Billions Of Dollars And Millions Of Lives Saved If Chronic Disease Totals Could Be Reduced

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Main Category: Public Health
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Article Date: 05 Dec 2007 - 0:00 PDT

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We could save millions of lives and billions of dollars worldwide if a 2% annual reduction in chronic disease mortality rates were achieved - this would have an enormous impact on the economies of low and middle income countries, according to Dr Colin Mathers, Department of Measurement and Health Information, WHO (World Health Organization), Switzerland, and teams, authors of the first paper in The Lancet Chronic Diseases Series.

If deaths were prevented it would mean people would live longer and healthier lives, say the authors. Even though death, and many chronic diseases, do eventually creep up on us, they could take place much later in life if the strategies summarized in this Series were put into practice. According to the research included in this Series, people in 23 countries* would have an extra 18 years of life - an incredible figure, calculated by dividing life years gained (454m) by deaths averted (24m).

80% of the total burden of chronic disease mortality in the developing world comes from these 23 countries the authors selected, including China, India, Russia, Brazil, Turkey, Mexico, Pakistan, South Africa, Poland and Nigeria. In these countries, such as diseases as cancer, diabetes, cardiovascular diseases, chronic respiratory diseases - in other words, chronic diseases - represented 50% of the total disease burden for 2005. In fact, in 15 of those countries the chronic diseases death rates are 86% higher for women and 54% higher for men, compared to females and males from developed nations.

"If nothing is done to reduce the risk of chronic diseases, an estimated US$84 billion of economic production will be lost from heart disease, stroke, and diabetes alone in these 23 countries between 2006 and 2015," the authors explain.

If mortality rates due to chronic diseases could fall an extra 2% per year in these 23 countries, 24 million deaths would be averted, as well as 10% of loss of income ($80 billion) by 2015.

If nothing is done about it, chronic diseases will account for 34.3 million deaths by 2030, compared to 23.1 million in 2005, representing 53% of all deaths for the under 70s by 2030, up from 46% today.

The paper, which looked at Brazil, explains how the benefits of reducing tobacco consumption have been offset by ever-increasing cholesterol and obesity levels. In Brazil, chronic diseases accounted for approximately 70% of all deaths in 2005.

"How realistic is the global goal proposal?" the writers ask.

Under baseline projections, chronic disease death rates for 0-59 and 60-69 age groups should drop by a yearly average 0•3% and 1•2% respectively for the 23 nations.

Therefore, the worldwide goal would correspond to an annual average fall of 2.3% for 0-59 year age group and 3•2% for the 60-69 year age group between 2005 and 2015.

Developed nations have shown that this is achievable with sustained interventions, the authors explain.

For 0-59 year olds, chronic disease death rates in El Salvador, Germany (males), and Panama dropped by over 2%. For those aged 60-69, average annual falls in chronic disease death rates were well over 3% for several populations, including Australia, Czech Republic, England and Wales.

Should the global goal be achieved, healthy life expectancy at birth would go up by 0.7-2.1 years in the 23 countries, the writers believe.

"Although most communicable diseases are widely accepted as primarily diseases of poor people, policymakers do not fully understand that chronic diseases have also become diseases of poor people in most settings. he rising burden of chronic disease will be especially severe in low-income and middle-income countries, which are those than can least afford a health-related setback to development. In these countries, resources for treatment are already stretched to the limit, and chronic disease prevention - focusing on reducing known, modifiable risk factors - will therefore be central to incidence and mortality reductions," the authors conclude.

*The 23 countries studies in the Series are: Argentina, Bangladesh, Brazil, Burma, China, Colombia, Democratic Republic of Congo, Egypt, Ethiopia, India, Indonesia, Iran, Mexico, Nigeria, Pakistan, Philippines, Poland, Russia, South Africa, Thailand, Turkey, Ukraine, Vietnam.

www.thelancet.com

Written by - Christian Nordqvist
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