Burden of non-communicable diseases in South Asia

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.2^–4 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 …