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New Health Crisis in Developing Countries: Heart attack, stroke, cancer, diabetes become the biggest killers

By Bloomberg Philanthropies Public Health Team

The biggest global health crisis in low- and middle-income countries is not Ebola, nor is it HIV/AIDS.  While the fight against those infectious diseases remains critically important, the emerging health issue in low- and middle-income countries is noncommunicable diseases (NCDs). These are defined as diseases that result in chronic illnesses. The crisis is related to lack of preventative measures and healthcare, as well as poorly functioning health systems. Noncommunicable diseases are becoming the biggest killers.

That is the message of a landmark new report by the Council on Foreign Relations, funded in part by Bloomberg Philanthropies, titled The Emerging Global Health Crisis: Noncommunicable Diseases in Low- and Middle-Income Countries. The report recommends specific steps the United States can take now and in the near and long term to use its leadership position on global health issues to address this crisis in lower-income countries.

Impact of NCDs

The World Economic Forum projects that the noncommunicable disease epidemic will inflict $21.4 trillion in losses in developing countries over the next two decades – a cost nearly equal to the total aggregate economic output ($24.4 trillion) of these countries in 2013.

In other words, more patients will get sick, suffer longer, require more medical care, and die young, causing a drain on these countries’ resources and workforces at precisely the time they are in the middle of their economic growth spurts.

At the household level in these low- and middle-income countries, it will mean less income, catastrophic health expenditures, and potential impoverishment. At the national level, it will mean lower productivity and competitiveness, higher health and welfare expenditures, and a potential missed opportunity for the demographic dividend that lifted the fortunes of many higher-income countries during their economic growth periods in the 20th century.

But there is something that can be done. High-income countries, even with higher rates of obesity and physical inactivity, have dramatically lowered premature deaths and disability from NCDs.

How? Through affordable and effective prevention, management, and treatment tools and policies that could be implemented widely in developing countries.

Courses of Action

Actions that the United States can take now to help low- and middle-income countries include:

  • Prevention of heart attack and stroke through wider availability of anti-hypertension drugs
  • Increased anti-tobacco efforts, modeled on programs in the U.S. and elsewhere
  • Wider availability of the hepatitis B vaccination, which prevents liver cancer
  • Wider availability of the Human Papillomavirus (HPV) vaccination and screening programs to prevent cervical cancer

Medium term efforts the report advocates include:

  • Improved but low-cost diagnostic and curative care strategies for treatable and curable cancers such as leukemia and breast cancer
  • Better diabetes management for countries with few resources

In the long term, the report urges the United States to help lower and middle-income countries with:

  • Programs to reduce poor diets and improve nutrition, increase physical inactivity, and lower obesity
  • Integration of mental health services into countries’ primary health care systems
  • More low-cost care programs and technologies for care of chronic diseases

Bloomberg Philanthropies is already deeply engaged around the world in public health work to reduce the impact of noncommunicable diseases. Bloomberg Philanthropies has committed more than $600 million since 2007 to reduce tobacco use worldwide. The rise in cigarette smoking has already made lung cancer the most common cancer and cause of death from cancer in low-and middle-income countries, according to the Council’s report.

We have also committed $10 million in Mexico to combat obesity, another condition leading to chronic noncommunicable diseases, including diabetes.

The United States became a leader in global public health by its efforts to fight HIV/AIDS and malaria in developing countries through the President’s Emergency Plan for AIDS Relief (PEPFAR) and by helping to set up the Global Fund to Fight AIDS, Tuberculosis, and Malaria, the report says. These successful programs can be adapted to noncommunicable disease prevention without high cost.

Just as the United States could not tackle HIV/AIDS alone, it cannot solve the crisis emerging in developing countries alone. To slow the rise of this epidemic, it will require a coalition of likeminded partners to help countries tackle this emerging crisis.