http://www.newscientist.com/article.ns?id=dn8099Chronic disease is biggest global killer
11:54 05 October 2005
NewScientist.com news service
Shaoni Bhattacharya By the end of 2005, twice as many people will have died from chronic diseases as from all infectious diseases, starvation and pregnancy and birth complications combined, international experts have warned.
The “neglected epidemic” of chronic disease will take 35 million lives in 2005, out of the total 58 million who will die globally. And contrary to popular belief, most of the deaths - 80% - from chronic conditions such as heart disease, diabetes and cancer will be in low to middle-income countries.
The two factors behind this epidemic are smoking and obesity, says Richard Horton, editor of The Lancet, in a commentary accompanying four studies published on Wednesday. “These risks and the diseases they engender are not the exclusive preserve of rich nations.”
If action is taken now, 36 million lives could be saved by 2015, says a major World Health Organization (WHO) report on chronic diseases also published on Wednesday.
While the world focuses on tackling the major infectious diseases – HIV/AIDS, malaria and tuberculosis – chronic diseases are largely overlooked, warns Horton. “Without concerted and coordinated political action, the gains achieved in reducing the burden of infectious disease will be washed away as a new wave of preventable illness engulfs those least able to protect themselves.”
Salt and tobacco
“I entirely agree, the facts are incontrovertible that we are moving in that direction,” says Andrew Prentice, professor of international nutrition at the London School of Hygiene and Tropical Medicine, UK. He notes that developing countries are facing a “double burden of disease”.
“They still have the unfinished agenda of infectious disease, together with the new agenda of non-communicable diseases,” he told New Scientist. These chronic diseases threaten to bring the health services of some developing countries “to their knees”, he warns.
“We cannot afford to say we must tackle other diseases first - HIV/AIDS, malaria, tuberculosis - then we will deal with chronic diseases,” commented President Olusegun Obasanjo of Nigeria on the WHO report. “If we wait even 10 years, we will find that the problem is even larger and more expensive to address."
HIV/AIDS is predicted to take 2.8 million lives around the world in 2005, for example, while the death toll from cardiovascular disease will be about 17.5 million globally.
The WHO proposes that if the projected deaths from chronic diseases can be reduced by just 2% a year until 2015, 36 million people around the world will be saved from dying prematurely. Key to achieving this is tackling preventable risk factors - for example, cutting salt in processed foods and taxing tobacco products. WHO estimates published in September 2005 suggested that one billion of the world’s population is now overweight or obese.
Cheap oils
But Prentice notes that changing people’s diets, particularly those on low incomes, will not be easy as there is a necessity for them to buy cheap, high-fat, heavily subsidisedfoods. “One of the main problems is that developing countries are at the mercy of huge multinational companies,” he says. For example, he says edible oils like vegetable oils can now be produced extremely cheaply compared with 30 years ago.
In its new report, the WHO attributes the deaths of 4.9 million people in 2004 to tobacco use, and 7.1 million deaths to raised blood pressure. While deaths from infectious diseases, pregnancy and birth complications and nutritional deficiencies are predicted to wane by 3% over the next 10 years, deaths due to chronic diseases are projected to rise by 17%.
This means that by 2015 almost two-thirds of deaths worldwide – 41 million of the 64 million projected - will be due to chronic disease.
Horton stresses there is evidence to back intervening early in this chronic disease epidemic. “There is an unusual opportunity before us to act now and prevent the needless deaths of millions. Do we have the insight and resolve to respond?” he asks.
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