HEALTH: Add Five to Ten Years to Life at Little Cost

By Sanjay Suri Reprint | | Print |

Sanjay Suri

LONDON, Oct 30 2002 (IPS) - People all over the world can add five to ten years to their life quite easily and at relatively little cost, the World Health Organisation (WHO) says after one of its largest ever health studies.

"It is possible with existing knowledge and available means to make a great change within a relatively short period of time," Dr Christopher Murray, Executive Director for Evidence and Information for Policy at the World Health Organisation told IPS in an interview before the launch of the report Wednesday.

"Five of the top ten risk factors are global: high blood pressure, tobacco, alcohol, high cholesterol and obesity," Murray said. Many of these are relatively easy to control.

"Higher taxation on tobacco and alcohol and restricting their use in public places can be very cost effective strategies," said Murray, who is the overall director of the report.

Unless action is taken there will be nine million deaths cause by tobacco in 2020. For every 10 percent real rise in price due to tobacco taxes, consumption generally falls between 2 and 10 percent, WHO says.

High blood pressure causes 7.1 million deaths a year, out of a total of about 56 million deaths worldwide, the report says. About 62 percent of strokes and 49 percent of heart attacks are caused by high blood pressure.

High cholesterol causes 4.4 million deaths a year, causing 18 percent of strokes and 56 percent of heart disease.

The report says that simple measures like cutting dietary fat and higher consumption of fruits and vegetables are "the most cost-effective interventions identified to reduce cardiovascular disease." Add a base combination of cholesterol lowering statins and low dose aspirin and you have "a highly effective drug combination that is likely to more than halve stroke and heart disease incidence, and could be widely used in the developed world and is increasingly affordable in the developing world."

The report brings out for the first time that 40 percent of global deaths are due to just the biggest 10 risk factors, while the next 10 risk factors add less than 10 percent, says Alan Lopez, co-director of the report. The other five risk factors in the top ten are childhood and maternal underweight, unsafe sex, indoor smoke from solid fuels, iron deficiency and unsafe water, sanitation and hygiene.

Murray points to simple ways of stopping many of these killers. "Blood pressure and cholesterol can be contained by limiting salt in processed foods and stepping up physical activity," he said. "Use of salt in processed foods can be reduced by government regulation or voluntary regulation. Such regulation can be effective, and its effectiveness can be tested by random sampling."

The WHO will support introduction of low-cost off-patent drugs in new combinations to reduce risks of blood pressure and cholesterol, Murray said. "These will cost only 14 U.S. dollars per person per year, and we think that is affordable in many developing countries," he added.

The total cost of improving health along recommended lines will depend on who implements what and where, particularly at sub-regional levels, Murray said. "What we focused on is low-cost strategies that are affordable in each region of the world," he said. "For example lack of Vitamin A, iron and zinc is a major determinant in child mortality. Our proposals for fortification of foods with these requirements can be very cost effective in all regions."

The report ‘Preventing Risks, Promoting Healthy Life’ breaks new ground by quantifying the actual impact of various risks from region to region. "The report provides a road map for how societies can tackle a wide range of preventable conditions that are killing millions of people prematurely and robbing tens of millions of healthy life," says WHO Director-General Gro Harlem Brundtland.

The study was a huge undertaking. "We had 150 researchers working over four years on quantifying risks to human health, and researchers in many different countries over four years on what initiatives will work, the cost and the benefits," Murray said. "We will now follow up on our report and seek to help countries who want to use this report."

Several countries have begun to do that already. The preliminary findings were discussed at the World Health Assembly in May. Some countries are already carrying out national assessments following from that meeting, Murray said. The results have led to new thinking over policies. "Obesity and zinc have not been on policy agendas," he said.

The study is already leading to a review of national policies that could add five years to life in developed countries and ten years in developing countries.

The difference in the health profile in developing countries and developed countries can be dramatic, the report shows. Some 170 million children in poor countries are underweight, mainly from lack of food, while more than one billion adults worldwide, in middle-income and high-income countries alike, are overweight or obese, the report says. About half a million people in North America and Western Europe die from overweight or obesity-related diseases every year.

The report does not measure just years lived, but the number of years lived healthily. Implementation of the measures recommended can add to both kinds of ‘lives’. If all these preventable risks are addressed as recommended – an ambitious goal, the WHO acknowledges – healthy life spans could increase as much as 16 years in parts of Africa, where healthy life expectancy can fall as low as just 37 years in Malawi.

In Europe, the United States, Australia, New Zealand and Japan, not only would people live longer, but also the healthy life span would rise five years.

The difference between life span and a healthy life span can be considerable. In Japan, for example, overall life expectancy is 84.7 percent for women and 77.5 percent for men, versus a healthy life expectancy of 73.6 years for both men and women.

The report shows that in Canada, the United States and Cuba, which have the healthiest lives in the Western hemisphere, healthy life expectancy can increase 6.5 years from the current healthy life expectancy of 69.9 years for Canada, 66.6 years for Cuba and 67.6 years for the United States.

In Germany, France, Italy, Spain and the United Kingdom healthy life expectancy can grow by 5.4 years, in most of Latin America, including Argentina, Brazil and Mexico, 6.9 years, in an Asian group including China, 6 years, and in another Asian group including India, 8.9 years.

"Every country has major risks to health that are known, definite and increasing, sometimes unchecked," says Anthony Rodgers from the University of Auckland in New Zealand, and one of the report’s main writers. "For each of these risks we have established effective, but often underused interventions." The report says that the potential for prevention is "much greater than commonly thought."

The full WHO report can be downloaded from http://www.hoffmanpr.com/whr02.

HEALTH: Add Five to Ten Years to Life at Little Cost

By Sanjay Suri Reprint | | Print |

Sanjay Suri

LONDON, Oct 30 2002 (IPS) - People all over the world can add five to ten years to their life quite easily and at relatively little cost, the World Health Organisation (WHO) says after one of its largest ever health studies.
(more…)