Noncommunicable Diseases: The Impending Global Health Crisis

The WHO’s “Ten years in public health 2007-2017” report chronicles the “evolution of global public health” over the past decade. The report emphasizes the escalation of chronic noncommunicable diseases (NCD) as the largest threat to global health.

Chronic NCDs are categorized as diseases that progress slowly. The four main NCDs are cancer, cardiovascular disease, diabetes and chronic respiratory disease, all of which share common risk factors abundant in non-health sectors. NCDs have only recently been recognized as a main component in the impending global health crisis. These chronic diseases share four risk factors: tobacco use, excessive alcohol use, unhealthy diet and minimal physical activity.

In 2015, the World Health Organization (WHO) reported 70 percent of global deaths were due to NCDs (39.5 million out of 56.4 million). Out of the 39.5 million NCD fatalities, 30.7 million occurred in low and middle-income countries.

Health systems traditionally rely on curing individual disease as they arise. However, current health systems are not sustainable due to insufficient disease management and care. Access to disease treatment is becoming unavailable for millions of individuals, including affluent people in wealthy countries.

A study released by the World Economic Forum states that diabetes cost the global economy nearly $500 billion in 2010 and this is projected to increase to $745 billion by 2030. Newly approved cancer treatments average $120,000 per person, causing medical care to be “unaffordable for even the richest countries in the world.”

These high costs have four severe implications:

1. They undermine the traditionally ethical ideal that healthcare should be available to everyone;
2. The need for social protection becomes obvious when a person has to spend much as 60 percent of their income to get diabetes medication;
3. Prevention becomes the foundation of global health;
4. High costs clarify that no economy can outlast the NCD global crisis by investing solely in treatment services.

The WHO report ‘Ten years in public health 2007-2017’ estimates that 40 million people die each year from NDCs, “accounting for 70 percent of all deaths worldwide.” According to Margaret Chan, Director-General at WHO, chronic noncommunicable diseases have surpassed infectious disease as the leading cause of death worldwide.

The WHO’s newly established ‘Health Emergencies Programme’, enables faster response to global pandemics and emergencies. The programme collaborates with various countries and partners to “prepare for, prevent, respond to and recover from all hazards that create health emergencies, including disasters, disease outbreaks and conflicts.” It is also focused on community engagement and increasing disease prevention in public health services.

Chan urges the world to focus on implementing universal health care to reduce noncommunicable diseases. It is the ultimate expression of equality, ensuring no one is left behind.

– Madison O’Connell

Photo: Flickr

Progress Toward Eradicating Ebola

Eradicating Ebola is the global community’s next step in ensuring worldwide health. The disease is rare but extremely contagious, and causes internal and external bleeding as well as a severe fever. As soon as the virus enters the body, it weakens the immune system by attacking immune cells. In time, it causes blood vessels to carry less blood, which results in organ failure and eventual death.

Also known as Ebola hemorrhagic fever or Ebola virus, the disease is spread through direct contact with bodily fluids or objects that have been contaminated by bodily fluids, such as medical needles. It can also be contracted through contact with infected animals, specifically bats and primates.

There have been a number of Ebola cases internationally but the disease has mainly remained in regions of West Africa. The disease originated in 1976 in the Democratic Republic of the Congo, but it was Guinea, Liberia, and Sierra Leone that witnessed the largest Ebola epidemic in 2014 through 2016. An estimated 28,616 people contracted the disease and this resulted in 11,310 deaths.

Fortunately, the presence of Ebola has been contained since the outbreak. In 2015, researchers from the World Health Organization began testing a vaccine in Guinea, which returned with a 100 percent success rate. This vaccine was developed through a “ring vaccination” approach. The approach separated patients and their immediate contacts from the general public.

The vaccination report was released in December 2016. As Marie-Paule Kieny, lead author of the report, states: “While these compelling results come too late for those who lost their lives during West Africa’s Ebola epidemic, they show that when the next Ebola outbreak hits, we will not be defenseless.” Although the vaccine demonstrates progress in eradicating Ebola, it is in need of additional safety research before it can be formally licensed.

Another development in eliminating Ebola comes from a group of Canadian researchers. The group administered a drug known as Interferon Beta-1a to patients infected with Ebola. The drug, which is used to treat hepatitis B and C, had surprisingly effective results. “After 21 days, 67 percent of the Interferon-treated Ebola patients were still alive, compared to just 19 percent of the others,” reports Tom Blackwell from The National Post.

Although more research must be conducted regarding Interferon Beta-1a, findings look promising. The vaccine also demonstrates significant progress in eradicating Ebola, a disease that is now destined to become an element of the past.

– Gigi DeLorenzo

Photo: Flickr

(RED) Celebrates 10 Years of AIDS Awareness

Since its discovery in 1981, 35 million people have died from AIDS or AIDS-related diseases. The early years of the disease presented challenges for the medical community. However, as more people learned about the disease, another challenge emerged: how to best educate the public about the dangers of the disease without creating a stigma. This challenge still persists today.

The worldwide impact of AIDS is prolific. In 2015, 36.7 million people were living with HIV. Every day approximately 5,753 people contract HIV — about 240 every hour. In 2015, 1.1 million people died from AIDS-related illnesses. Since the beginning of the pandemic, 78 million people have contracted HIV and 35 million have died of AIDS-related causes.

In 2006, Bono, lead singer of the Irish band U2, and Bobby Shriver, an activist and attorney, created Product (RED) to advocate for better awareness of AIDS. The two men believed that if they combined the efforts of NGOs, governments, the medical community, global business brands and celebrities, they could create a powerful force to foster understanding of the disease. The influential allies also provided funding for research to eradicate the disease.

Product (RED) business partnerships include Apple, Gap, Starbucks, and Coca-Cola. By creating products specifically for Product (RED), the partnership allows consumers to use purchasing power to fund AIDS treatment and awareness around the globe. (RED) partners contribute a portion of their (RED) product profits to fight AIDS, and up to 50 percent of the profits go directly to fighting AIDS.

Over the past decade, Product (RED) raised $365 million to support the Global Fund. Product (RED) has become a global brand; the combination of awareness and research is powerful. The money raised by Product (RED) provides life-saving medicine for those living with AIDS in Ghana, Kenya, Lesotho, Rwanda, South Africa, Swaziland, Tanzania and Zambia.

When Product (RED) began, only 2.1 million people had access to medication. Through their efforts, the organization raised money to fund medication for more than 18 million people. They have also increased the access to medication; in rural areas of Africa, filling a prescription is not easily accomplished. However, Product (RED) and its partnership with the Global Fund help create a pathway for the medication, by making sure the medicine reaches the people that need it most, the system is more efficient and life-saving.

AIDS is a worldwide epidemic, but the decade of Product (RED) illustrates the power of the combination of global alliances and knowledgeable consumers as a force for change.

– Jennifer Graham

Photo: Flickr

Disease Prevalence in Impoverished Conditions

Viruses like Ebola and Zika might dominate the news, but for those living in poverty, disease prevalence of this type is anything but new.

Living in poverty is one of the key factors increasing someone’s risk of contracting an infectious disease. Though diseases like Ebola and Zika may hold prominence in the media at the moment, the prevalence of HIV/AIDS, Tuberculosis, Diarrhea, Malaria and others still remain firm in many parts of the world. HIV/AIDS alone infected 36.7 million people in 2015. In impoverished areas in Sub-Saharan Africa, almost 1 in every 25 people is HIV positive.

The areas where disease prevalence is high are also areas of extreme poverty. Communicable diseases impact a greater number of people when they are living in destitution, war zones or in other remote places without medical infrastructure. In addition, those with diseases in poor countries often face ostracization in their communities over the stigma of their illnesses.

Looking at this phenomenon in the 20th Century, the Zika Virus first emerged in Uganda and Tanzania in the 1950s. Ebola appeared in two simultaneous outbreaks in South Sudan and the Democratic Republic of Congo in 1976. It isn’t mere coincidence infectious diseases emerge in these places. Large groups of people living together in poverty provide a breeding ground for new diseases.

The reasons for this phenomenon are simple, without access to healthcare, poor people who find themselves contracting a disease are forced to suffer through the infection unaided. In turn, those who come into contact with them risk contamination and if their living conditions lack basic sanitation or host crowded conditions, a disease can spread quickly.

Developed nations in Europe are already facing this problem as refugees, eager to escape war zones in the Middle East, bring their health problems with them. In Greece for example, refugees are grouped into crowded camps without access to health infrastructure in many cases.

Rather than trying to restrict the flow of people over increasingly porous international borders, developed nations would do better to address the source of the problem. By reducing poverty and helping to improve healthcare infrastructure in poor countries, developed nations can lessen the spread of infectious diseases around the world and prevent disease prevalence.

The World Health Organization recently announced it would be “scaling up its emergency response activities” for 800,000 individuals living in refugee camps in Northeast Nigeria. Refugees have fled recent fighting between the government and Boko Haram and now live in crowded conditions without healthcare.

The WHO’s response efforts in the country will focus on providing health services to refugees, but the situation is complicated by ongoing violence and starvation. The current level of response from the international community is not adequate to prevent new outbreaks in Nigeria and other depressed regions.

Enclaves of poverty like the refugee camps in Nigeria present a viable threat to the health of the world. While the WHO’s response to the crisis is commendable, more is needed to reduce the possibility of new viruses developing before new outbreaks occur.

By simply supporting programs aimed at reducing malnutrition in poor countries, officials hope the health outcomes of those living there can be improved exponentially.

– Will Sweger

Photo: Flickr

The Top 10 Diseases in Afghanistan and their Treatment

Afghanistan is the 15th least developed country in the world, where thousands of people die each year from preventable diseases. The World Health Organization (WHO) uses age-adjusted rates to compare these diseases and see which ones cause the most deaths. Age-adjusted rates are the rates/dates that would have existed if the population under study had the same age distribution as the “standard” population. Based upon this data, the following are the top 10 diseases in Afghanistan:

1. Coronary Heart Disease: A disease in which a plaque builds up in the coronary artery and blocks oxygen-rich blood from reaching the heart muscle.
   Based on an age-standardized death rate taken in 2014, coronary heart disease ranks number one of the top diseases in Afghanistan taking thousands of lives each year. Of all the deaths in Afghanistan according to the 2014 data, coronary heart disease accounted for a little more than 9 percent. The age adjusted death rate for this disease calculates to 193.21 per 100,000 people ranking Afghanistan twentieth in the world.
2. Pneumonia: Lung inflammation caused by bacterial or viral infection.
   Influenza: Also known as the “common flu.”
   According to data recorded in 2014, deaths caused by influenza or pneumonia totaled 28,841 people. The age-adjusted death rate is 97.78 per 100,000 people making it the second most prominent disease in Afghanistan. Unfortunately 72 percent of children who suffer from pneumonia are unable to reach the necessary care of a doctor.
3. Tuberculosis: a bacterial disease caused by growth of nodules in the tissues.
   The age-adjusted death rate for tuberculosis as of 2014 is 70.41 per 100,000 people. This ranks Afghanistan number 13 in the world regarding mortalities from tuberculosis. Early treatment and proper diagnosis needed to cure tuberculosis and therefore upwards of 13,000 Afghans die each year from the preventable diseases in Afghanistan.
4. Diarrheal Diseases: Loose bowel movements that often cause dehydration.
   In 2014, 15,977 people or 7.10 percent of the population died because of diarrhoeal diseases. This often can be prevented by drinking safe, clean water and access to adequate sanitation which many Afghans cannot accomplish. Only 48 percent of those with a diarrhoeal disease receive the proper rehydration needed to survive. With many diseases causing early childhood deaths, diarrheal diseases account for 25 percent of them.
5. Diabetes Mellitus: The most common form of diabetes.
   In 2015 there were 935,800 cases of diabetes in Afghanistan and 19,698 deaths. The age adjusted death rate for tuberculosis as of 2014 ranks diabetes mellitus in Afghanistan number 71 in the world regarding mortalities.
6. Lung Disease: A problem with the lungs that prevents the lungs from working properly.
   Lung disease caused 2,874 deaths according to data recorded in 2014. The age adjusted death rate is recorded as 27.77 per 100,00 people ranking Afghanistan number 43 in the world regarding lung disease mortalities.
7. Rheumatic Heart Disease: The age adjusted death rate for this heart disease is 27.57 per 100,000 people as published by data in 2014. Rheumatic heart disease is a condition in which heart valves are damaged (caused by the rheumatic fever). The rheumatic fever is a disease caused by untreated strep throat or scarlet fever.
8. Hypertension: Abnormally high blood pressure.
   The age adjusted death rate ranks hypertension in Afghanistan at 25th in the world for deaths from hypertension. Without the proper access to professionals and doctors, diagnosing then implementing a way to fix hypertension is extremely difficult.
9. Breast Cancer: A group of cancer cells that begin in the breast and often spread to other parts of the body.
   One in eight Afghan women are affected by breast cancer. According to the Minister of Public Health Affairs, “[Breast cancer] is not a fatal disease if we seek treatments.” However, the age adjusted death rate of breast cancer ranks Afghanistan number 20 in the world.
10. Liver Disease: Some type of damage or disease to the liver.
    One of the most serious liver diseases in Afghanistan is hepatitis or inflammation of the liver. In 2013, almost 30,000 cases of viral hepatitis were diagnosed. The WHO is dedicated to fighting the “silent killer” by raising awareness and providing cures.

While deadly, the top 10 diseases in Afghanistan are treatable with the proper awareness and care.

– Casey Marx

Photo: Flickr