The Cost of Chronic Diseases

by Howard Jamison on January 23, 2013

Noncommunicable diseases – or NCDs – like heart attacks and strokes, cancers, diabetes and chronic respiratory disease account for over 63% of deaths in the world today. The socio-economic impact is staggering – trillions of dollars!

The predominant view is that chronic illnesses are the rich man’s burden. Only the wealthy, the thinking goes, live long enough to die in large numbers of cancer and heart disease. (We tend to think a lot less about the other two big killers in Western society, diabetes and chronic obstructive pulmonary disease.) The flip-side of this view is that the poor, those in developing countries, are ravaged by infectious diseases such as HIV-AIDS, malaria, tuberculosis and childhood killers such as measles and diarrheal illnesses, so they don’t have the “luxury” of dying of chronic illnesses.

But the reality is a lot more complex.

Non-communicable diseases are becoming more common and deadly because of our lifestyle excesses such as poor diet, sedentary behaviour, smoking and excessive alcohol consumption, not to mention our overreliance on expensive treatments rather than cheap prevention tools.

NCDs are rising at a dizzying rate because of a combination of lifestyle, environmental threats and poor access to basic care.

Shifting wealth and food supply patterns mean that as many people now die of excess food consumption as malnutrition.

Similarly, while smoking is on the decline in the developed world, rates continue to rise in the developing world. And while cervical cancer is rare in Western countries with Pap testing, it is one of the leading killers of women worldwide.

In fact, the poor – and poor women specifically – are now the principal victims of NCDs, particularly in emerging economies such as China and India.

In India, new-found wealth has created a huge market for Western-style packaged foods (rife with salt, sugar, trans fats etc.) and helped engineer activity out of daily living. This, in turn, has fuelled an epidemic of high blood pressure, and troubling rates of diabetes and heart disease.

While China’s factories crank out consumer goods for the planet, workers in these plants – who often toil in horrible conditions – are seeing their rates of respiratory illness and cancer soar. The Chinese government also relies heavily on revenues from tobacco sales, which exceed $76-billion a year.

Those realities make it difficult to get buy-in for the simple measures that are required to slow the rate of chronic illnesses.

Of course, we’re all going to die some day. Those who live a long life will invariably succumb to a non-communicable disease.

But the goal here is not to help people live forever. Rather, it is to stave off the ravages of illness and disability as long as possible to ensure a good life before a good death.

The only way to do that successfully is to invest in prevention, to invest in people, not diseases. Billions spent wisely today will save trillions tomorrow.



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