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BANGKOK , Feb 15 2006 (IPS) - Mounting evidence that more people in Asia and the Pacific will be dying of chronic diseases rather than infectious ones by 2015 will force the region’s governments to redraw their public health budgets, say United Nations officials.
The stress in public health expenses is still weighted towards curative care than preventive efforts, say the officials from the Economic and Social Commission for Asia and the Pacific (ESCAP), a regional U.N. agency based in Bangkok.
That is because the ”thrust has been more towards a clinical approach than a public health approach,” adds an official from ESCAP’s health and development section.
And even here, the government expenditure on health when set against the gross domestic product (GDP) is low in most developing countries.
Regional giant China only allocated 2.2 percent of its GDP in 2002 for public health, while India had allocated 1.3 percent of the GDP in the same year for public health, according to the United Nations Development Programme (UNDP).
In other Asia-Pacific countries, public health expenditure ranged through 0.8 percent, in Bangladesh, 1.5 percent, in Laos, 1.1 percent, in the Philippines, 4.6 percent, in Mongolia, and 3.1 percent, in Thailand.
By contrast, two of the region’s developed nations, Japan and Australia, have 6.5 percent of the GDP set aside for public health expenses.
Yet officials from the World Health Organisation (WHO) say that more investment to support a more broader health prevention agenda is needed to save millions of people from succumbing to premature deaths from preventable chronic diseases. They are cancer, heart disease and strokes, diabetes and asthma and chronic respiratory diseases.
What is required is a change of lifestyle that is fuelling these high fatalities, says the Geneva-based health agency. The major causes for the chronic diseases are physical inactivity, tobacco use and unhealthy diets. These result in obesity and being overweight, rise in cholestrol levels and increase in blood pressure.
”There is not one country, one community left untouched by cancer, stroke, heart disease or respiratory disease,” Dr. Catherine Le Gales-Camus, the WHO’s assistant director general for noncommunicable diseases, said here Tuesday during the regional launch of ‘Preventing Chronic Diseases – a vital investment.’
For the Asia-Pacific region, there is more reason to worry at the deaths linked to chronic ailments, she warned, since over 70 percent of the people who will die in the next 10 years from such diseases will be from this region. That amounts to 270 million deaths from 53 countries in the region out of an estimated 388 million deaths globally by 2015.
The estimated global toll due to health-related deaths in 2005 offers sufficient reason for the public health community to raise the alarm. Of the nearly 58 million deaths from all causes the last year, it was projected that chronic diseases would account for 35 million deaths worldwide.
These numbers – 17.5 million deaths due to cardiovascular disease, 7.5 million deaths due to cancer and 4.05 million deaths due to chronic respiratory diseases – tower over the annual death toll in 2005 from the three widely known major infectious diseases. The latter includes 2.8 million deaths due to HIV/AIDS, 1.6 million deaths due to tuberculosis and 883,000 deaths due to malaria.
In some Asian countries, according to the WHO, the death toll from chronic diseases account for nearly 50 percent of annual cases, such as in Bhutan, Bangladesh, Pakistan and India. While in other countries the toll is higher, such as Indonesia having over 60 percent of its citizens dying due to chronic diseases and for China, Iran, Fiji, and Brunei the annual figure accounting for over 70 percent of the deaths.
”This growing epidemic has substantial macro-economic impact on the economies of the region,” says Kim Hak-Su, executive secretary of ESCAP. ”Countries in the region, such as China, India and the Russian Federation, could forego billions of dollars in national income over the next 10 years as a result of chronic diseases.”
Worst off will be the region’s poor, since they account for nearly 80 percent of the deaths, says the WHO report. Currently, close to 621 million people of the world’s nearly 1.2 billion people who live in extreme poverty – surviving on less than one U.S. dollar a day – are in the Asia-Pacific region. These poor account for nearly 20 percent of the region’s population.
At the same time, the Asia-Pacific countries have taken the lead within the developing world – although incremental- to counter this problem, as reflected in what the WHO describes as the ‘Stepwise Framework’ approach. India, Indonesia, the Philippines, Vietnam, China and Tonga are among them.
”The ‘Stepwise Framework’ took off in this region in 2000. Tonga was among the pioneers,” Dr. Robert Beaglehole, director at the WHO’s department of chronic diseases and health promotion, told IPS. ”It stemmed from the obesity problem they (Tonga) were having, where 90 percent of the middle aged men and women were obese.”
This initiative requires surveys to assess the quality of people’s diets, level of alcohol consumption, tobacco use and time spent for physical activity. It is followed by public sector programmes to change harmful lifestyles after taking into consideration the local conditions and ”potential constraints and barriers to action.”
Targeting multi-national companies in the food and beverage industry should also be part of the equation, says Le Gales-Camus, since ”people are eating more and more processed food containing high amounts of sugar and salt.”
”Private companies may not have health as part of their goal, but they have a role to play in ensuring that their consumers remain healthy,” she said. ”Many countries are concerned about the aggressive marketing of food for children.”
Thailand is proving that the public is increasingly receptive to such new health concerns, in the wake of early successes to slash the number of people who smoke and drink alcohol.
”We have managed to get three million people to stop drinking during the annual Buddhist period of lent,” says Dr. Supakorn Buasai, director of the Thai Health Promotion Foundation. ”The tobacco market has shrunk by 20 percent since we started the anti-smoking campaign.”
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