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Global shift in disease patterns requires aid rethink

Professor Rob Moodie, Chair of Global Health at the Nossal Institute of Global Health, alerts us to an upcoming UN meeting which could save the lives of millions of people, he writes….

A global pandemic taking the lives of tens of millions of people across the world and costing trillions of dollars each year, has gone largely unnoticed – until now.

In September, the United Nations will convene the first special health ‘summit’ in 10 years to address the biggest health challenge facing the world today: non communicable diseases (NCDs). The summit signals a major turning point in global health as these chronic diseases overtake infectious diseases as the leading cause of death and ill-health across the world. Cancer, cardiovascular disease, diabetes, and respiratory disease now cause more than 60% of all deaths across the globe at a cost to the global economy of trillions of dollars. By 2030 they are expected to cause five times as many deaths as infectious diseases.

But NCDs are no longer an exclusive affliction of the rich. Eighty percent of victims live in poor countries and the epidemic is growing most quickly in the world’s poorest regions. Africa, South Asia and the Western Pacific are expected to experience the largest increases in NCD deaths this decade. In developing regions such as South Asia, the burden of NCDs is now greater than the combined burden of infectious diseases, maternal and child health issues, and nutritional causes.

The poorest and most disadvantaged populations in these countries are those who suffer the most. Many cannot afford treatment or can no longer work, intensifying their poverty and making NCDs a major cause of health inequity. Poorer health systems and few effective prevention or treatment programs in poor countries exacerbate the impact of NCDs. Health systems also struggle to cope with the double disease burden of growing rates of NCDs while infectious diseases are still widespread. In addition to their health and social impacts, NCDs have a profound impact on economic development.

The World Economic Forum has identified NCDs as a major risk to the global economy. People in developing countries tend to develop and die from NCDs at younger ages than those in high-income countries, affecting them during the most productive period of their lives. Lost productivity due to NCDs has been estimated to cost up to 10% of GDP each year in India and around US$55 billion a year in China. The international aid effort has yet to catch up with this shift in disease patterns. It is estimated that less than three percent of the US$22bn spent on health aid in developing countries each year is dedicated to NCDs.

There are reports that requests from some low and middle income countries for assistance in tackling these diseases go largely unheeded. Yet so much can be done to prevent and treat NCDs. Better still, preventing NCDs is not expensive. Global implementation of a package of key measures including tobacco control, salt reduction, improving diets and physical activity, reducing harmful alcohol intake, and increasing access to essential medicines and technologies, is estimated to cost just US$9 billion annually. These are blue chip investments in anyone’s terms compared to the estimated global annual cost of NCDs of over a trillion US dollars.

The landmark UN meeting, to be held in New York on 19-20 September provides an exceptional opportunity to put NCDs on the global health and development agenda and redress the balance of international health aid to better reflect the global disease burden. But negotiations over the outcomes to be agreed at the meeting have stalled, raising fears that this historic opportunity to change the course of the global chronic disease pandemic may be squandered. It is feared that sound proposals for clear goals and timelines to tackle these devastating diseases are being systematically deleted, diluted and downgraded by some UN Member States and urgent action is needed to put the negotiations back on track, when they recommence on September 1.

To do that we need governments, including our own, to agree and act on common goals. The UN meeting must agree to:

  • An overarching goal to reduce preventable deaths from NCDs by 25% by 2025
  • A clear timeline for tackling the epidemic of the four major NCDs – cancer, cardiovascular disease, diabetes and chronic respiratory disease • A set of specific, evidence-based targets and global indicators
  • A high-level collaborative initiative of governments and UN agencies with civil society to stimulate and assess progress.

Australia has a strong record in prevention and management of chronic disease – including ground breaking tobacco control efforts such as plain packaging – and is very well placed to continue to lead global change by working to achieve tangible outcomes from the UN meeting. Australia can also boost efforts beyond the summit to assist developing nations in our region escalate their NCD prevention efforts and improve screening, early detection, treatment and palliation. If we can achieve a coordinated global response to NCDs through the UN Summit with substantially increased resources, we will be well on the way to helping millions of people worldwide to lead longer, healthier, happier and more productive lives.

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#LivingOurWay
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