Time to Treat Global Chronic Disease

Experts are calling for global health-system reforms. They say the rising global burden of chronic diseases, such as heart disease, cancer and diabetes, needs a coordinated effort from policy makers, advocates and health professionals.

The authors of the special communication published in The Journal of the American Medical Association say chronic diseases are the leading cause of death worldwide. In 2002, cardiovascular disease caused 17 million deaths. Another 7 million were from cancer, 4 million from chronic lung disease, and 1 million from diabetes mellitus. They say these numbers are only expected to increase substantially over the next two decades.

The majority of these chronic diseases are affecting people in developing countries. The authors note, “Between 1990 and 2020, mortality from ischemic heart disease in developing countries is expected to increase by 120 percent for women and 137 percent for men.” They believe this is due, in part, to rising risk factors for chronic diseases, such as smoking, alcohol use, and obesity levels.

The authors make the point that chronic diseases are not replacing acute infectious ones. Instead, they are causing a double burden. For example, India has the highest number of diabetics in the world and annual coronary deaths are expected to reach 2 million by 2010. At the same time, around 2.5 million children in India die from infections like pneumonia, diarrhea and malaria every year.

The health services in these countries are being strained by the double burden because they have inadequate financing and lack of manpower.

The authors conclude, “Decision makers need to be fully informed with the up-to-date evidence about the burden and impacts of chronic disease.” They say the health systems in these developing countries need to be realigned to accommodate diagnosis and prevention of chronic disease, which includes intensified attention on tobacco use, unhealthy diets, and physical activity.

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