Clinical Review

Burden of non-communicable diseases in South Asia

BMJ 2004; 328 doi: http://dx.doi.org/10.1136/bmj.328.7443.807 (Published 01 April 2004) Cite this as: BMJ 2004;328:807
  1. Abdul Ghaffar (ghaffara@who.int), public health specialist1,
  2. K Srinath Reddy, professor of cardiology2,
  3. Monica Singhi, research assistant3
  1. 1 Global Forum for Health Research, World Health Organization, 1211 Geneva 27, Switzerland
  2. 2 Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
  3. 3 Initiative for Cardiovascular Health Research in the Developing Countries, T-7, Green Park Extension, New Delhi 110016
  1. Correspondence to: A Ghaffar

    This article explores the burden of the major non-communicable diseases in South Asia and the extent to which obstacles hinder prevention and management of these diseases

    Introduction

    The World Health Organization (WHO) stated in 2002 that “in many regions, some of the most formidable enemies of health are joining forces with the allies of poverty to impose a double burden of disease, disability and premature death in many millions of people.”1 This is what is happening in South Asia, which has one quarter of the global population but where about half the population lives below the poverty line and has limited access to health care. Although infectious diseases remain a formidable enemy, the population is ageing and non-communicable diseases are rising.24 South Asia has made fair economic progress in recent decades but is struggling to find a road towards sustainable development.

    We review here the estimated burden of noncommunicable diseases in South Asia, the risk factors for these diseases, the limitations of the available data, and the attempts being made to gather evidence of better quality. We aim to provide a profile of non-communicable disease burdens in this region.

    Sources and selection criteria

    We conducted a systematic search on Medline; used reports from WHO and other international organisations; and communicated with experts in the field. Although non-communicable diseases have been variously defined, we propose to limit the term to four major disease categories that are linked by common risk factors: cardiovascular diseases, diabetes mellitus, cancers, and chronic obstructive pulmonary disease. Dietary consumption patterns, physical inactivity, tobacco use, and environmental pollution are among the common risk factors shared by these disorders, providing common pathways of epidemiological transition as well as public health action.

    Estimating the burden of non-communicable diseases

    Validated nationally representative estimates of cause specific mortality are not available for any country in South Asia. The available …

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