Addressing the impact of noncommunicable diseases

 

In the world today, more people live in urban than in rural communities, more people are overweight than are underweight, and more people die from noncommunicable diseases (NCDs) than from infections. In fact, NCDs are the biggest killer around the world, and in 2008 accounted for 63%—or 36 million—of the 57 million deaths globally.[1]

It is a misconception that NCDs are exclusively diseases of developed countries, as the burden of these diseases has been rising disproportionately within low- and middle-income countries (LMIC). In 2008, almost 80% of all NCD deaths—nearly 29 million—occurred in LMICs. [2] WHO has classified the four main disease types responsible for 80% of NCD deaths globally[3]:

  • cardiovascular disease (48% of NCD deaths)
  • cancer (21% of NCD deaths)
  • chronic respiratory disease (11% of NCD deaths)
  • diabetes (3.6% of NCD deaths)

As LMICs make strides in economic development and in reducing infectious disease and malnutrition, they have become increasingly vulnerable to NCDs and their significant socioeconomic consequences.

Noncommunicable diseases have an increasingly important impact on development both at home and abroad, primarily because unlike most acute infections, the chronic course of NCDs often impedes social and economic growth and upward mobility, thereby deepening inequalities.[4] Additionally, most NCDs share several common risk factors that not only present challenges to clinical management, but warrant an integrated health system, as opposed to the vertical program management of many infectious diseases.

How the global community approaches these challenges will determine the global health landscape for the years to come. JSI’s work has long centered on tackling the growing problem of NCDs and the inequities associated with them, both domestically and internationally.

Working within the United States, and with the priorities set by national and state governments, JSI has led over 60 programs aimed at addressing the NCD epidemic. From running the Massachusetts Smokers Helpline, the only publicly funded statewide tobacco cessation resource available, to the REACH Breast and Cervical Cancer project, a national, multi-level initiative in the CDC’s efforts to eliminate racial and ethnic health disparities, JSI has been developing effective, evidence-based solutions to the NCD epidemic.

These efforts extend internationally, where NCDs are expected to increase in the coming decades by 15% globally, and more than 20% in Africa, South-East Asia, and the Eastern Mediterranean. Even in Africa, a hold-out for infectious causes of mortality, NCDs are expected to surpass infections as the leading cause of death by 2030.[5]

JSI’s multi-faceted and integrated approach to mitigating NCDs internationally begins with education and health promotion—such as the cancer awareness campaigns on the Survive Project in the Republic of Georgia and JSI’s work with LIVESTRONG in South Africa and Mexico. It also includes re-thinking policy and public planning—similar to the ongoing multi-decade work that the JSI-led USAID | DELIVER PROJECT has done in supply chain management reform and strengthening.

Global attention for the issue is gaining momentum, and in May 2013, the 194 World Health Organization member states endorsed the 2013-2020 NCD Global Action Plan and the Global Monitoring Framework for NCDs at the World Health Assembly. The goal of this plan is to “reduce the preventable and avoidable burden of morbidity, mortality, and disability due to noncommunicable diseases by means of multisectoral collaboration and cooperation at national, regional, and global levels, so that populations reach the highest attainable standards of health and productivity at every age and those diseases are no longer a barrier to well-being or socioeconomic development.” [6]

The release of the proposed monitoring framework has laid a political commitment and data-driven foundation to tackle these diseases. Further, as the Sustained Development Goals (SDGs) are being defined, it is hoped that the prominence of NCDs will their mitigation a priority. JSI will continue to support these efforts in the United States and globally.

Learn more about noncommunicable diseases on jsi.com.

 


[1] Alwan A et al. Monitoring and surveillance of chronic noncommunicable diseases: progress and capacity in high-burden countries. The Lancet, 2010, 376:1861–1868.

[2] World Health Organization. Global status report on noncommunicable diseases (2010) http://www.who.int/nmh/publications/ncd_report_full_en.pdf

[3] World Health Organization. Package of essential noncommunicable (PEN) disease interventions for primary health care in low-resource settings (2010) http://whqlibdoc.who.int/publications/2010/9789241598996_eng.pdf

[5] The global burden of disease: 2004 update.  Geneva, World Health Organization, 2008.

[6] Follow-up to the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases; SIXTY-SIXTH WORLD HEALTH ASSEMBLY WHA66.10 Agenda item 13.1, 13.2; 27 May 2013

 

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