverweight Overweight OverweightOverweightOverweight
ObeseObeseObeseObeseObese
Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional status Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional status Prevalence of hypertension by nutritional status Prevalence of hypertension by nutritional status Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional status
Men Men
WomenWomenWomen Women
83.5
10.1
6.4
80.6
11.8
7.6
0
10
20
30
40
50
60
70
80
90
NormalNormalNormal
Prediabetes PrediabetesPrediabetesPrediabetes PrediabetesPrediabetes Prediabetes
Diabetes Diabetes DiabetesDiabetes Diabetes
Prevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetes Prevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetes Prevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetes Prevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetes Prevalence of prediabetes and diabetes Prevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetes Prevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetesPrevalence of prediabetes and diabetes
Men Men
WomenWomenWomen Women
8
10.3
7.7
35.8
64.8
14.6
10.4
27.8
72.2
0
10
20
30
40
50
60
70
80
High_cholesterolHigh_cholesterolHigh_cholesterolHigh_cholesterolHigh_cholesterolHigh_cholesterolHigh_cholesterolHigh_cholesterolHigh_cholesterolHigh_cholesterolHigh_cholesterolHigh_cholesterol High_cholesterol High_cholesterol
High_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterol High_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterolHigh_LDL_cholesterol High_LDL_cholesterol High_LDL_cholesterol
High TriglyceridesHigh TriglyceridesHigh TriglyceridesHigh TriglyceridesHigh Triglycerides High Triglycerides High TriglyceridesHigh TriglyceridesHigh Triglycerides High TriglyceridesHigh Triglycerides High TriglyceridesHigh TriglyceridesHigh Triglycerides
Low_HDLLow_HDLLow_HDLLow_HDLLow_HDLLow_HDL
Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex Prevalence of Dyslipidemia (%) by sex
Men Men
WomenWomenWomen Women
8.3
23.8
44.9
22.9
40
58.5
0
10
20
30
40
50
60
70
18-35
36-49
≥50 ≥50
Prevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by gender Prevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by gender Prevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by gender Prevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by gender Prevalence of abdominal obesity (%) by gender Prevalence of abdominal obesity (%) by gender Prevalence of abdominal obesity (%) by gender Prevalence of abdominal obesity (%) by gender Prevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by gender Prevalence of abdominal obesity (%) by gender Prevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by genderPrevalence of abdominal obesity (%) by gender
Men Men
WomenWomenWomen Women
9
71.7
38.9
84.7
39.3
0
10
20
30
40
50
60
70
80
90
Moderate ModerateModerateModerateModerate
VigorousVigorousVigorousVigorousVigorous VigorousVigorous
Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at Proportion (%) reporting physical activity (for at least 60 minutes a day) in last one week least 60 minutes a day) in last one week least 60 minutes a day) in last one week least 60 minutes a day) in last one weekleast 60 minutes a day) in last one weekleast 60 minutes a day) in last one week least 60 minutes a day) in last one weekleast 60 minutes a day) in last one week least 60 minutes a day) in last one week least 60 minutes a day) in last one weekleast 60 minutes a day) in last one weekleast 60 minutes a day) in last one week least 60 minutes a day) in last one weekleast 60 minutes a day) in last one week least 60 minutes a day) in last one week least 60 minutes a day) in last one week least 60 minutes a day) in last one week least 60 minutes a day) in last one week
Men Men
WomenWomenWomen Women
93.5
94.8
Men Men
WomenWomenWomen Women
Reported use of salted tea %Reported use of salted tea %Reported use of salted tea %Reported use of salted tea % Reported use of salted tea %Reported use of salted tea %Reported use of salted tea %Reported use of salted tea %Reported use of salted tea % Reported use of salted tea % Reported use of salted tea % Reported use of salted tea %Reported use of salted tea %Reported use of salted tea %Reported use of salted tea %Reported use of salted tea %Reported use of salted tea % Reported use of salted tea %
(4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average) (4 cups of tea in a day on average)
10
18.3
40.5
27.6
36.5
14.2
0.6
3.7
2.2
17.9
14.9
0
5
10
15
20
25
30
35
40
45
Smoke currentSmoke current Smoke current Smoke current Smoke currentSmoke currentSmoke current Smoke currentSmoke current
Smoke pastSmoke past Smoke past Smoke past Smoke past Smoke past
Snuff or naswarSnuff or naswarSnuff or naswarSnuff or naswar Snuff or naswar Snuff or naswar Snuff or naswar Snuff or naswarSnuff or naswar
Exposure at workExposure at workExposure at workExposure at workExposure at workExposure at workExposure at work Exposure at work Exposure at workExposure at workExposure at work
Exposure atExposure atExposure atExposure atExposure atExposure atExposure at Exposure at homehomehome
Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, Proportion (%) smoke cigarette, use snuf, exposed to secondhand smokingexposed to secondhand smoking exposed to secondhand smoking exposed to secondhand smokingexposed to secondhand smokingexposed to secondhand smoking exposed to secondhand smoking exposed to secondhand smokingexposed to secondhand smoking exposed to secondhand smokingexposed to secondhand smokingexposed to secondhand smoking exposed to secondhand smoking
Men Men
WomenWomenWomen Women
11
RESULTS NCDs Nagar District
83.2
67.3
33.3
48.7
6.4
6.8
0
10
20
30
40
50
60
70
80
90
18-35
36-49
≥50 ≥50
Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in Participants Reporting Formal Schooling (%) in NagarNagar Nagar
Men Men
WomenWomenWomen Women
34.3
52.1
21.1
26.8
41.6
24.1
0
10
20
30
40
50
60
Under-secondary Under-secondaryUnder-secondaryUnder-secondary Under-secondaryUnder-secondaryUnder-secondaryUnder-secondaryUnder-secondaryUnder-secondary
SecondarySecondarySecondarySecondarySecondarySecondarySecondary
College/University College/UniversityCollege/UniversityCollege/UniversityCollege/UniversityCollege/UniversityCollege/University College/UniversityCollege/University College/University College/UniversityCollege/University
Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar Level (%) of formal Schooling in Nagar
Men Men
WomenWomenWomen Women
12
12.4
36.5
36.7
15.1
17
35.1
0
5
10
15
20
25
30
35
40
18-35
36-49
≥50 ≥50
Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and Prevalence of hypertension (%) by age and gender, Nagargender, Nagar gender, Nagargender, Nagar gender, Nagar gender, Nagar gender, Nagar
Men Men
WomenWomenWomen Women
9.5
64.4
21.1
4.9
6.6
62.6
22
8.7
0
10
20
30
40
50
60
70
Underweight UnderweightUnderweightUnderweight UnderweightUnderweightUnderweight
Normal weightNormal weightNormal weight Normal weight Normal weightNormal weightNormal weightNormal weightNormal weight
OverweightOverweight Overweight OverweightOverweightOverweight
ObeseObeseObeseObeseObese
Nutritional status (%) by genderNutritional status (%) by genderNutritional status (%) by gender Nutritional status (%) by genderNutritional status (%) by genderNutritional status (%) by genderNutritional status (%) by gender Nutritional status (%) by gender Nutritional status (%) by genderNutritional status (%) by gender Nutritional status (%) by genderNutritional status (%) by gender Nutritional status (%) by genderNutritional status (%) by gender Nutritional status (%) by genderNutritional status (%) by gender
Men Men
WomenWomenWomen Women
13
21.4
41.7
50
18.2
28.6
20
0
10
20
30
40
50
60
Normal weightNormal weightNormal weight Normal weight Normal weightNormal weightNormal weightNormal weightNormal weight
OverweightOverweight Overweight OverweightOverweightOverweight
ObeseObeseObeseObeseObese
Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional status Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional status Prevalence of hypertension by nutritional status Prevalence of hypertension by nutritional status Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional statusPrevalence of hypertension by nutritional status Prevalence of hypertension by nutritional status
Men Men
WomenWomenWomen Women
86.6
11
2.4
91.1
7.1
1.8
0
10
20
30
40
50
60
70
80
90
100
NormalNormalNormal
Prediabetes PrediabetesPrediabetesPrediabetes PrediabetesPrediabetes Prediabetes
Diabetes Diabetes DiabetesDiabetes Diabetes
Prevalence of prediabetes and diabetes (%) Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%) Prevalence of prediabetes and diabetes (%) Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%) Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%)Prevalence of prediabetes and diabetes (%) Prevalence of prediabetes and diabetes (%)
Men Men
WomenWomenWomen Women
14
7.3
10.1
18.2
1
4
6.1
0
2
4
6
8
10
12
14
16
18
20
Normal weightNormal weightNormal weight Normal weight Normal weightNormal weightNormal weightNormal weightNormal weight
OverweightOverweight Overweight OverweightOverweightOverweight
ObeseObeseObeseObeseObese
Prevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional status Prevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional status Prevalence of diabetes (%) by nutritional status Prevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional status Prevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional status Prevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional status Prevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional status Prevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional status Prevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional statusPrevalence of diabetes (%) by nutritional status Prevalence of diabetes (%) by nutritional status
Prediabetes PrediabetesPrediabetesPrediabetes PrediabetesPrediabetes Prediabetes
Diabetes Diabetes DiabetesDiabetes Diabetes
5.7
0.5
12.1
3.6
0
2
4
6
8
10
12
14
Prediabetes PrediabetesPrediabetesPrediabetes PrediabetesPrediabetes Prediabetes
Diabetes Diabetes DiabetesDiabetes Diabetes
Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by Prevalence of Prediabetes and diabetes (%) by abdominal obesity abdominal obesityabdominal obesity abdominal obesity abdominal obesity
No abdominal obesityNo abdominal obesityNo abdominal obesity No abdominal obesityNo abdominal obesityNo abdominal obesity No abdominal obesity No abdominal obesityNo abdominal obesityNo abdominal obesityNo abdominal obesityNo abdominal obesity
Had abdominal obesityHad abdominal obesity Had abdominal obesity Had abdominal obesityHad abdominal obesityHad abdominal obesity Had abdominal obesity Had abdominal obesityHad abdominal obesityHad abdominal obesityHad abdominal obesityHad abdominal obesity
15
4.8
6.5
20.7
78.5
4.7
5.4
18.6
74.4
0
10
20
30
40
50
60
70
80
90
High total cholesterolHigh total cholesterolHigh total cholesterolHigh total cholesterolHigh total cholesterol High total cholesterol High total cholesterolHigh total cholesterolHigh total cholesterolHigh total cholesterolHigh total cholesterolHigh total cholesterolHigh total cholesterolHigh total cholesterol High total cholesterolHigh total cholesterolHigh total cholesterol
High LDL-CholHigh LDL-CholHigh LDL-CholHigh LDL-CholHigh LDL-Chol High LDL-Chol High LDL-Chol High LDL-CholHigh LDL-Chol
High triglyceridesHigh triglyceridesHigh triglyceridesHigh triglyceridesHigh triglycerides High triglyceridesHigh triglyceridesHigh triglyceridesHigh triglycerides High triglyceridesHigh triglycerides High triglyceridesHigh triglyceridesHigh triglycerides
Low HDL-CholLow HDL-CholLow HDL-CholLow HDL-Chol Low HDL-CholLow HDL-CholLow HDL-Chol Low HDL-CholLow HDL-Chol
Participants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by gender Participants with dyslipidemia (%) by genderParticipants with dyslipidemia (%) by gender
Men Men
WomenWomenWomen Women
76.8
83.4
37.2
42.8
0
10
20
30
40
50
60
70
80
90
Men Men
WomenWomenWomen Women
Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least Proportion (%) reporting physical activity (at least 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week 60 minutes in a day) last one week
Moderate physical activity Moderate physical activityModerate physical activityModerate physical activityModerate physical activity Moderate physical activity Moderate physical activityModerate physical activity Moderate physical activityModerate physical activityModerate physical activity Moderate physical activity
Vigorous physical activityVigorous physical activityVigorous physical activityVigorous physical activityVigorous physical activity Vigorous physical activityVigorous physical activityVigorous physical activity Vigorous physical activityVigorous physical activity Vigorous physical activityVigorous physical activityVigorous physical activity Vigorous physical activity
16
95.4
95.8
10
20
30
40
50
60
70
80
90
100
Men Men
WomenWomenWomen Women
Salted consumption Salted consumption Salted consumption Salted consumption Salted consumption Salted consumption Salted consumption Salted consumption Salted consumption Salted consumption
Men 3 cups a day Women dayMen 3 cups a day Women Men 3 cups a day Women dayMen 3 cups a day Women Men 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women Men 3 cups a day Women Men 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women Men 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women Men 3 cups a day Women Men 3 cups a day Women dayMen 3 cups a day Women Men 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day Women Men 3 cups a day Women Men 3 cups a day Women dayMen 3 cups a day Women dayMen 3 cups a day
Women 18.3
40.5
36.3
39.4
3.8
8.4
10.8
43.7
0
5
10
15
20
25
30
35
40
45
50
Smoker-currentSmoker-current Smoker-current Smoker-currentSmoker-currentSmoker-currentSmoker-currentSmoker-current Smoker-currentSmoker-currentSmoker-current
Smoker-pastSmoker-past Smoker-past Smoker-pastSmoker-pastSmoker-pastSmoker-past Smoker-past
Use naswar (snuff) Use naswar (snuff)Use naswar (snuff) Use naswar (snuff) Use naswar (snuff)Use naswar (snuff) Use naswar (snuff)Use naswar (snuff) Use naswar (snuff)
Secondhand smokeSecondhand smokeSecondhand smokeSecondhand smokeSecondhand smokeSecondhand smokeSecondhand smokeSecondhand smoke Secondhand smokeSecondhand smoke Secondhand smoke Secondhand smoke
Reported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposure Reported (%) tobacco consumption and exposure Reported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposure Reported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposure Reported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposure Reported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposure Reported (%) tobacco consumption and exposure Reported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposure Reported (%) tobacco consumption and exposure Reported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposure Reported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposureReported (%) tobacco consumption and exposure
Men Men
WomenWomenWomen Women

Recommended Read – for teachers and students interested in free world class education

Sources for Lifelong Learning

There are countless free sources available online. Here are a few of the best:

The Open Education Consortium

[http://www.oeconsortium.org/about-oec/]

Who We Are

We are a global network of educational institutions, individuals and organizations that support an approach to education based on openness, including collaboration, innovation and collective development and use of open educational materials. The Open Education Consortium is a non-profit, social benefit organization registered in the United States and operating worldwide.

Our Mission

We promote, support and advance openness in education around the world.

Our Vision

Empowerment through education. We envision a world where everyone, everywhere has access to the high quality education and training they desire; where education is seen as an essential, shared, and collaborative social good.

Our Values

• Global focus
• Openness
• Equity
• Collaboration
• Multiculturalism

Our Activities

• Awareness raising
• Networking and community development
• Advocacy and advising
• Capacity building and training
• Implementation support
• Consultancies

What is Open Education?

Open education encompasses resources, tools and practices that employ a framework of open sharing to improve educational access and effectiveness worldwide.

Open Education combines the traditions of knowledge sharing and creation with 21^st century technology to create a vast pool of openly shared educational resources, while harnessing today’s collaborative spirit to develop educational approaches that are more responsive to learner’s needs.

The idea of free and open sharing in education is not new.  In fact, sharing is probably the most basic characteristic of education: education is sharing knowledge, insights and information with others, upon which new knowledge, skills, ideas and understanding can be built.  Open Education seeks to scale educational opportunities by taking advantage of the power of the internet, allowing rapid and essentially free dissemination, and enabling people around the world to access knowledge, connect and collaborate. Open is key; open allows not just access, but the ability to modify and use materials, information and networks so education can be personalized to individual users or woven together in new ways for large and diverse audiences.

Why is Open Education important?

Education is an essential tool for individuals and society to solve the challenges of the present and seize the opportunities of the future. However, the current provision of education is limited by educational institutions’ capacity, consequently, this resource is available to the few, not the many.  The digital revolution offers a potential solution to these limitations, giving a global audience unprecedented access to free, open and high-quality educational resources.

People want to learn. By providing free and open access to education and knowledge, people can fulfill this desire. Students can get additional information, viewpoints and materials to help them succeed. Workers can learn something that will help them on the job. Faculty can exchange material and draw on resources from all around the world. Researchers can share data and develop new networks. Teachers can find new ways to help students learn. People can connect with others they wouldn’t otherwise meet to share information and ideas. Materials can be translated, mixed together, broken apart and openly shared again, increasing access and allowing new approaches. Anyone can access educational materials, scholarly articles, and supportive learning communities anytime they want to. Education is available, accessible, modifiable and free.

Our Sponsors

Activities of the Open Education Consortium are generously supported by:

The William and Flora Hewlett Foundation

Sustaining Members of the Open Education Consortium:

• The African Virtual University
• Community College Consortium for Open Educational Resources
• Delft University of Technology
• Fundação Getulio Vargas – FGV Online
• Japan OpenCourseWare Consortium
• Johns Hopkins Bloomberg School of Public Health
• Korea OpenCourseWare Consortium
• Massachusetts Institute of Technology
• Netease Open Courses
• Open Universiteit
• Organisation Internationale de la Francophonie
• Taiwan Open Course Consortium
• Tecnológico de Monterrey
• Tufts University
• Universia
• Universidad Politécnica de Madrid
• University of California, Irvine
• University of Michigan

·         and contributions of member organizations

You can read or download our bylaws here.

Highlights for High School : features MIT OpenCourseWare materials that are most useful for high school students and teachers.

For Students 

For Teachers 

OCW Educator

Sharing teaching approaches and materials from MIT with educators everywhere, for free.

OCW Educator is an MIT faculty-inspired initiative to enhance the value of OCW materials for educators at the Institute and around the world. Search across the MIT curriculum to find teaching materials to use with your own students. Explore faculty insights about instructional approaches. Go behind the scenes to learn how MIT courses are taught on campus.

TOPIC

Active Learning

Assessment

Augmenting Curricula

Course Histories and Development

Critical Thinking

Diversity and Inclusion

Engaging Learners

Insights from MIT Teaching Award Recipients

Instructional Design

Instructors

Learning Communities

Lecturing

Non-Traditional Courses

Professional Competencies

Real-World Contexts

Reflective Practice

Teaching Communication

Teaching Novices

Teaching Problem Solving

Teaching the Design Process

Teaching with Technology

Views of Learning & Knowing

TEACHING EXCELLENCE AT MIT [http://teachingexcellence.mit.edu/]

The Teaching Excellence Project highlights the extraordinary teaching and learning at MIT, documented by MIT Video Productions (MVP) over several decades. With generous support from Neil and Jane Pappalardo, MVP has digitized, preserved and now shares these inspiring videos. 

Teaching excellence is not formulaic on campus. Rather, it originates in classrooms, laboratories, common spaces, residence halls, and along the great corridors of MIT. Within this site are a number of videos that showcase the experiential learning that is MIT. 

A selection of courses are presented in their entirety in the Inspiring Teachers section. In class lectures and often through real-time demonstrations, faculty reveal the process of achieving fluency in the languages of their disciplines, while sharing unique perspectives on their own trajectories to discovery and excellence. Footage From the Vault, drawn from several MIT archives, showcases the culture of Institute life, work, and play through vintage films and special events spanning several generations of the MIT community.Must See! videos highlight favorite talks, lectures, and events from a variety of venues across the campus. 

Watch, enjoy, and be inspired!

MIT Crosslinks and OCW [http://ocw.mit.edu/courses/crosslinks/]

If you're learning about foundational STEM topics, you may want to explore MIT Crosslinks as a guide to OCW and other open educational resources.

MIT Crosslinks describes how STEM topics are introduced, developed and applied across select MIT undergraduate courses. While only the MIT community may create and edit this crowdsourced content, the results are open to the world.

Each Crosslinks topic, like the example to the right, starts with a brief definition. That's followed by links to content which MIT students recommend to each other – and to you – to help learn about the topic.

Coursera. Coursera works with top universities from around the world to offer classes online for free. You can take classes from a variety of disciplines including computer sciences, psychology, and Spanish.

OpenStudy. OpenStudy is a social learning network that allows you to connect with individuals with the same learning goals as you.

Khan Academy. I freaking love Khan Academy. You’ll find over 4,000 videos covering topics ranging from algebra to finance to history. My favorite part of Khan Academy, though, is math exercises. You start with basic math and work your way up to calculus in an adaptive, game-like environment. I’ve been slowly going through the exercises to freshen up on my math.

Duolingo. Free website to learn foreign languages. It’s a pretty cool set up. As you progress through the lessons, you’re simultaneously helping translate websites and other documents.

Code Academy. Learn to code for free with interactive exercises. I wish Code Academy was around when I was learning how to build AoM. It would have helped a lot.

edX. Harvard University and MIT partnered together to create interactive, free online courses. The same world-renowned professors that teach at Harvard and MIT have created the courses on edX. You can find courses for just about any subject. I’ve signed up for a class called The Ancient Greek Hero. Class started last week, but you can still sign up. Join me!

Udacity. Udacity is similar to edX and Coursera. College level classes taught online for free.

CreativeLive. I discovered CreativeLive a few weeks ago. It’s an interesting concept. You can watch the live stream of the course being taught for free, but if you want to view the course later and at your own pace you have to pay for it. The courses focus on more creative and business subjects like videography and online marketing. I’ve sat in on a few of the free courses and was impressed with the curriculum.

TED. TED compiles speeches and lectures not only by professors but interesting people from many different walks of life. TED talks are lighter than academic lectures, often quite funny, and concentrate on interesting ideas and concepts. And most are 20 minutes or less, so they’re great for those with a short attention span.

iTunes U. Download thousands of free podcast lectures taught by the best professors from around the world and learn while in your car.

YouTube EDU. Instead of watching a bunch of auto-tuned cats, enrich your mind by browsing through YouTube EDU. They have thousands of videos that cover a variety of topics.

For more ideas on free learning resources, check out this post: How to Become a Renaissance Man Without Spending a Dime.

Russian's New Friends Among Afghan Taliban

RELATED GREAT GAME
In response to growing concerns about the Islamic State’s growing strength throughout Afghanistan, Russia is now pursuing a military alliance with the Afghan Taliban, under the concept that “my enemy’s enemy is my potential ally.”

The Russian courtship of the Taliban began some time prior to Taliban’s dramatic 15-day takeover of the northern Afghan city of Kunduz, which was reportedly facilitated by the delivery of Russian weapons to the group via Tajikistan. Among the Russian-supplied weapons were new AK-47s, PK machine guns and RPGs (rocket-propelled grenades).

The US Director of National Intelligence, Gen. James Clapper so much as confirmed the Russian increased role in the Central Asia security situation in February 9, 2016 Congressional testimony, where he stated that “Central Asian states remain concerned about the rising threat of extremism to the stability of their countries, particularly in light of a reduced Coalition presence in Afghanistan. Russia shares these concerns and is likely to use the threat of instability in Afghanistan to increase its involvement in Central Asian security affairs.”

Following the death of Taliban leader Mullah Omar, the Islamic State sought to exploit factional splits in the group, and dispatched several hundred ISIL operatives to Afghanistan. According to the United Nations, ISIL now has a presence in 25 of Afghanistan’s 34 provinces, and has as many as 3,000 fighters in the country now, mostly recruited from the ranks of Taliban splinter factions and other militias. 

The point man for the Russian outreach to Taliban is President Vladimir Putin’s personal envoy to Afghanistan, Zamir Kabulov.  Kabulov was in charge of KGB operations in Afghanistan during the period of Soviet Red Army occupation—including the period of the entire Afghan War. He later was Russia’s Ambassador to Pakistan. In 1995 he established personal contact with Mullah Omar, to negotiate the freeing of Russians whose plane flight had made an emergency landing in Kandahar. He retained those contacts, after he later became the Director of the Second Department for Asian Countries in the Russian Foreign Ministry and then in his second current post as Putin’s personal Afghan envoy.

The Uzbek-born Kabulov has handled his negotiations with the Taliban through Dushanbe, Tajikistan, working with a Taliban liaison, Dr. Tahir Shamlazi, the brother of a former Taliban commander. Shamlazi has also represented Taliban in talks with Chinese officials.

In a recent interview with Interfax, Kabulov gave a detailed assessment of ISIL’s planned expansion into Central Asia and Russia. He identified two “beachheads” facing Tajikistan and Turmenistan, where a large number of Central Asian recruits are being concentrated, after receiving training in three ISIL camps inside northern Afghanistan.

In that interview Kabulov said Russian officials were concerned that the routes through which Afghan heroin is smuggled across the Caspian Sea into Dagistan can be used to smuggle ISIL fighters back into the Caucasus region of Russia to launch what he called “a spring offensive” against Central Asia and Russia. 

Speaking at a Moscow conference on Afghanistan in January 2016, Kabulov candidly acknowledged that “Taliban interests objectively coincide with ours. Both the Afghan and Pakistan Taliban have said they don’t recognize ISIS… That is very important. We have communications channels with the Taliban to exchange information.”

Russia is not putting all of its Afghan-Central Asian eggs in the Taliban basket. Russia has recently expanded its arms sales to both Pakistan and Afghanistan, negotiating the sale of as many as 20 Mi-35 helicopters to Pakistan, along with surface-to-air missiles. Afghanistan is also planning to purchase Russian Mi-35 helicopters. Russia has also announced first-ever joint maneuvers with Pakistan this year. That was announced on January 22, 2016 by Russian Army Commander-in-Chief Gen. Oleg Salyukov.

Afghanistan’s Chief Executive Officer Abdullah Abdullah confirmed on February 3, 2016 that he is coordinating with Moscow on the peace talks with the Taliban. “We expect countries to set aside their grievances for the sake of dealing with the most important challenge that we are all facing. Russia has an interest because of the terror groups from Chechnya and the Central Asian republics.”

Iran is also warming up to the Taliban, as they escalate their surrogate war with Saudi Arabia, which Tehran believes is still backing ISIL. Iran has recently begun training Taliban fighters in camps in Tehran, Mashhad and Zahedan.

It would remains to be seen whether these “strange bedfellow” dealings, such as Russia and Iran’s collusion with the Taliban, can be sustained. US intelligence has definitely taken notice of the emerging channels and is carefully assessing the implications, now that President Obama has agreed to retain a residual US training and counter-terrorism force of nearly 10,000 American and allied troops in Afghanistan through past the end of his presidency.

Russia and China have the opportunity to work through the Shanghai Cooperation Organization, which now includes all of the Central Asian republics, Pakistan and India. Russia and China have both announced their support for Iran to be the next full member of SCO. Iran already has observer status with the organization. And later this year, Russia is scheduled to begin construction on a 1,100 kilometer gas pipeline from Karachi to Lahore that is scheduled to be completed by 2017, and will provide Pakistan with over 30 percent of its natural gas needs. Such projects can only succeed if there is a degree of stability in the area.

Special Envoy Kabulov, however, got to the heart of Russia’s concerns in his Interfax interview. He said: “Better to fight Islamists on Amu Daryan than on the Volga.”