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Need to increase focus on non-communicable diseases in global health, says WHO

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c7065 (Published 08 December 2010) Cite this as: BMJ 2010;341:c7065
  1. John Zarocostas
  1. 1Geneva

Governments worldwide need to increase the priority given to fighting non-communicable diseases especially in the poorest nations, the World Health Organization says.

The sense of urgency by WHO is driven by the high and projected increases in the prevalence rates of non-communicable diseases—cardiovascular diseases, cancers, diabetes, and chronic lung diseases.

These four major groups of diseases share four risk factors—tobacco use, unhealthy diet, physical inactivity, and the harmful use of alcohol.

Ala Alwan, WHO’s top official for non-communicable diseases and mental health, said, “The reason for the focus on these four major group of diseases is because they are responsible for about 80-85% of mortality due to chronic diseases, and because they also share the same risk factors.”

Dr Alwan told reporters the magnitude is increasing globally. Non-communicable diseases are currently responsible for 60% of all deaths, or more than 35 million deaths every year, of which 80% occur in low and middle income countries.

Up to 25% of deaths from non-communicable diseases occur in people under 60 years of age, he said.

“They are not only an enormous health problem, but they are also a problem that has very negative socioeconomic consequences,” he added.

Dr Alwan said that according to mortality estimates in all regions except Africa more than 50% of deaths are caused by non-communicable diseases and among these, the leading cause of death is cardiovascular disease.

The WHO predicts that global mortality from non-communicable diseases will increase by 17.6% during 2006 to 2015; by more than 24% in some regions such as Africa, and by 23% in the Western Pacific and South East Asia.

The treatment and health care for people with non-communicable diseases is also expensive, and increasing, Dr Alwan said. In poor populations a substantial proportion of families with a relative with cancer or heart disease will experience catastrophic expenditure, which will drive the family below the poverty line.

“We see higher levels of risk factors like tobacco, and overweight and obesity in the lower social-economic class[es] and we also see the highest prevalence of diabetes occurring in developing populations,” he said.

Dr Alwan, a former minister of health of Iraq, also highlighted that non-communicable diseases are “largely preventable if we address risk factors with tobacco control, address unhealthy diet and physical inactivity.”

He said international efforts to implement a global strategy to control and prevent non-communicable diseases is leading to the development of indicators similar to the millennium development goals together with a monitoring mechanism. Greater priority needs to be given to non-communicable diseases in health and broader development agendas, he said.

Dr Alwan added that the private sector, including the food and beverages industries, also has to provide some solutions. These include responsible marketing, especially for children, and a greater emphasis on more healthy products.

Notes

Cite this as: BMJ 2010;341:c7065