WHO’s pricetag for fighting ‘noncommunicable diseases’: $11.4 billion a year

NEW YORK — Millions of deaths from chronic illness and up to one-third of those from heart disease, the world’s leading killer, could be avoided or postponed if developing nations increased their health budgets by about 4 percent to put basic prevention measures in place.

The package — which includes tobacco control, reduction of salt and fat in processed food, basic generic drugs for heart patients, screening for cervical cancer, and a few other measures — would cost less than $1 a year per person in the poorest countries and about $3 per person in richer ones. For the world’s 144 low- and middle-income nations, the investment would be at least $11.4 billion.

That’s the conclusion of a long-awaited estimate by the World Health Organization in the war against the world’s latest enemy: “noncommunicable diseases.”

Who will pay?

Many unanswered questions linger, however. The biggest are: Who’s going to foot the bill? And is the world really ready for another global campaign against disease?

The price tag for the “best buys” in prevention was unveiled Sunday on the eve of a two-day meeting at the United Nations to discuss the growing epidemic of these ailments, principally heart attacks, strokes, cancer, diabetes and chronic lung conditions such as emphysema and asthma. Together they account for 63 percent of deaths each year.

Despite their stereotype as being “diseases of affluence,” the vast majority occur in the developing world. People in the poorest countries — sub-Saharan Africa and parts of Central and Southeast Asia — are three times as likely to die of them before age 60 than are Americans and Europeans.

While their global importance is undisputed, the viability of a campaign against “the NCDs,” as they’re called in epidemiological parlance, is clouded in doubt.

Bringing optimal AIDS treatment to people in poor countries and reducing deaths associated with childbirth are the high priorities on the global health agenda. A new campaign might also distract from the “Millennium Development Goals,” eight economic, environmental, social and health targets that U.N. member states pledged to reach by 2015.

More important, wealthy nations don’t want to be expected to pay for the treatment and prevention of chronic illnesses in poor countries, especially not in the middle of an economic downturn. That is why no hard targets appear in the draft of the “political declaration” circulating here.

No target set

The WHO suggested a goal of reducing national NCD mortality rates by 25 percent by 2025. But the United States, the European Union and Canada opposed it, so no target was set and discussion of the matter will be deferred until 2012.

“The fear is that if you commit to something there will be the expectation that wealthy countries are going to finance this,” J. Stephen Morrison, director of global health policy at the Center for Strategic and International Studies in Washington, said in advance of the meeting here. “It just shows you how we’ve become habituated to simply expecting that donors are going to pay the bills.”