Press Release N° 39
18 May 1998
A GLOBAL PRIORITY, SAYS THE WORLD HEALTH ASSEMBLY
A major resolution on noncommunicable diseases was adopted by the highest governing body of the World Health Organization (WHO) -- the World Health Assembly, which met last week in Geneva.
The resolution called upon WHO, together with its Member States and other interested parties, to develop a strategy, which could address the growing global burden of this group of ailments including cancers, cardiovascular diseases (CVDs), diabetes mellitus, chronic respiratory diseases and other degenerative disorders.
For the past quarter-century, WHO has advocated the importance of national, regional and global programmes to fight NCDs and provided technical leadership in the fields of prevention and control. However, only recently has the growing worldwide toll of NCDs been fully appreciated.
Rising income, improved nutrition, and the provision of basic public health services have all contributed to increasing life expectancy at birth, especially in developing countries. Linked with these are changes in lifestyles and, as a result, substantial increases in the frequency of NCDs. This trend is particularly alarming in developing countries -- home to some 80% of the world's population -- where NCDs strike people of younger age, many of whom die prematurely.
One look at mortality statistics will suffice to grasp the magnitude of the problem worldwide. NCDs are responsible for at least 40% of all deaths in developing countries and 75% in industrialized countries, where CVDs are the first cause of mortality and cancer the third.
However, mortality statistics alone do not provide a full picture of the global social and economic burden of NCDs: in addition to being life threatening, many of them are also disabling. Degenerative disorders of bones and joints, for example, may cause as much as a quarter of all incapacitating conditions, thus being the single most important common cause of physical disability.
Once NCDs develop, they are costly to treat. Diabetes mellitus, which affects some 143 million people worldwide, alone claims on average around 8% of total health budgets in industrialized countries.
In absolute figures, major noncommunicable diseases -- CVDs, cancer, diabetes, chronic respiratory diseases and hereditary disorders -- are responsible for some 25 million deaths worldwide annually with two-thirds occurring in the developing countries.
In developing countries, out of an estimated 40 million deaths which occurred in 1997, major noncommunicable diseases caused 15,2 million. Projections prepared by WHO indicate that, during the next 25 years, the burden of disease will shift from infectious to noncommunicable diseases.
This shift is coming most rapidly in Asia. In South-East Asia, for example, with an average life expectancy at birth of about 63 years, CVDs are now the second leading cause of mortality while almost 1000 people die of cancer every day. Hypertension has been found to affect up to 15% of the adult population in India, Indonesia and Thailand. Diabetes, while low in rural areas, reaches industrialized country proportions in urban populations.
In Africa, hypertension rates are rising sharply, as is the prevalence of diabetes. In a large percentage of affected individuals, both conditions remain untreated. Rheumatic fever and rheumatic heart disease are major causes of premature mortality, and account for one third of all cases of cardiac disease admitted to hospitals.
The Eastern Mediterranean region is a classic example of countries in the midst of epidemiological transition, which is characterized by increasing rates of obesity, accompanied by growing prevalence of diseases of the circulatory system and diabetes.
Despite these statistics, WHO experts believe the NCD toll could be significantly reduced. They estimate, for example, that 50% of all CVDs and one third of cancers are preventable. These estimates are based on the scientific evidence that risk factors, which include tobacco smoking, inappropriate diet (high in calories and saturated fats), lack of physical exercise and excessive consumption of alcohol, are common for major NCDs and that these risk factors are modifiable.
The resolution adopted by the World Health Assembly called for the development of a strategy, which can help reduce these risk factors in the whole population, as well as in high-risk groups. In addition to health promotion and disease prevention, such a strategy will incorporate early detection, treatment and rehabilitation.
Other essential elements of the strategy should include recognition of NCDs as a priority area within national public health policies, and collaboration and cooperation between ministries of health, nongovernmental organizations, the private sector and community groups.
For further information, journalists can contact Igor Rozov, Health Communications and Public Relations, WHO, Geneva. Telephone (4122) 791 25 32. Fax (4122) 791 48 58. Email: email@example.com
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