Lancet series focuses on chronic diseases, development

"Just a small percentage of low- and middle-income countries' health care budgets are allocated toward the treatment and prevention of chronic diseases even though such illnesses are expected to account for 69% of global deaths by 2030," according to a paper published Wednesday in the Lancet, as part of a series on chronic disease and development, ModernHealthcare.com reports. 

"According to the authors, by 2030, 80% of deaths from chronic diseases such as cancer, heart disease and diabetes will occur in low- and middle-income countries. While many of these countries posses the medical technology needed for preventing and managing these diseases they lack the health-system infrastructure and support systems necessary for a sustain, broad-reaching approach to chronic disease care," the news service writes (Rhea, 11/10).

The authors identify five recommended actions for global health officials to tackle chronic diseases in low- and middle-income countries: "i) embed the discourse on chronic diseases in the emerging agenda for health-systems strengthening and promote the needs of health systems to chronic disease advocates ii) avoid fragmentation of the response to chronic disease (by single condition or subgroup). iii) agree on targets for measurement of progress in health-systems strengthening using criteria related to chronic diseases as key indicators. iv) broaden ownership of responses to chronic disease and of health-systems strengthening. V) increase funding for health that is oriented towards a health-systems response to the growing burden of chronic diseases," according to a Lancet press release (11/10).

"At present, chronic disease programmes are languishing at the bottom of the agenda for global-health development. Instead, progress in the response to chronic diseases as a whole should represent a litmus test for health-systems strengthening," the authors of the paper write. "If a national health system is designed so that it can respond effectively to chronic diseases, that country will also be well equipped to respond to a wide range of other population-health needs, including acute conditions. Investment in a systems approach to chronic diseases in low-income and middle-income countries could therefore represent a strategic focus for a new, post-2015 global health agenda," they conclude (Samb et al., 11/11).

A separate paper in the Lancet series warns "unhealthy diets and a lack of physical inactivity were pushing obesity rates in [the nations examined] rapidly towards the average of all OECD [Organisation for Economic Cooperation and Development] nations, where half of the population is already overweight and one in six people is obese," Reuters reports in an article that examines researchers' strategy for preventing obesity.

For the report, researchers from the WHO and OECD "looked at strategies to tackle risk factors for obesity in seven countries: Brazil, China, India, Mexico, Russia, South Africa, and, for comparison, England. In all of these countries obesity and its related chronic diseases are a big problem," according to a Lancet press release. For the "analysis, the authors compared these strategies with the alternative strategy of no prevention plus treatment of cardiovascular disease or cancer only once it had developed" (11/10).

"The OECD said a combined strategy on preventing obesity could cost less than a dollar per person and would pay for itself - through reduced health care costs - in half the countries surveyed, and would become cost-effective in the others within 15 years," Reuters reports. "A multiple intervention strategy would achieve substantially larger health gains than individual programs, with better cost-effectiveness," Michele Cecchini, an OECD health policy analyst and one of the authors of the study, said (Kelland, 11/11).

Additional papers and comments included in the Lancet Chronic Disease and Development Series can be found here.

Reuters Examines How Growth In Chronic Diseases In Poor Countries May Force Drug Industry To Rethink Pricing System On Drugs

Reuters, in a separate story, examines what the pharmaceutical industry plans to do for the pricing of drugs for chronic diseases as global number of cases continues to climb. The article includes comments by AstraZeneca CEO and International Federation of Pharmaceutical Manufacturers and Associations President David Brennan, who "said on Wednesday [at the Reuters Health Summit] he expected to see a rethink on drug prices for poor countries," according to the news service.

Though Brennan said he expected to "see more willingness to do tiered pricing" for drugs to treat chronic diseases, "[w]orking out a balance to improve access to treatments for the poorest countries while ensuring profits in richer markets would be a key priority for the lobby group, he said," according to Reuters.

"Chronic diseases which were previously largely confined to rich, well-fed populations are an increasing problem in poorer nations in Asia and Africa, whose populations are increasingly adopting Western lifestyles and living longer. … Yet the price of many medicines remains a high barrier to access," Reuters writes. "Some pharmaceutical firms are already cutting drug prices for poorer people, in part to improve their foothold in fast-growing emerging markets. But health care campaigners argue deeper price cuts are needed if real progress is to be made on expanding access to medication" (Hirschler, 11/11).