Noncommunicable diseases like heart disease, cancer and diabetes, are increasingly affecting young people in low- and middle-income countries. Worse still, they are increasingly deadly. As the world’s poorest countries continue to improve, the burden of health problems is shifting from infectious diseases, like HIV and malaria, to chronic diseases, according to the Council on Foreign Relations.
Its report finds that deaths related to these diseases have risen by more than 50 percent in low- and middle-income countries over the past 20 years. The rise of chronic diseases coupled with inadequate health systems makes for a worrying combination. About 8 million people in these countries died of noncommunicable diseases before turning 60 years old. Projections, using unpublished data from the University of Washington’s Institute for Health Metrics and Evaluation, show that the numbers will continue to rise for lower-income countries, while things keep getting better for richer ones.
“More patients will get sick, suffer longer, require more medical care and die young. Given the scale of these trends, the results will reverberate,” according to the panel of global health experts who wrote the report.
That translates into more families facing the cost of long-term care for sick loved ones. Time and money spent caring for people suffering from chronic diseases places even more stress on already struggling households. The report says countries will in turn see overall productivity of working-age individuals decrease while public expenditures increase.
Such a trend will stress developing economies to the tune of $21.3 trillion over the next two decades. To put that in perspective, the total economic output of developing countries was $24.5 trillion in 2013. If estimates hold up and nothing changes, developing countries will essentially be set back a full year. The good news, according to the report, is the trajectory of the trend can be altered. It begins with increasing health spending by the countries that are home to 5.7 billion people.
Much like the case with the spread of Ebola in West Africa, change begins with improving health systems. The report indicates that poor access to preventive care and “more exposure to behavioral health risks” places adults at risk of developing these diseases. A lack of support for those who fall ill makes matters even worse.
This is not really new news. Noncommunicable diseases were a top-line issue during the U.N.’s General Assembly meetings in 2011. Activists gathered in New York City, meetings were held to raise the alarm about the global burden of chronic diseases and pledges were made to do more.
Three years has shown little change. Most donors, including the United States, focus on HIV, malaria and TB, even though noncommunicable diseases are more deadly than the big three. The CFR analysis reveals that in countries where the United States spent $5 million or more on health aid, noncommunicable diseases caused 28 percent of premature deaths – 1.6 times the number of people who died of malaria, TB and HIV.
Of the $8 billion that the United States spent on global health aid in 2013, only $10 million was on chronic diseases.
“There is much the United States can do to help developing countries met the NCD challenge at relatively modest cost. U.S. efforts should focus on specific NCDs and risk factors that are especially prevalent among the working-age poor in developing countries and for which there are existing low-cost interventions that can leverage current U.S. global health programs,” said CFR President Richard Haass, in the report’s forward.
Areas where the United States can have an immediate and important impact include primary and secondary prevention of cardiovascular disease; tobacco control; hepatitis B vaccination; and human papillomavirus (HPV) vaccination and cervical cancer screening. Launching an immediate intervention to address noncommunicable disease could avert as many as 12 million deaths if action is taken today.
If nothing changes, the number of premature deaths caused by noncommunicable diseases will continue to rise. The authors are clear that the United States alone cannot solve the problem, but can serve as a leader to affect fellow donors and developing country priorities.