Monday, September 19, 2011

[EQ] The Global Economic Burden of Non-communicable Diseases

The Global Economic Burden of Non-communicable Diseases

A report by the World Economic Forum and the Harvard School of Public Health

September 2011

Available online PDF [48p.] at: http://bit.ly/odBjrH

“……As policy-makers search for ways to reduce poverty and income inequality, and to achieve sustainable income growth, they are being encouraged to focus on an emerging challenge to health, well-being and development: non-communicable diseases (NCDs).

After all, 63% of all deaths worldwide currently stem from NCDs – chiefly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. These deaths are distributed widely among the world’s population – from high income to low-income countries and from young to old (about one-quarter of all NCD deaths occur below the age of 60, amounting to approximately 9 million deaths per year). NCDs have a large impact, undercutting productivity and boosting healthcare outlays. Moreover, the number of people affected by NCDs is expected to rise substantially in the coming decades, reflecting an ageing and increasing global population.

With this in mind, the United Nations is holding its first High-Level Meeting on NCDs on 19-20 September 2011 – this is only the second time that a high-level UN meeting is being dedicated to a health topic (the first time being on HIV/AIDS in 2001). Over the years, much work has been done estimating the human toll of NCDs, but work on estimating the economic toll is far less advanced.

In this report, the World Economic Forum and the Harvard School of Public Health try to inform and stimulate further debate by developing new estimates of the global economic burden of NCDs in 2010, and projecting the size of the burden through 2030.

Three distinct approaches are used to compute the economic burden:
(1) the standard cost of illness method;
(2) macroeconomic simulation and
(3) the value of a statistical life.

This report includes not only the four major NCDs (the focus of the UN meeting), but also mental illness, which is a major contributor to the burden of disease worldwide.

This evaluation takes place in the context of enormous global health spending, serious concerns about already strained public finances and worries about lack lustre economic growth. The report also tries to capture the thinking of the business community about the impact of NCDs on their enterprises.

Five key messages emerge:

• First, NCDs already pose a substantial economic burden and this burden will evolve into a staggering one over the next two decades. For example, with respect to cardiovascular disease, chronic respiratory disease, cancer, diabetes and mental health, the macroeconomic simulations suggest a cumulative output loss of US$ 47 trillion over the next two decades. This loss represents 75% of global GDP in 2010 (US$ 63 trillion). It also represents enough money to eradicate two dollar-a-day poverty among the 2.5 billion people in that state for more than half a century.

• Second, although high-income countries currently bear the biggest economic burden of NCDs, the developing world, especially middle-income countries, is expected to assume an ever larger share as their economies and populations grow.

• Third, cardiovascular disease and mental health conditions are the dominant contributors to the global economic burden of NCDs.

• Fourth, NCDs are front and centre on business leaders’ radar. The World Economic Forum’s annual Executive Opinion Survey (EOS), which feeds into its Global Competitiveness Report, shows that about half of all business leaders surveyed worry that at least one NCD will hurt their company’s bottom line in the next five years, with similarly high levels of concern in low-, middle- and high-income countries – especially in countries where the quality of healthcare or access to healthcare is perceived to be poor. These NCD-driven concerns are markedly higher than those reported for the communicable diseases of HIV/AIDS, malaria and tuberculosis.

• Fifth, the good news is that there appear to be numerous options available to prevent and control NCDs. For example, the WHO has identified a set of interventions they call “Best Buys” There is also considerable scope for the design and implementation of programmes aimed at behaviour change among youth and adolescents, and more cost-effective models of care – models that reduce the care-taking burden that falls on untrained family members.
Further research on the benefits of such interventions in relation to their costs is much needed….”

Table of Contents

Preface

Executive Summary

1. Background on NCDs

2. The Global Economic Burden of NCDs

2.1 Approach 1: Cost-of-Illness

2.2 Approach 2: Value of Lost Output

2.3 Approach 3: Value of a Statistical Life

3. Conclusion

References

List of Tables

List of Figures

List of Boxes

Bloom, D.E., Cafiero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K.,
Rosenberg, L., Seligman, B., Stein, A., & Weinstein, C. (2011).

The Global Economic Burden of Non-communicable Diseases. Geneva: World Economic Forum.

See www.weforum.org/EconomicsOfNCD

See online appendix for detailed notes on the data sources and methods: www.weforum.org/EconomicsOfNCDappendix

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[EQ] Reduction in health inequalities made the population of Japan healthy

From: David McDaid
Sent: Monday, September 19, 2011

fyi

What has made the population of Japan healthy?

ayu Ikeda PhD a, Eiko Saito MSc a, Naoki Kondo PhD b, Manami Inoue MD c, Prof Shunya Ikeda PhD d, Prof Toshihiko Satoh MD e, Koji Wada PhD f, Andrew Stickley PhD a, Kota Katanoda PhD g, Tetsuya Mizoue PhD h, Mitsuhiko Noda MD i, Prof Hiroyasu Iso PhD j, Prof Yoshihisa Fujino PhD k, Tomotaka Sobue MD g, Shoichiro Tsugane MD c, Prof Mohsen Naghavi PhD l, Prof Majid Ezzati PhD m, Prof Kenji Shibuya MD a
The Lancet, Volume 378, Issue 9796, Pages 1094 - 1105, 17 September 2011

Abstract: http://bit.ly/nMymzL

“…..People in Japan have the longest life expectancy at birth in the world. Here, we compile the best available evidence about population health in Japan to investigate what has made the Japanese people healthy in the past 50 years.

The Japanese population achieved longevity in a fairly short time through a rapid reduction in mortality rates for communicable diseases from the 1950s to the early 1960s, followed by a large reduction in stroke mortality rates. Japan had moderate mortality rates for non-communicable diseases, with the exception of stroke, in the 1950s.

The improvement in population health continued after the mid-1960s through the implementation of primary and secondary preventive community public health measures for adult mortality from non-communicable diseases and an increased use of advanced medical technologies through the universal insurance scheme.

Reduction in health inequalities with improved average population health was partly attributable to equal educational opportunities and financial access to care. With the achievement of success during the health transition since World War 2, Japan now needs to tackle major health challenges that are emanating from a rapidly ageing population, causes that are not amenable to health technologies, and the effects of increasing social disparities to sustain the improvement in population health…..”

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[EQ] Global Atlas on cardiovascular disease prevention and control

Global Atlas on cardiovascular disease prevention and control

CVDs Joint Publication of the World Health Organization the World Heart Federation Organization
editors: Shanthi Mendis, Pekka Puska and Bo Norrving

Available online PDF [164p] at: http://bit.ly/mUce0M

Lives Cut Short: New Report Reveals Divide between Rich and Poor Countries for Premature Cardiovascular Disease Deaths

Data provides a wake-up call for governments and individuals to take action against heart disease and stroke

New York, 17 September 2011 – A new global analysis reveals that some of the poorest countries in the world have among the highest age-standardized mortality rates of cardiovascular disease (CVD). The data, launched today ahead of the United Nations High-Level Meeting (HLM) on Non-Communicable Diseases, reveals growing inequalities in the cases and deaths of CVD between countries and populations, with the percentage of premature deaths from CVD more than twice as high in low-income countries compared with high-income countries.

The Global Atlas on Cardiovascular Disease Prevention and Control also shows that by taking action to curb CVD risk, governments and individuals can reduce the health and socioeconomic burden caused by these diseases.1

“Heart disease and stroke, together with other cardiovascular diseases, are often wrongly seen as diseases of affluence, although they affect the poor as well as the rich,” said Dr Shanthi Mendis, Coordinator of CVD, World Health Organization. “The new Global Atlas data reveal that although death rates from CVD have been declining in high-income countries over the past two decades, they have increased at an astonishingly fast rate in low- and middle-income countries. Now is the time for us to invest in affordable health interventions to ensure that the world’s poorest people are not subject to the growing CVD burden in addition to communicable diseases.”

CVD remains the biggest cause of deaths worldwide. More than 17 million people died from CVD in 2008, with 82 per cent of deaths occurring in low- and middle-income countries. More than 3 million deaths occurred before the age of 60, many of which could have been prevented through the modification of risk factors: tobacco use, unhealthy diet, lack of physical activity, excessive alcohol consumption and strengthening primary care….”

Content:

Section A – Cardiovascular diseases (CVDs) due to atherosclerosis 1

1. What are cardiovascular diseases (CVDs)? 2

2. Death and disability due to CVDs (heart attacks and strokes) 8

3. The underlying pathology of heart attacks and strokes 14

4. Evidence for prevention of heart attacks and strokes 16

5. Reducing cardiovascular risk to prevent heart attacks and strokes 18

6. Tobacco: The totally avoidable risk factor of CVDs 26

7. Physical inactivity: A preventable risk factor of CVDs 28

8. Harmful use of alcohol: A preventable risk factor of CVDs 30

9. Unhealthy diet: A preventable risk factor of CVDs 32

10. Obesity: A risk factor of CVDs 36

11. Raised blood pressure (hypertension): A major risk factor of CVDs 38

12. Raised blood sugar (diabetes): A major risk factor of CVDs 40

13. Raised blood cholesterol: A major risk factor of CVDs 42

14. Social determinants and CVDs 44

15. Risk factors take root in the womb, childhood and youth 46

16. Heart attacks and strokes in women 48

17. Other determinants of CVDs: Ageing, globalization and urbanization 50

18. Inequities and CVDs 54

Section B – Other cardiovascular diseases 57

19. Cardiac arrhythmia 58

20. Congenital heart disease 60

21. Rheumatic heart disease: A neglected heart disease of the poor 62

22. Chagas disease (American trypanosomiasis): A neglected disease of the poor

Section C – Prevention and control of CVDs: Policies, strategies and interventions 69

23. Prevention and control of CVDs: How do we know what works? 70

24. Prevention and control of CVDs: The need for integrated and complimentary strategies 72

25. Prevention and control of CVDs: Health in All Policies 74

26. Prevention and control of CVDs: The need for a national NCD policy framework 76

27. Policies and strategies for tobacco control 78

28. Policies and strategies to facilitate healthy eating 80

29. Policies and strategies to facilitate physical activity 84

30. Policies and strategies to address the harmful use of alcohol 88

31. Individual interventions for prevention and control of CVDs 92

32. Role of primary health care in prevention and control of CVDs 94

33. Best buys for cardiovascular disease (CVD) prevention and control 96

34. Bridging the implementation gap for prevention and control of CVDs 100

35. Monitoring CVDs 102

36. Social mobilization for prevention and control of CVDs 104

37. Prevention and control of CVDs and socioeconomic development 106

38. Generating resources for CVD prevention and control 108

39. CVD prevention and control: Why it should not be ignored any longer? 110

40. CVD prevention and control : Vision, roadmap and a landmark event 114

References

Annexes

Annex i – World Health Assembly resolution A64/61

Annex ii – Moscow Declaration

Annex iii – Regional Declarations on NCDs

Annex iv – Contact information

Annex V – Age-standardized death rates per 100,000 both sexes by cause and Member State, 2008 (1)

[EQ] UN Summit discusses ways to curb death toll from Non-Communicable Diseases

UN Summit discusses ways to curb death toll from Non-Communicable Diseases

UN Press Release New York, Sep. 19, 2011 2:05PM

Website: http://bit.ly/pzFUWF

“……..The United Nations heard calls today for an all-out attack on non-communicable diseases (NCDs) such as cancer and diabetes with a summit meeting devoted to curbing the factors, like tobacco and alcohol use, behind the often preventable scourge that causes 63 per cent of all deaths.

The two-day high-level General Assembly meeting, attended by more than 30 heads of State and Government and at least 100 other senior ministers and experts, is discussing a draft declaration calling for a multi-pronged campaign by governments, industry and civil society to set up by 2013 the plans needed to curb the risk factors behind the four groups of NCDs – cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.

Steps proposed range from price and tax measures to reduce tobacco consumption to curbing the extensive marketing to children, particularly on television, of foods and beverages that are high in saturated fats, trans-fatty acids, sugars, or salt. Other measures would cut the harmful consumption of alcohol, promote overall healthy diets and increase physical activity. The overall toll of NCDs is estimated at 36 million out of a total of 57 million annually.

“This will be a massive effort, but I am convinced we can succeed,” Secretary-General Ban Ki-moon told the opening session of the landmark summit, only the second ever to deal with health (the first was HIV/AIDS), noting that over a quarter of all people who die from NCDs succumb in the prime of their lives, the vast majority of them in developing countries.

“Our collaboration is more than a public health necessity. Non-communicable diseases are a threat to development. NCDs hit the poor and vulnerable particularly hard, and drive them deeper into poverty,” he said, with millions of families pushed into poverty each year when a member becomes too weak to work or when the costs of medicines and treatments overwhelm the family budget.

“The prognosis is grim. According to the World Health Organization (WHO), deaths from NCDs will increase by 17 per cent in the next decade. In Africa, that number will jump by 24 per cent.”

He called on governments, individuals, civic groups and businesses to all play their part. “There is a well-documented and shameful history of certain players in industry who ignored the science, sometimes even their own research, and put public health at risk to protect their own profits,” he said.

“There are many, many more industry giants which acted responsibly. That is all the more reason we must hold everyone accountable, so that the disgraceful actions of a few do not sully the reputation of the many which are doing such important work to foster our progress,” he added, calling on corporations that profit from selling processed foods to children, including manufacturers, media, marketing and advertising companies, to act with the utmost integrity.

General Assembly President Nassir Abdulaziz Al-Nasser stressed the need for international cooperation to tackle the problem. “The global community must work together to monitor, reduce exposure to risks, and strengthen health care for people with non-communicable diseases,” he said.

“The impact of this loss, this tragedy, goes beyond individuals, beyond families. NCDs are altering demographics. They are stunting development. And they are impacting economic growth.”

The draft summit declaration calls for greater measures at global, regional and national levels to prevent and control NCDs, stresses that about 9 million of the deaths occur before the age of 60, with nearly 80 per cent of those in developing countries, and cites “the vicious cycle whereby non-communicable diseases and their risk factors worsen poverty, while poverty contributes to rising rates of non-communicable diseases.”

Noting that “the rising prevalence, morbidity and mortality” of NCDs can be largely prevented and controlled through collective and multisectoral action by all Member States and other relevant stakeholders, it highlights the need for universal national health coverage and strengthened international cooperation to provide technical assistance and capacity-building to developing countries.

It calls on WHO, as the lead UN specialized agency for health and the vanguard of the global effort, to set up a comprehensive global monitoring framework and prepare recommendations for voluntary global targets before the end of 2012….

Related Documents:

Global_Diabetes_Plan_Final[1].pdf

Global asthma Report.pdf

WHO-UNION_TB_DMcover.pdf

TB_DM Framework_eng.pdf