We are entering a new era in global health.
It starts with some good news: the number of people who die each year from infectious diseases around the world Petni. less Women are dying in childbirth. More children survive childhood and average life expectancy growth In many places this results in billions of people living lives that would have been shortened in decades past.
But here’s the bad news: with More people are living longer, Non-communicable diseases – Conditions not transmitted from person to person, such as most cancers, diabetes and heart disease – are becoming more common. In 2019, the most recent year for which data is available, noncommunicable or chronic diseases nearly killed 41 million People, has increased by about 10 million since 2000. It accounts for about 75 percent of all deaths worldwide, making it an international crisis.
This story first appeared in the Future Perfect Newsletter.
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Rich countries – surrounded by a old age Population and rapid growth obesity And Physical inactivity – has been dealing with these problems for decades with varying degrees of success. But they have modern health system to treat people. Low- and middle-income countries – where the number of people with chronic diseases is growing faster than in developed countries – lack of The same health infrastructure for prevention and treatment of these diseases. almost 80 percent All deaths from noncommunicable diseases are in low- and middle-income countries. The burden of chronic disease is rising fastest in these countries.
And although many of these poor countries have made great strides against infectious diseases, threats such as malaria or tuberculosis are still high. This dual burden of chronic and communicable diseases will only further strain the health system and even Set back National and global economic gains.
To understand the sheer global scale of noncommunicable diseases and the challenges that low- and middle-income countries face in particular, here are four charts that show how urgently we need increased funding and society-wide solutions.
The global burden of non-communicable diseases
D most common Noncommunicable diseases worldwide are cardiovascular disease, cancer, chronic respiratory disease and diabetes.
every year 18 million People die from Cardiovascular disease which affects the heart and blood vessels and can lead to heart attack, stroke or heart failure. About 9 million people die each year from cancer, 4 million from chronic respiratory diseases disease such as asthma or COPD, and 2 million from diabetes. But both the burden of disease and access to modern healthcare are disproportionately distributed.
Low- and middle-income countries, including Uzbekistan, Afghanistan, Yemen, Egypt, and Syria, have the highest incidence and mortality rates. rate. Increases in air pollution, tobacco use, excessive alcohol consumption, poor diet and aging. the risk For cardiovascular disease. stress And Post-traumatic stress disorder may also increase the risk of cardiovascular disease, which may explain why the burden is so high in war-torn countries.
Cancer incidence is highest in Australia and New Zealand, with more than 400 cases per 100,000 people. there is Some forms of cancer. Denmark, the United States, Norway, Canada, Ireland and other high-income European countries follow. The lowest cancer rates, adjusted for age, are in Sierra Leone, Gambia, Congo, Nepal, Qatar, Yemen, Rwanda and Niger – all low-income countries except Qatar.
The global burden of cancer is high concentrated in developed countries, but the burden of diabetes is more evenly spread and is increasing rapidly in developing countries. International Diabetes Foundation estimates 537 million Adults were living with diabetes in 2021, and 75 percent of them lived in a low- or middle-income country. about 18 percent Adults in the Middle East and North Africa had diabetes in 2021, the highest for any global region.
Between 2000 and 2021, diabetes rates nearly tripled in the Western Pacific region and nearly doubled in Southeast Asia, the Middle East and North Africa, and South and Central America. Sub-Saharan African countries had the lowest burden in 2021, with only 5 percent of adults having diabetes, but that rate has increased fivefold since 2000.
Aging, obesity and physical inactivity are known risk factors For diabetes. African countries are the youngest countries in the world, most activeAnd At least gross population, so it makes sense that they have the lowest rate of diabetes.
But that is beginning to change in many African countries. People are increasingly crowding into the rapidly developing urban city centers where they live More possibilities To find higher amounts of low-quality food, to be less active and to live longer.
Challenges in treating non-communicable diseases in developing countries
Developing countries face many of the same challenges in the prevention and treatment of infectious diseases—eg weak Health care systems, lack of access to medicines and insufficient funding – are also barriers to high quality care for non-communicable diseases.
But, in many ways, treating noncommunicable diseases is more complicated than treating people with communicable diseases.
For one, patients with noncommunicable diseases require treatment over years or even decades, whereas those with infectious diseases usually require immediate but relatively short-term care. And people with noncommunicable diseases often require multifaceted care; A cancer patient may need radiology, chemotherapy and surgery, not to mention palliative care or pain management.
These services are usually offered in a handful of health facilities located in capital cities the urban There are also such treatment centers expensiveAnd the vast majority of people in developing countries No health insurancepublic or private. So many people either avoid care altogether or end up in catastrophic medical debt. African households are more likely to overspend 25 percent Their total household budget on health compared to other regions.
Social stigma Another obstacle to proper treatment is gender disparity around non-communicable diseases. For example, in Bangladesh, social taboos surround breast cancer screening resistance Early detection. In some countries, Once a woman is diagnosed with breast cancer, there is often a stigma that she is having punishment For immorality and as a result, are often confronted Abuse or abandonment from his family.
Despite growing numbers, noncommunicable diseases are not always a public health priority. In 2021, 143 of 194 Countries for which data were available had a dedicated department within their National Health Organization. However, 41 countries, including many in Africa, did not.
Global health spending has not kept pace; only about 2 percent All expenditure on global health is attributed to non-communicable diseases. Developing countries now face the dual threat of infectious and chronic diseases, stretching already overburdened and under-resourced health and public health systems.
Historically silent approaches to addressing global health will not suffice in this new era of public health challenges. What is needed are solutions that truly strengthen the health care system. These include improving health financing, expanding access to specialized services, and ensuring patients trust the health care system and get care before they get sick.
