Non-communicable disease epidemic a global problem

By Dr. Ananya Mandal, MDSep 9 2011

Later this month the United Nations will convene a high-level meeting on non-communicable diseases. The world's global health news has been so dominated by infectious culprits - HIV/AIDS, malaria, tuberculosis, influenza - that it's easy to forget just how big a toll conditions like diabetes, cancer and heart and lung disease take say experts.

Roughly two out of every three deaths on the planet is now caused by non-communicable disease, and the U.N. estimates that by 2030, 52 million people will die annually from these diseases. That's five times as many deaths as the estimated death toll for infectious disease.

Not all non-communicable diseases are linked to lifestyle choices, but many are exacerbated by poor diet, smoking, alcohol use, or environmental conditions. Obesity is a major risk factor for diabetes, heart disease and some types of cancers, creating a stereotype of these conditions as a rich country problem.

The experts add that the burden of non-communicable illness falls heavily on the poor. The death rate, by far, is highest in countries ranked as lower-middle income. The U.N. finds that the rates in lower-middle income countries come not from the fact that they have large populations, but rather from unplanned urbanization, aging populations.

The increase is usually due to low-income states becoming richer, as disease as a result of cancer and diabetes is seen more in higher income countries. Cancer, long considered the health threat of developed countries, is now as high as 21% worldwide, while this is expected to increase by 10% over the next few decades.

A UN General Assembly later this month will address the issue, ten years after it last met about the HIV/AIDS pandemic. The impact of a global 'epidemic' of cancer might have far-reaching impact, added the Union for International Cancer Control, an advocate of the Summit.

“While non-communicable diseases have traditionally afflicted mostly high income populations, current evidence shows that the spread of such diseases...now outstrip communicable diseases in every region except Africa.” the UN statement read. “By 2030, non-communicable diseases are projected to cause nearly five times as many deaths as communicable diseases worldwide.”

The summit hopes to release an agreed declaration that is meant to pave the way to reducing the number of premature deaths from non-communicable diseases – or NCDs - the vast majority of which take place in poorer countries.

Australia has its own proud track record on NCDs: smoking has plummeted to 15 per cent under a world-leading tobacco control strategy; cardiovascular disease mortality has been reduced by about 75 per cent in the past 40 years, and the Preventative Health Taskforce has provided the blueprint for action on obesity, tobacco and alcohol. In addition, Australia continues to lift its aid commitments towards the target of 0.5 per cent of gross national income, so we are providing foreign aid leadership as well.

NCDs have a direct impact on women's health especially in developing countries like India. A staggering 50,000 women lose their lives to NCDs every single day. More than 1,000 women die from cardiovascular disease, one of the four main NCDs, every hour.

Women are uniquely affected by NCDs. New research published in The Lancet (Aug 2011) shows that for women, especially pregnant women, the harmful effects of smoking are even higher than for men. When it comes to coronary heart disease, smoking is 25% more dangerous for women.

In the developing world, the effect of NCDs on women is even more pronounced. Women comprise 60% of the world's poor, and poverty worsens chances of survival from NCDs. Women in developing countries also cook daily over open flames, and as a result acquire NCDs like Chronic Obstructive Pulmonary Disease.

Women are disadvantaged with regard to prevention. While 80% of cardiovascular disease and diabetes and 40% of cancer are preventable through stopping tobacco use, increasing physical activity and improving diet, often these prevention efforts are not accessible to women. When women make up 2/3 of illiterate adults, they are at a great disadvantage to even learn about prevention. NCDs are an integral part of maternal and child health. Since low birth weight predisposes a baby to get diabetes and cardiovascular disease later in life, it is imperative that we educate pregnant women about good nutrition during pregnancy.