Low-income nations have options against diseases

A new World Health Organization (WHO) study reveals on Monday that low-income countries could introduce a core set of strategies to prevent and treat cancer, heart disease, diabetes, and lung disease for just USD 1.20 per person per year. "Noncommunicable diseases are the leading cause of death worldwide, killing ever more people each year. Nearly 80 percent of these deaths occur in low and middle income countries," says Assistant Director-General for Noncommunicable Diseases and Mental Health at WHO Dr. Ala Alwan. "The challenge to these countries is tremendous, but this study proves that there are affordable steps all governments can take to address noncommunicable diseases." The impact of noncommunicable diseases - or NCDs - goes beyond health; their socioeconomic effects are staggering. The cost of not taking action to address this global threat is already severe and will intensify over time. "Noncommunicable diseases are one of the leading threats to global economic growth and development. Over the next 15 years, noncommunicable diseases will cost low and middle income countries more than USD 7 trillion," says Chairman of World Economic Forum (WEF) USA, Jean-Pierre Rosso, quoting the results of a WEF and Harvard School of Public Health study released today. "When so many of the workforce is sick and dies in their productive years, national economies lose billions of dollars in output. And millions of families are pushed into poverty." The WHO study set out to help low and middle-income countries identify low-cost interventions that can help turn the tide on NCDs and reduce their economic burden. The interventions must be highly cost-effective, and there must be strong evidence that they prevent disease and save lives. The list includes measures that target the population as a whole, such as excise taxes on tobacco and alcohol, smoke-free indoor workplaces and public places, health information and warnings, as well as campaigns to reduce salt content and replacement of trans-fats with polyunsaturated fats, along with public awareness programmes about diet and physical activity. Other tactics focus on the individual. These include screening, counseling, and drug therapy for people with or at high risk of cardiovascular disease, screening for cervical cancer, and hepatitis B immunization to prevent liver cancer. Many countries have already adopted these approaches, and have seen a marked reduction in disease incidence and mortality. WHO monitored progress over ten years in 38 countries taking steps to address cardiovascular disease at both the population and individual level; all recorded a substantial decrease in exposure to risk, incidence of disease, and deaths. "The new tool will help countries with limited resources work out what the "best buys" are and what they will cost," adds Dr. Alwan. "Implementing them would save literally millions of lives over the next 15 years." In compiling the tool, WHO considered five key ingredients: the size of the population; the extent of the burden of disease; the proportion of the population that would be covered by the strategies; the resources required (human, medicines, technology); and the unit cost for salaries and medicines. No intervention that costs more than USD 0.50 per person per year was included. The total cost for adopting these strategies in all low and middle-income countries would be USD 12 billion per year. Providing access to population-based interventions in all low and middle income countries would cost a total of USD 2 billion per year. That breaks down to less than USD 0.20 per person per year in low-income and lower middle-income countries, and around USD 0.50 per person per year in upper-middle income countries. Providing access to individual-level NCD best buys costs just over USD 10 billion per year for all low and middle-income countries. For the period 2011-2025, the annual per capita cost will be USD 1 in low-income countries; USD 1.50 in lower middle income countries; and USD 2.50 in upper middle income countries. High-income countries spend USD 4 trillion per year on health. The United States of America alone spends USD 2 trillion per year. Noncommunicable diseases - heart attacks and strokes, cancers, diabetes, and chronic respiratory disease - account for over 63 percent of deaths in the world today. Every year, NCDs kill 9 million people under 60 years old, and 90 percent of these premature deaths occur in low and middle income countries. September 19-20, 2011, world leaders gather at the United Nations High-level meeting on noncommunicable diseases in New York to set a new international agenda for tackling the issue.