BMJ  2004;328 (3 April), doi:10.1136/bmj.328.7443.0-a

The double burden of diseases in South Asia

Almost half of all deaths in South Asia are now attributable to non-communicable diseases, accounting for 47% of global burden of disease. On page 807 Ghaffar and colleagues analyse how obesity, the rising prevalence of diabetes, higher tobacco consumption among the lower socioeconomic groups, and outdoor and indoor air pollution contribute to the rise of cardiovascular diseases, chronic respiratory diseases, and cancer in the region. Rich people will develop chronic diseases but poor people will die earlier. Meanwhile common infectious diseases, such as neonatal infections, diarrhoea, and acute respiratory infections, remain major child killers, as Zaidi and colleagues report (p 811); 4.58 million people are infected with HIV, tuberculosis is endemic and poorly controlled. Antibiotic resistance is common, and only half of children receive routine immunisation. Tackling these diseases will require innovation, political commitment, and partnership between individuals, communities, and healthcare providers, say Basnyat and Rajapaksa in an editorial (p 781).

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