The next health tsunami: Non-communicable diseases

The next health tsunami: Non-communicable diseases

GENEVA: The International Diabetes Federation (IDF), the International Union Against Cancer (UICC) and the World Heart Federation (WHF) called today on the UN’s Economic and Social Council (ECOSOC) to take immediate action to avert the fastest growing threat by non-communicable diseases (NCDs) to global health.

NCDs which include cardiovascular disease, diabetes, cancer and chronic respiratory disease, cause 60% of all deaths globally and 80% of these are in low- and middle-income countries. WHO projects that globally NCD deaths will increase by 17% over the next 10 years. The greatest increase will be seen in the African region (27%) and the Eastern Mediterranean region (25%). The highest absolute number of deaths will occur in the W. Pacific and S.E. Asia regions.

The global call, issued by the three organizations at the meeting of the UN ECOSOC in Geneva, demands five essential actions:

1. Call for an ‘MDG Plus’ containing NCD progress indicators in the 2010 Millennium Development Goals (MDGs) review

2. Support the availability of essential medicines for people living with NCDs

3. Support a UN General Assembly Special Session on NCDs

4. Support the immediate and substantial increase of funding for NCDs

5. Integrate NCD prevention into national health systems and the global development agenda

The UN MDGs state that health is critical to the economic, political and social development of all countries, yet they contain no goals or targets for NCDs, which are the largest threat to health systems.

Public health experts are expecting ECOSOC leaders to show the way in confronting this health crisis faced by millions. The emerging epidemic of NCDs is threatening to overwhelm healthcare systems worldwide unless action is taken.

“This tsunami didn’t arise yesterday; it evolved over time and is getting worse. We need a revolution to change the trajectory if we are serious,” stated Dr Leslie Ramsammy, Minister of Health, Guyana at this morning’s WHO Ministerial breakfast meeting. The World Economic Forum’s 2009 Global Risks report supports this with evidence that the incidence of chronic disease is rising across both the developed and developing world. Medical advances and awareness can reduce the risk severity but chronic non-communicable diseases are still the main cause of death worldwide.

Evidence shows that up to 80% of NCDs can be prevented by addressing risk factors like unhealthy diet, physical inactivity and tobacco use and those that are non-preventable can be treated inexpensively with essential medicines. While medicines such as aspirin, penicillin, insulin and morphine have been on the Essential Medicines List for years, they still remain beyond the reach of many.

The three NGOs request that the final declaration of the ECOSOC High Level Segment include a call for NCD indicators to be included in the 2010 review of the MDGs to form an ‘MDG Plus’, as this fast emerging global threat has not, to date, been addressed.

The three organizations together represent 730 member organizations in over 170 countries and vast networks of health care professionals, patient, and civil society organizations. They have joined forces to create a powerful voice for change and urge ECOSOC to take action in the face of the NCD epidemic.

Vitamin A supplements reduces child mortality by over 20 per cent

Vitamin A supplements reduces child mortality by over 20 per cent

The vitamin A supplementation of infants and children can potentially reduce child mortality by over 20 per cent, said Howard B. Schiffer, founder and President of Vitamin Angels in an interactive community health literacy programme organized hardly 25 kilometers away from the state council house of Uttar Pradesh in India. I wonder if the policy makers in the state parliament were aware that a cost-effective intervention like vitamin A supplementation can reduce child mortality by over 20 per cent!

The state of Uttar Pradesh qualifies for this vitamin A supplementation programme because of chronic malnutrition, high vitamin A deficiency prevalence, and high rates of infant and child mortality, informed Howard.

Vitamin A deficiency does its worst damage during childhood and is a major contributor to child mortality and illness. The most commonly known effect of vitamin A deficiency is blindness. Less well known is that vitamin A is also essential for functioning of the immune system. “Even before blindness occurs, vitamin A-deficient children are at risk of dying from infectious diseases such as measles, diarrhea and malaria” said Arulmony Thangaswamy, the President of Believers Church.

However when the Vitamin Angels began this initiative to save lives more than a decade ago, particularly of young children, they weren’t aware of the impact of this intervention – they knew the significance of providing vitamin A supplementation but the global mandate came only last year at the Copenhagen Consensus.

At the Copenhagen Consensus 2008, more than 50 economists have worked to find the best solutions to ten of the world’s biggest challenges. During the last week of May 2008, an expert panel of 8 top economists, including five Nobel Laureates, sat down to assess the research. Combating malnutrition among the 140 million children who are undernourished was ranked number one. Providing micronutrients for 80% of the 140 million children who lack essential vitamins would cost just USD 60 million per year, according to the analysis. More importantly, this action promises yearly benefits - in the form of better health, fewer deaths, increased future earnings, etc - of more than USD 1 billion. Each dollar has a return of USD 17 - making this an incredible investment for donor nations and organizations.

Vitamin Angels is committed to eradicating childhood blindness due to Vitamin A Deficiency (VAD) on the planet by the year 2020, which is referred to as Operation 20/20. Vitamin A is critical for vision, bone growth and normal bodily development, and plays an active role in supporting a child's immune system. Today, half of the children who go blind from Vitamin A deficiency die each year from opportunistic infections and otherwise non-life-threatening illnesses.

“In addition to the vitamin A, all the children will receive de-worming medicine to improve the absorption of the vitamin A and help combat intestinal parasites” informed Howard Schiffer. Delivering vitamin A capsules and de-worming tablets together makes sense for health reasons:
* Parasites will consume the vitamin A before the child can absorb it.
* Worm infections and vitamin A deficiency both have serious health repercussions for a growing child and cause infection and disease.

The evidence demonstrating how worm infections damage a child’s health is unambiguous: worm infections are associated with a significant loss of micronutrients. It can cause significant vitamin A mal-absorption, which can aggravate malnutrition and anemia rates and contribute to retarded growth. A child’s physical fitness and appetite are negatively affected and his/ her cognitive performance at school is compromised. The constant and life long immune activation due to worm infections reduces the body’s capacity to resist other infections. Therefore to complement the impact of these simple health interventions, vitamin Angels are providing vitamin A supplementation along with the de-worming tablets.

Jojo Mathews, from Believers Church in Lucknow where the health camp was organized, had contributed immensely in mobilizing people from the neighbouring communities to benefit from this health initiative. Many children were administered vitamin A and de-worming pills. Hundreds of people from neighbouring area were benefiting from this initiative. Hardly half-a kilometer away from this church which was catering to the health needs of the community, stands the majestic premises of a state-of-the-art super-speciality medical institute. This indeed poses a question whether our health programmes are meeting people’s need, and investing resources optimally?

Bobby Ramakant

Published in
Media for Freedom, Kathmandu, Nepal
Citizen News Service (CNS)
The Seoul Times, Seoul, South Korea
Bihar and Jharkhand News Service (BJNS)

Evidence is key in improving health responses during financial crisis

Evidence is key in improving health responses during financial crisis

The study of causes, distribution, spread and control of diseases in populations, epidemiology, is a fundamental science and an integral part of public health. Epidemiology has helped address old public health challenges and continues to be a tool to investigate new challenges by providing evidence required for sound public health action.

Efforts to strengthen epidemiology should remain a priority of Member States even when plagued by the challenge of climate change, an energy crisis or a global financial crisis.

"To address each of these challenges, what we need is the information or the evidence or data not only for developing of our strategies and policies, but also for advocacy," said Dr Samlee Plianbangchang, Regional Director of the World Health Organization (WHO) South-East Asia at the inauguration of a "Regional Meeting on Application of Epidemiological Principles for Public Health Action" in New Delhi.

The two-day meeting is aimed at formulating an agreed framework for action, both within WHO and in Member States. This would help to strengthen epidemiological capacities in the Region and to apply this know-how and skills to overcome current public health challenges such as those arising from the current financial downturn, climate change and from emergence of new pathogens.

"The main idea behind this meeting is to ascertain how we can together strengthen and focus our attention on the application of epidemiological concepts and principles in national health programme development and management of health problems," said Dr Jai P. Narain, Director, Communicable Diseases, WHO SEARO.

More than 50 eminent epidemiologists are attending this two-day regional meeting.

Published in
Bihar and Jharkhand News Service (BJNS)
Citizen News Service (CNS)
The Seoul Times, Seoul, South Korea