A threat to reaching the MDGs: Preventable diseases

With the UN Summit just around the corner, Nalini Saligram of Arogya World urges people to take action on preventable diseases like cancer, diabetes and chronic lung diseases.

MDGs

In the context of fighting extreme poverty and preventable disease, which are at the core of ONE’s mission, I want to discuss here the global crisis of chronic non-communicable diseases, or NCDs — a set of largely preventable diseases that are intricately linked with poverty.

NCDs, which include cardiovascular disease, cancer, diabetes and chronic lung diseases, are one of the greatest health and development challenges of the century. These diseases are the world’s leading killers, collectively causing two out of every three deaths. Approximately 36 million people die from NCDs each year — that is nearly 100,000 people every day. And while these chronic diseases are often seen as the burden of the rich, what is frightening is that 80 percent of NCD deaths actually occur in developing countries.

Recognizing the enormous global impact of NCDs, the United Nations is holding a High Level Meeting on NCDs on Sep 19 to 20, and the focus will be the effect of NCDs on low- and middle-income countries. We believe that the UN High Level Meeting represents an unprecedented opportunity to mobilize the world to take action against NCDs. Many organizations big and small are working hard to make this meeting a transformative moment in global health.

Did you know that this is only the second time in history that a health-focused UN summit is taking place? HIV/AIDS was the first in 2001. It is imperative that we raise the profile of NCDs as a major development and social justice issue.

The poorest populations in developing countries are most affected.

By 2030, NCDs are projected to cause nearly five times as many deaths worldwide as HIV/AIDS, tuberculosis and malaria COMBINED. China and India have the highest numbers of NCD deaths, and sub-Saharan Africa has a serious chronic disease burden. The highest rates of high blood pressure are seen in Africa, as are the highest age specific mortality rates from chronic diseases. Over the next ten years, Africa is predicted to experience the largest increase in deaths from NCDs.

But why are the poorest regions of the world so deeply affected by NCDs?

NCDs and poverty exist in a vicious cycle: NCDs drive people into poverty, while poverty results in rising rates of NCDs.

In developing countries, if someone falls ill, their family can be pushed into deeper and deeper levels of poverty because of the loss of income and costs of care, which can mount for decades. At the same time, the major risk factors for NCDs — tobacco use, poor diet, physical inactivity, and harmful consumption of alcohol — are compounded by poverty. When impoverished, people have little access to healthy fruits and vegetables, and are often drawn to tobacco and alcohol.

Did you know that the highest smoking rate among men is in lower-middle-income countries? Education too influences one’s vulnerability to NCDs. For instance it is known that use of tobacco and alcohol, hypertension and physical inactivity are more common among people at lower educational levels, according to a UN report.

Moreover, poverty forces 3 billion people — nearly half the world’s population — to use cheaper fuels and unclean stoves. Women in developing countries often slave for hours over open fires, and as a result get NCDs like chronic obstructive pulmonary disease. How is it right that 1.9 million people a year — mostly women and children — die because of everyday cooking? How is it right that the NCD death rate for women is 85 percent higher in low- and middle-income countries than in high-income countries?

The opportunity to survive should not be dependent on income or geography. Yet it is.

NCDs also stand as a barrier to global development. In 2010 the World Economic Forum rated NCDs as the second most severe threat to the global economy, equal in cost to the financial crisis. New studies estimate that the global price tag of NCDs runs into trillions of dollars. In fact, NCDs threaten to reverse the progress the world has made over the last two decades towards the Millennium Development Goals.

People are angry about this. Especially because NCDs are largely preventable.

Approximately 80 percent of cardiovascular disease and diabetes and 40 percent of cancers can be prevented through stopping tobacco use, increasing physical activity and through healthy eating. Moreover, action against NCDs is affordable: for example, full implementation of tobacco control and salt reduction, two of the top priority actions for NCD control, cost about 20 US cents per person per year in China and India, according to WHO.

Sweeping policy changes are needed, and more investment of dollars — more than the 3 percent of overseas development assistance currently allocated to NCDs. But individuals can make a difference too.

On the occasion of the UN High Level Meeting, Arogya World has initiated a women’s movement — Women for a Healthy Future — in partnership with other organizations, mobilizing women from around the world to ignite action against NCDs. We ask world leaders from government and business to take steps now to prevent NCDs and ensure a healthy future for women and children. We believe that by preventing chronic disease, we can fight poverty head on. And at ONE, that should resonate.

Whatever the outcomes of the UN summit — and it is a huge pity if the UN summit doesn’t quite live up to its promise because of weakening political stance on commitments — it is a fact that NCDs are changing the face of global health as we know it, and threatening the realization of the MDGs. Don’t sit on the sidelines of this grand dialogue. Join us by raising your voice.

Nalini Saligram, Ph.D. is the founder & CEO of Arogya World, a non-profit organization committed to changing the course of chronic disease.