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HEALTH: Lifestyle Diseases Overtake Asia's Infectious Killers
By Marwaan Macan-Markar
BANGKOK , Feb 15 (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.'' (END/2006)
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