Global health: noncommunicable diseases


Customers smoke and drink beer with their food at a stall in Beijing: Tobacco, alcohol and overeating are among the leading causes of noncommunicable disease in both rich and poor countries. (Alexander F. Yuan/AP)
September 19, 2011

T en years ago, the United Nations convened an unprecedented meeting of heads of state to discuss a health crisis — the spread of HIV/AIDS. The U.N. spotlight helped focus the attention and resources that led to a decade of progress in fighting the disease. This week, the United Nations is holding its second such “high-level meeting” on a health issue. The subject this time is noncommunicable diseases, or NCDs — chiefly cancer, diabetes, and heart and respiratory ailments. These are the four main killers in the world, and they are often caused by four behaviors: smoking, eating unhealthful foods, physical inactivity and too much alcohol.

Last week, Washington Post Live, the division of The Post that organizes forums and debates, invited some of the people who are at the U.N. this week, as well as other key thinkers on global health, to a discussion about curbing the rise of NCDs.

Speaking at the opening panel, Julio Frenk, dean of faculty at the Harvard School of Public Health, called it a moral as well as a medical issue. While millions of people in poor nations increasingly adopt the same bad habits and unhealthy lifestyles as people in affluent ones — and get the same diseases — they don’t have access to the same level of health care. As a result, while those who live in wealthy societies can often manage their conditions, those in poor countries die sooner. For example, in Sierra Leone, 56 percent of people with NCDs die before they reach 60, while in Sweden only 7 percent do. In Canada, 90 percent of children with leukemia survive to adulthood, compared with just 10 percent in the world’s 35 poorest countries.

It’s time for the public “to feel as angry about this as I do,” said Ann Keeling, chief executive of the International Diabetes Federation and chair of the NCD Alliance. She called for governments to “lead, regulate and invest” in measures that would prevent these diseases. Keeling advocated planning cities in ways that foster more walking, as well as an outright ban on tobacco and mandated limits on trans fats, sugar and salt in food.

Individuals have to change their own habits, many speakers agreed, and the private sector must be involved. Mark Kramer, managing director of the nonprofit consulting firm FSG, noted that for many businesses, doing good and doing well are not mutually exclusive. Selling nutritious food and drinks can be profitable, and there is money to be made bringing better health care and more medicine to the developing world. Kramer said that when addressing this social problem is part of a business strategy and not just philanthropy, companies will devote “hugely more resources” and stay with the commitment for a long time.

Keeling sees a growing movement to beat back this health crisis, to make our lives more healthy. She is no doubt right that it would help if more of us got angry about the millions of people who die every year from preventable diseases.

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