HEALTH: Call for healthier lifestyles may fall on deaf ears
Community approaches to better health could cut costs
NEW YORK, 19 September 2011 (IRIN) - New global guidelines on best practices to counter non-communicable diseases (NCDs) could avert up to 15 percent of preventable deaths over the next 20 years, but may fail to gain currency in countries already struggling to keep pace with communicable diseases, maternal and child mortality and other public health issues, economic and health experts say.
“Many countries are saying this issue of NCDs is an additional burden where we need to put money, and we are not in a position where we can mobilize additional resources,” Olivier Raynaud, senior director of health and healthcare industries at the Switzerland-based World Economic Forum (WEF), told IRIN.
“This report is saying, 'Careful. If you do not mobilize resources today, can you afford the cost tomorrow of not doing the right thing?'”
The WEF and Harvard School of Public Health released two reports on 18 September analyzing the economic impact - especially in low and middle-income countries - of an unchecked, increasing prevalence of NCDs, and the action countries must take to prevent them. Their launch marked the beginning of a UN two-day conference on NCDs, coinciding with the opening of the General Assembly autumn session.
The potential economic impact of cardiovascular diseases, cancers, chronic respiratory diseases and diabetes is steep: it will cost the world US$47 trillion over the next decade to treat and care for people with these diseases, which will also contribute to a 17 percent increase in mortality rates.
NCDs are already known to cause about 36 million deaths annually, including nine million under the age of 60.
Developing countries are expected to shoulder the highest numbers of such deaths.
The cost of creating measures to help avoid this trend is far less: $11.4 billion annually to create a sustainable package of best practices, including tax increases on tobacco and alcohol, smoke-free public places and public awareness campaigns on diet and exercise.
But Dan Chisholm, a health economist at the World Health Organization (WHO), concedes that the package – which does not include any sort of specific global funding goals or national budget strategies – could be a hard sell, as “the real size of the magnitude of this problem has taken a while to be realized”.
“There are always competing priorities, so if you have a low-income country in Africa with a raging HIV epidemic or high rates of child or maternal morality, it's a very tough choice of how to invest your scarce dollars,” explained Chisholm, who helped present the reports. “I suppose this is really just trying to raise awareness of the consequences of NCDs and that they need to be built into a sort of development agenda.”
Thobeka Madiba-Zuma, South Africa’s first lady, questioned broader issues of economic disparity, saying that people who lived in slums, for example, could not easily exercise or have steady access to healthy food.
Some civil society networks and organizations also said the reports failed to consider challenges such as government ties to tobacco and alcohol producers, for instance, and a shortage of healthcare practitioners in many low-income countries.
“What we need to confront this crisis is the sort of thing we have done with malaria, tuberculosis and HIV,” said Jonathan Brown, vice-president of the International Diabetes Federation. “We need to use those models to set up non-physicians, local people, to monitor the situation.
“There are lots of ways to approach this and it doesn't have to be expensive, it doesn't have to be cumbersome. We just have to get going on this thing.”
The conference on NCDs is set to adopt an “action-oriented outcome document”, acknowledging the economic and social risks of NCDs and calling for “multisectoral national policies and plans for the prevention and control” of NCDs by 2013.
It also brings to light the issue of mental and neurological disorders, presented as periphery NCDs that still cause significant financial loss and are often linked with the four core broad diseases.
“You could have visited a country before the UN summit and said, 'What's your plan for NCDs?' and they would have said, “'What NCDs?',” said Raynaud.
“This meeting will enable that discussion and lead different nations to make a plan. It's a start.”