GLOBAL: Chronic diseases reach "epidemic" proportions - WHO

Photo: IRIN

Samjhana Lama from Nepal died from heart disease after treatment delays (file photo)

DAKAR, 19 June 2009 (IRIN) -

Chronic diseases-especially cancer, diabetes, and chronic respiratory and heart diseases - kill twice as many people worldwide every year than do infectious diseases HIV, malaria and tuberculosis, combined. But despite their stealth ascent to epidemic proportions - mostly in poor countries, according to World Health Organization (WHO) - chronic diseases receive scant donor and government attention.

Chronic diseases like diabetes and heart disease progress slowly and account for 60 percent of all deaths, according to WHO.

"It [chronic disease] is a silent killer," said WHO's Boureima H. Sambo, non-communicable disease (NCD) advisor for West Africa. "For other epidemics like measles, meningitis or cholera, you see and hear people dying. But in a hospital ward of dying chronic respiratory, hypertension and cancer patients, there is not as much noise," he told IRIN.

Less than 1 percent of official development assistance funds chronic disease prevention and treatment, according to the Organisation for Economic Cooperation and Development (OECD). From WHO's overall 2008-2009 budget of US$3.9 billion, 13 percent went toward chronic diseases.

Major donor funding for chronic diseases has increased since 2004 when it was less than US$200 million to US$700 million in 2008, according to OECD.

But funding still lags far behind the numbers of deaths caused by chronic illnesses, as reported in the medical journal "The Lancet". HIV prevention and care received US$2.5 billion from major donors in 2005 when there were less than five million reported HIV deaths.

While more than 25 million died from chronic diseases the same year, donors gave US$200 million toward NCD's.

Double burden

Africa is expected to have the biggest increase in deaths from NCD's over the next decade, or an additional 28 million sufferers, according to WHO. "The emphasis thus far [in Africa] has been on infectious diseases," Boureima told IRIN. "But we have a growing burden of NCD alongside the known burden of communicable [infectious] diseases."

Hypertension and obesity affected up to 60 percent of those surveyed in West Africa by WHO, said Boureima. "Children as young as 12 are smoking, some parts of the region abuse alcohol and vegetable consumption is low. Risk factors of today are chronic diseases of tomorrow," he told IRIN.

Despite dozens of resolutions at WHO to fight chronic disease dating back more than 60 years, Stig Pramming with the UK-based NGO Oxford Health Alliance told IRIN chronic illness is still not "on the [international development] agenda."

Recommendations from a UN-organized ministerial meeting in Doha, Qatar in May on NCDs will be considered at the UN Economic and Social Council (ECOSOC) 7 July meeting in Geneva. WHO is working with governments to incorporate chronic diseases into the UN Millennium Development Goals, according to WHO NCD staff.

How much?

While the cost of chronic diseases has been estimated to be in the hundreds of billions in lost income and health fees, it is hard to put a price tag on fighting those diseases, said Oxford Health Alliance's Pramming. "Chronic diseases are a complex problem not solved through a simple treatment. It is the way we eat, move. It is our lifestyle and social determinants like access to health care and [quality of] those health systems.

"Health care systems are very much focused on acute diseases and are not geared to follow people over the long term."