Non-Communicable Diseases in the Caribbean RegionNon-Communicable Diseases (NCDs) are now causing more damage than communicable diseases, globally killing approximately 40 million persons annually, three-quarters of which occur in low and middle-income countries. Cardiovascular disease, cancer, diabetes, chronic respiratory disease and mental disorders have now been confirmed as the leading causes of death worldwide.

Unfortunately, this reality is no different in the Caribbean. According to the Pan American Journal of Public Health, every year 16,000 persons prematurely succumb to Non-Communicable Diseases in the Caribbean region. In fact, over 70% of all deaths in the region can be traced back to an NCD. Such a record has lasting effects, significantly stunting economic growth and productivity, and has been brought to the alarming attention of health authorities. While the exact reasons for such high mortality rates still remain an ongoing point of research and discussion, risk factors, including tobacco smoking, harmful use of alcohol, poor diet and physical instability, have been found to significantly contribute to the mortality of NCDs in the Caribbean Region. Furthermore, the lack of improvement in the quality of available health care has also been identified as one of the leading causes of the rise in NCD prevalence, case-fatality rate and mortality burden in the Caribbean region.

Investment in Prevention and Control of NCDs

For a long time, regional leaders wrote off deaths associated with NCD as unavoidable. However, the impacts of the NCD epidemic in the region have been found to be much more far-reaching than just health and well-being. Moreover, the existing NCD epidemic has served as a catalyst for negative ripple effects on the economies, productivity and quality of life in the region. Investing in the prevention and control of NCDs is therefore needed to keep other indicators of economic growth and development in check.

Existing Policy Action to Address the NCD Epidemic

Caribbean leaders have put forward outstanding effort and measurements to curb the growing costs associated with NCDs. While sticking with the timeline has proven to be quite a challenge, the regional health authorities have set the following paths and goals toward slowing the progression of its NCD epidemic:

  • The 2007 Mandates of the Port of Spain Declaration (POSD): This includes 27 commitments to action in the areas of reducing NCD risk factors, which include improving healthcare awareness and quality, increasing development of appropriate legislative frameworks and establishing NCD commissions to provide effective monitoring and evaluation of NCD prevention and control efforts.
  • The World Health Organization’s Best Buys/Investments: WHO has designed a set of affordable, cost-effective and evidence-based interventions termed the “WHO Best Buys” to achieve the Sustainable Development Target of 30% reduction of premature NCD related deaths by 2030. Made up of six policy target areas: tobacco use, harmful alcohol use, poor diet, low physical activity, management of cardiovascular diseases and diabetes and cancer management, the regional health authorities have set out to generate a $7 yield in health care costs for every $1 invested in Caribbean health care reform by 2030. Additionally, with 16 areas of targeted intervention to guide the policy decisions of each country in the region, countries can design their health policy to address their specific NCD related challenges.
  • Global WHO 25 x25 Strategy: After the 2007 mandate of the POSD in the Caribbean, the World Health Assembly set a global target of a 25% reduction in NCD related mortality by 2025. Set as a part of the WHO’s Global NCD Action Plan 2013-2020, the WHO detailed a total of nine voluntary national targets, with reduced mortality from NCDs and stopping the rise in diabetes and obesity being among the most urgent. This is set to be done through directed health and public policy, focusing on social, political and economic determinants of NCDs in the Caribbean Region.

With continued health policy effort and focus, both the Caribbean Region and the world at large will be able to successfully control this Non-Communicable Diseases epidemic.

Rebecca Harris
Photo: Flickr

Common Diseases in IndiaNon-communicable diseases (NCDs) account for 60 percent of deaths in India. In recent years, most common diseases in India are non-communicable, as opposed to the communicable diseases that dominated the charts in previous decades.

In a 2015 report, the World Health Organization stated that common non-communicable diseases in India are the overwhelming leading cause of death across all classes and regions. At this time, one in four Indians risk death due to an NCD before the age of 70.

India has undergone rapid development and growth in the last three decades. In 2015 its GDP growth was 7.6 percent, making India the fastest major growing economy in the world. Furthermore, India is set to overcome China as the most populous state as early as 2022.

India’s transition from a developing nation to an emerging power is marked by its rapid growth. It is also transitioning from a state vulnerable to communicable diseases to one plagued by lifestyle diseases, particularly heart disease. Currently, Indian citizens are twice as likely to die from a non-communicable disease than from a communicable one.

The decline of communicable diseases in India speaks to the dramatically positive impact development has on water quality, health services, sanitation and general health. The decrease of communicable diseases is certainly worth celebrating, yet India faces new challenges.

Heart disease, diabetes and cancer are among the leading causes of death in India today. Factors that contribute to the rise in these diseases include poor diet, pollution, tobacco use and alcohol use.

In light of the health issues emerging powers such as India and China face, the health community has established that the links between health and development go both ways. Improved health notoriously encourages development in countries just as poor health hinders development; a population’s health directly correlates to its productivity.

India is in a particularly vulnerable position. While communicable diseases have been overtaken by non-infectious diseases, they remain a problem. This creates a dual burden of diseases in the state, one that needs to be addressed through policy and action. If either communicable diseases or noncommunicable diseases become too burdensome, it will risk India’s development and further potential.

Fortunately, India is tackling NCDs as fervently as it tackled communicable diseases decades ago. General Electric India, for example, is making significant progress in developing cheap and effective diagnostic devices to battle the heart disease epidemic.

While communicable diseases are decreasing and noncommunicable diseases are increasing significantly, the list of common diseases in India still has a mixture of both communicable and non-communicable ailments. Going forward, continued investment in health and access to health centers are essential to India’s development.

Catherine Fredette

Photo: UN Multimedia

world cancer day 2015
February 4 was World Cancer Day 2015, taking place under the tagline “Not beyond us.” The campaign had four key areas of focus: choosing healthy lives, delivering early detection, achieving treatment for all and maximizing quality of life.

There were 690 official events planned for World Cancer Day this year across the globe, ranging from a university awareness event in Israel to a World Cancer Day Walk in Ohio to a free cancer screening for women event in Lagos, Nigeria.

World Cancer Day is observed each year to “unite the world in the fight against the disease through raising awareness, educating the public and lobbying for change.”

Cancer is not just one disease but a collective name for many diseases; there are more than 100 types of cancer. Cancer is the term given to a disease characterized by the uncontrollable division of abnormal cells, which can spread throughout the body. There are five broad categories of cancer types: carcinoma, sarcoma, leukemia, lymphoma and melanoma and central nervous center cancers.

Worldwide, cancer is a leading cause of mortality with about 14 million cases and 8.2 million deaths in 2012. Globally, the number of new cancer cases is expected to rise almost 70 percent in the next 20 years. More than 60 percent of these new cases and 70 percent of cancer-related deaths occur in Africa, Asia and Latin America.

Risk factors for cancer include tobacco use, alcohol use, infection by Hepatitis B, sexually transmitted HPV-infection, urban air pollution, ionizing and nonionizing radiation, unhealthy diet, lack of physical activity, indoor smoke from use of solid fuels and being overweight or obese. By modifying or avoiding these risk factors, 30 percent of cancer deaths could be prevented.

Cancer detection and treatment are expensive and often unavailable to poor communities, especially in developing countries. Although fewer cancer cases occur in developing countries, there is a higher mortality rate. This shows that detection and treatment options are severely lacking. Because governments’ health budgets are usually constrained, difficult decisions have to be made about expenditures. Generally, infectious diseases get a higher percentage of the budget, leaving cancer and other non-communicable diseases to continue to wreak havoc.

Cancer is part of a larger group of diseases called non-communicable diseases, or NCDs. NCDs include cancer, heart disease, diabetes and chronic respiratory diseases and cannot be passed from one person to another directly. NCDs have been on the rise in developing countries but still receive little funding or treatment. The World Health Organization launched a campaign called the Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013 – 2020, which aims to reduce premature mortality caused by NCDs by 25 percent by 2025.

– Caitlin Huber

Sources: Union for International Cancer Control, National Cancer Institute, World Health Organization, International Network for Cancer Treatment and Research
Photo: Post Media Canada

The largest public health problem in the developing world is currently non-communicable diseases, or NCDs. NCDs like cardiovascular disease and cancer kill around eight million people before they are 60 years old each year in developing countries. NCD-attributed deaths make up about 90 percent of  premature deaths in the world.

Urbanization, higher life expectancy and global trade drive NCDs in developing countries. Even though developed countries may have similar public health issues, they are much more equipped to deal with them because they have better and less expensive prevention and management tools and more experience dealing with the diseases.

Non-communicable diseases cause early deaths and debilitation for those in poverty in both developing and developed countries. However, the people effected in developing countries are, on average, younger and have worse outcomes than their counterparts in developed nations.

On a global scale, NCDs will cost developing countries $21.3 trillion over the next 20 years. Even though global focus and aid goes towards communicable diseases like HIV/AIDS and tuberculosis, non-communicable diseases effect a much larger portion of the population and are growing quickly in middle- and low-income countries.

The last time a global public health crisis that disproportionately affected the developing world was attacked was the HIV/AIDS epidemic. The effort originated in the U.S. with PEPFAR and grew to a worldwide effort. While lessons can be gleaned from that effort, the growing NCD crisis presents different challenges. Of course, the U.S. cannot make resource allocation decisions or policy solutions for other countries. An effort to attack this crisis has to be at the national level with the help and support of the international community.

Because most NCDs are characterized by chronicity, they have devastating socio-economic consequences. Patients require more care for longer periods of time. This not only takes them out of the workforce and reduces productivity but also uses up scarce healthcare resources. With a sicker, smaller workforce, economic growth can be stunted and have reverberating economic, social and political impacts for the country and region.

– Caitlin Huber

Sources: Council on Foreign Relations, Harvard University
Photo: Business Insider