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NCDs: The biggest threat to health systems and economic growth in developing countries

By Grace Virtue

The outbreak of Ebola in West Africa between 2013 and 2016 caused widespread disruption in Liberia, Sierra Leonne, and Guinea. It triggered global hysteria amid fear that, in an interconnected world, the deadly virus could quickly spread anywhere in the world. A relatively new virus, Ebola first appeared in Sudan and Zaire in 1976 and is ranked among the deadliest, killing 90 percent of its victims.

While fears of a pandemic may have been exaggerated, they were not entirely unfounded. Thousands of miles away from Guinea, where the outbreak began, the first case of Ebola in the United States turned up in Dallas, Texas, in September 2014. The U.S. Centers for Disease Control confirmed that a man who traveled from West Africa was infected with the Ebola virus. He died October 8, 2014. Two healthcare workers who cared for him were also infected with the virus. Both recovered. Overall, 11 people were treated for Ebola in the United States between 2014 and 2016.

Ebola also turned up in Europe in October 2014 when a nurse in Madrid who had treated two patients also contracted the disease. She recovered, but even more attention was drawn to her case by the Spanish government’s decision to euthanize her dog, fearing that he could become a benign carrier. By the end of 2016, the tremendous effort and resolve by national governments and international agencies brought the outbreak under control. Yet, in just the last month, the virus has reemerged in the Democratic Republic of the Congo, again calling attention to the lethal nature of the disease and again raising fears of a pandemic.

Ebola is not unlike other infectious diseases that have devastated populations worldwide. In the 20th century alone, smallpox killed more than 300 million people. The discovery of the smallpox vaccine led to its eradication with the last known case reported in 1977, according to the World Health Organization (WHO). Polio is on the verge of being eradicated this year, following the development of a preventative vaccine and global efforts to eradicate it. Tuberculosis (TB), another deadly infectious disease still kills nearly two million people a year and is ranked among the top ten leading causes of death. This year, the United Nation’s will host the first ever high-level meeting on TB in a bid to end the disease by 2030.

The scourge of non-communicable diseases

Where infectious diseases were once the scourge of humanity, non-communicable diseases now pose the greatest threat to health and well-being and the greatest disease burden on national economies, particularly in developing countries.

This may come as a surprise to some since NCDs are medical conditions or diseases that are non-transmissible and, in some cases, preventable. NCDs include diabetes, cancer, heart disease, strokes, and hypertension (or high blood pressure). While genetics and environmental factors play a part, the escalating crisis of NCDs is attributed to lifestyle conditions, including tobacco smoking, alcohol consumption, inappropriate diet, and lack of exercise. Rapid urbanization, rural-urban drifts, and the adoption of urban lifestyles in rural areas — such as driving instead of walking and overconsumption of pre-packaged foods high in sugar, fat, and fiber but low in nutrients — are among the lifestyle choices fueling the epidemic of obesity, stroke, stress, atherosclerosis, cancer, and other NCDs.

With an estimated 7 out of 10 deaths attributable to NCDs, health systems and the economies of most developing countries are buckling under the weight of NCDs, which are also the world’s main killer. The negative impact on developing countries rests not only in the treatment costs, but also in the fact that NCDs typically affect people in the prime of their lives. Resulting disabilities and deaths rob societies of their primary workforce and impose great financial costs on individuals and families. Experts estimates that over the next 20 years, NCDs will cost more than US$30 trillion, representing 48 percent of global GDP in 2010, and will push millions of people below the poverty line. In the absence of coordinated efforts by governments, the private sector, and multilateral agencies to prevent millions of deaths and avert the massive economic cost to national economies, the ageing of the global population and continued rapid and unplanned urbanization will exacerbate the problem.

An opportunity at the World Health Assembly

In a roundtable on the sidelines of the 71st World Health Assembly in Geneva, Switzerland, the ACTION global health advocacy partnership, Global Health Council, the NCD Roundtable, and the Stop TB Partnership seek to address the burden of NCDs compounded by the persistence of TB in developing countries and the need for an integrated approach to address the problem. The session, titled “From the Ground Up: TB, NCDS, and Resilient Health Systems for All,” will examine how these conditionsimpede economic growth, undermine progress toward global poverty eradication, and slow progress towards development goals like universal health coverage.”

The evidence is clear that NCDs represent a serious and growing threat to the global economy with disease trends running counter to the Sustainable Development Goal (SDG3) of “health for all, at all ages” by 2030. Without immediate action that is coordinated, consolidated, and targeted to address the problem, it is already obvious that this goal — to be attained in a mere 12 years — will remain little more than a pipe dream.

Grace Virtue, Ph.D., is senior communications advisor at ACTION.