Lancet series examines health issues facing populations in Southeast Asia

"Southeast Asia's 600 million people are facing a raft of new health challenges as the disaster-prone region undergoes some of the world's fastest social change," according to a series of papers and commentary pieces, published Tuesday in the Lancet, Agence France-Presse reports (O'Brien, 1/25). "Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Vietnam were among the countries surveyed by the journal, which called for universal health coverage especially to protect the poor," Reuters writes (Lyn, 1/25).

"'A health crisis is transpiring right before our eyes,'" warned one paper in the series that documented the rise of chronic non-communicable diseases in the region, AFP continues (1/25). According to the study authors, "an estimated 2.6 million people from the ten ASEAN [Association of Southeast Asian Nations] countries died from chronic non-communicable diseases in 2005," accounting for "nearly 61.5% of the total deaths in these countries" (Dans et al., 1/25). With aging populations and growing exposure to the risk factors for such diseases, the authors predict: "Chronic disease could kill up to 4.2 million people annually in Southeast Asia by the year 2030," according to IRIN (1/25).

While "the figure of 60 percent of deaths from chronic illnesses is lower than Europe's 86 percent and 78 percent in the United States, the health infrastructure in Asia is frail and the region is much less prepared to handle such illnesses which can be very expensive to treat," Reuters adds. The piece details the researchers' estimates of the national costs associated with chronic illness and their calls for increased surveillance to help better target programs to reduce the epidemic (1/25).

The series explores several other health topics impacting the region, including "infectious disease control, maternal and child health … and the finance and human resource issues that need to be addressed to improve health and health equity in this diverse region of the world," according to an introduction to the journal series (1/25).

"Despite substantial improvements in maternal, neonatal, and child health since 1990, most notably in Malaysia, Thailand, and Vietnam, high mortality, poor coverage, and high inequity continue to challenge other countries in the region, such as Laos, Cambodia, and Myanmar," write the authors of another paper in the series (Acuin et al., 1/25). "Although less than 10 children under 5 died for every 1,000 live births in Brunei, Singapore and Malaysia, the rate in Cambodia, Laos and Myanmar was between 50 and 70, among the highest in Asia," Reuters writes.

"Disparities exist in antenatal care coverage, use of skilled birth attendants, and diphtheria, polio, tetanus and measles vaccination together with use of oral rehydration therapy (for diarrhea), which are all key to the development of a continuum of care," study authors wrote, according to Reuters (1/25).

AFP also reports on the threat of emerging infectious diseases in southeast Asia, as described in another paper in the series which examines how rising temperatures in the region could lead to an increase in cases of malaria, cholera and dengue (1/25).

"Researchers warned that the region was a hot spot for emerging infectious diseases -- such as SARS and the H5N1 bird flu virus -- because of population growth and movement, urbanization, changes in food production and other factors," Reuters adds (1/25).

Southeast Asia "is an acknowledged hotspot for risk, with new, emergent, and resurgent infectious diseases," the authors of the paper write. "The pace of environmental transitions that are being witnessed in parts of southeast Asia makes the emerging infectious disease a reality," they add. Though "[v]ery substantial sums have been invested in emerging infectious diseases in the region, in large part in response to HIV/AIDS, tuberculosis, malaria, and, more recently, SARS and H5N1 influenza … the coordination, governance, and sustainability of regional control efforts in the face of global economic pressures remain a significant challenge," the authors conclude (Coker et al., 1/25).

A complete list of the papers and commentary in the Lancet series on Southeast Asia can be found here.