Macroeconomics and Health (CMH)

MacroHealth Newsletter

No. 10, August 2004

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Recent reports highlight the economic costs of NCDs and violence

A string of reports published in the last several months have drawn attention to non-communicable diseases (NCDs) and violence, highlighting their economic costs and the urgent need to address them in developing countries worldwide. Illness and death from these causes is expected to rise in developing countries, suggesting a strong imperative to take into account NCDs and violence in long-term strategic planning for the health sector, including Macroeconomics and Health work. For example, in developing countries of the European Region, NCDs are by far the major cause of morbidity.

April 2004 saw the publication of " A Race Against Time", which showed that cardiovascular disease is a much greater public health problem in developing countries than has previously been understood. The Report followed on from the 2001 Report of the Commission on Macroeconomics and Health, seeking to integrate cardiovascular diseases into the health and development framework advocated by the CMH Report.

In May 2004, the proposed WHO strategy for addressing the rising health effects of leading chronic diseases was presented to the WHO Director-General. This document defines chronic diseases to include cardiovascular disease, diabetes, cancers, and chronic respiratory diseases. The report emphasizes that the rising incidence of chronic disease in developing countries is leading to a double burden of disease, and says that in developing countries, disease and death from chronic diseases are higher in young people compared with developed countries. The prevalence of risk factors in developing countries is increasing, with long-term economic growth increasing the risks. After detailing the problem, the document emphasizes the economic impact of chronic diseases and notes their omission from the 2001 Report of the Commission on Macroeconomics and Health. Finally, it reviews past efforts to address communicable diseases and sets out recommendations for future work. Among other recommendations, the strategy urges the inclusion of chronic diseases in MH Health Investment Plans.

The human and economic costs of violence were highlighted in a report released by the WHO at the 7th World Conference on Injury Prevention and Safety Promotion in early June 2004. The report, entitled "The economic dimensions of interpersonal violence", found that violence prevention is cost-effective given the enormous costs of violence to societies. In many parts of the world, however, particularly in developing countries, the costs of violence are not well understood. It was found that more studies into the economic costs of violence are needed to build evidence for policy-making. Presently, as part of the work of the Caribbean Macroeconomics and Health mechanism, a Working Paper is being prepared to assess the economic costs of external causes (violence and injuries) to the Caribbean (see below).

Reports of the 2nd Consultation, regional MH meetings available on MH website

The Report of the 2nd Consultation on Macroeconomics and Health, "Increasing Investments in Health Outcomes for the Poor," is now available on the Macroeconomics and Health website at

The report reviews major outcomes from the Working Groups and Consultation sessions and includes excerpts from speeches and an overview of Consultation papers and media coverage.

In addition, reports from the three regional meetings on Macroeconomics and Health, held during the summer of 2003 in Africa, the Eastern Mediterranean, and South-East Asia, can be accessed via the website.

Please visit to download the reports.

A regional MH framework for South-East Asia

The "Regional Macroeconomics and Health Framework" for South-East Asia is now available on the Macroeconomics and Health website. This report, prepared by MH consultant Dr Abusaleh Shariff, aims to help guide Macroeconomics and Health work in the countries of the South-East Asian region. It highlights the importance of investments in health for economic development in the region. It also examines health spending in the countries of the region, identifies ways to increase coverage of essential health services, particularly for the poor, and looks at the effects of global developments, such as the Trade-related Aspects of Intellectual Property Rights (TRIPS) Agreement, on availability of drugs and overall health awareness. Please visit to view the report.

MH work discussed at Médecins Sans Frontières debate

The CMH Executive Secretary, Dr Sergio Spinaci, presented MH work at the Médecins Sans Frontières (MSF) Heads of Mission week in Brussels, Belgium in June 2004. The session was organized by MSF's Access to Health Care Unit, which was launched in April-May 2003 and is looking at possibilities for MSF to develop capacity to "campaign for structural changes in access to health care."