Resources Lesson 1: Non-Communicable Diseases

Non- Communicable diseases (NCD's) are an increasingly important cause of death and disability worldwide. The NCD Alliance states in its section NCDs "Noncommunicable diseases (NCDs) – mainly cancer, cardiovascular disease, chronic respiratory diseases, and diabetes – are the most common cause of death and disability worldwide, accounting for 70% of all deaths and more than three out of four years lived with a disability.

70% of global deaths are attributable to noncommunicable diseases (NCDs)

NCDs are diseases which are not transmissible from person to person

Each year, 15 million people aged 30-69 die from a NCD

86% of premature NCD deaths occur in low and middle income countries (LMICs)

Most NCDs are preventable

Historically considered to be diseases of the rich and elderly, NCDs are now severely impacting on people in low- and middle-income countries (LMICs). Four out of five people with an NCD live in a LMIC. 
 
Driven largely by four main modifiable risk factors – tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol – NCDs are a major cause of poverty and a barrier to economic and social development. 
 
Many NCDs are preventable and premature - claiming health and lives, with the global burden of NCDs expected to increase by 17% by 2025.
 
With the largest NCD burden occurring in LMICs and leading to and perpetuating poverty, the prevention and control of NCDs is an urgent development issue. The costs to individuals and society of healthcare and loss of income-earners hampers poverty reduction and sustainable development.  NCDs constrain the bottom billion in chronic poverty."
The top 10 causes of death from WHO: shows that these differ according to the country's income group. Only in low-income group countries do infectious diseases (pneumonia and diarrohoea) cause more deaths than ischaemic heart disease.

You may like to choose a particular disease and read the relevant sections on Diabetes, Cancer, Cardiovascular Disease, and Chronic Respiratory Diseases.

The rising burden of non-communicable diseases in sub-Saharan Africa gives us some more figures: "Non-communicable diseases (NCDs) represent the leading cause of death worldwide, killing 41 million people each year—equivalent to 71% of all deaths globally. Among NCDs, the four top killers that together account for more than 80% of all premature NCD deaths include cardiovascular diseases (17·9 million deaths annually), cancers (9·0 million), respiratory diseases (3·9 million), and diabetes (1·6 million).

NCDs are set to overtake communicable, maternal, neonatal, and nutritional (CMNN) diseases combined as the leading cause of mortality in sub-Saharan Africa by 2030."

Obesity is also a major global epidemic and Obesity and overweight from WHO gives a nice summary.

Planetary health. Global Environmental Change and Noncommunicable Disease Risks is a provocative paper which breaks new ground. The abstract states: "Multiple global environmental changes (GECs) now under way, including climate change, biodiversity loss, freshwater depletion, tropical deforestation, overexploitation of fisheries, ocean acidification, and soil degradation, have substantial, but still imperfectly understood, implications for human health. Noncommunicable diseases (NCDs) make a major contribution to the global burden of disease. Many of the driving forces responsible for GEC also influence NCD risk through a range of mechanisms. This article provides an overview of pathways linking GEC and NCDs, focusing on five pathways: (a) energy, air pollution, and climate change; (b) urbanization; (c) food, nutrition, and agriculture; (d) the deposition of persistent chemicals in the environment; and (e) biodiversity loss."

Global control and prevention programs

The Disease Control Priorities DCP3 includes an important section: Cardiovascular, Respiratory, and Related Disorders: Key Messages on Essential Interventions to Address its Burden in Low-and Middle-Income Countries where you can read details of the existence of relevant cost-effective interventions. Here is the abstract, but if you go to the site you will be able to read each of the chapters and download the pdf files for more detail:

"Adults living in low- and middle-income countries (LMICs) face high risk for death, disability, and impoverishment from cardiovascular, respiratory, and related disorders (CVRDs). Most of these disorders prove preventable or, if they occur, remain medically treatable to improve longevity and reduce disability. Optimal prevention and treatment—which require resources but also consistent and persistent therapeutic compliance—remain a challenge even in high-income countries (HICs). Additionally, in LMICs, the limited capacity to detect these silent diseases and provide early treatment contributes to the rapid emergence of advanced complications and premature death. Effective prevention strategies remain underutilized, and primary care centers require strengthening to treat the current and growing burden of CVRDs. Cost-effective prevention policies and treatments for CVRDs remain possible to implement in LMICs, and universal health care that includes care for CVRDs provides benefits beyond individual health to financial protection of families. Many important issues remain uncertain, however, especially given the scarcity of LMIC economic evidence, including research in areas likely to produce high public benefit and new technologies, medications, and delivery platforms."

Last modified: Saturday, 5 June 2021, 5:49 PM