Health

Developing countries are ill-equipped to manage the growing chronic-disease burden

April 07, 2017

Global

April 07, 2017

Global
Martin Koehring

Senior Manager for Sustainability, Climate Change and Natural Resources & Head of the World Ocean Initiative

Martin Koehring is senior manager for sustainability, climate change and natural resources at (part of The Economist Group). He leads Economist Impact's sustainability-related policy and thought leadership projects in the EMEA region. He is also the head of the, inspiring bold thinking, new partnerships and the most effective action to build a sustainable ocean economy.

He is a member of the Advisory Committee for the UN Environment Programme’s Global Environment Outlook for Business and is a faculty member in the Food & Sustainability Certificate Program provided by the European Institute for Innovation and Sustainability.

His previous roles at The Economist Group, where he has been since 2011, include managing editor, global health lead and Europe editor at The Economist Intelligence Unit.

He earned a bachelor of economic and social studies in international relations from Aberystwyth University and a master’s degree in diplomacy and international relations from the College of Europe.

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As World Health Day is celebrated around the globe on April 7th, the rising burden of chronic diseases in developing countries must become a priority for global health policy. Healthcare systems in many developing countries have evolved to cope with the burden of infectious diseases and to improve child and maternal health. There is now a pressing need to include the prevention and management of chronic diseases in these systems, requiring new thinking on how such medical services are financed.

Non-communicable diseases (NCDs) such as cardiovascular disease, cancer, mental illness, diabetes and chronic respiratory disorders are posing a growing threat to healthcare systems in developing countries. This is highlighted in a recent report by The Economist Intelligence Unit (EIU), , commissioned by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) on behalf of Access Accelerated, an initiative to address the NCD burden.

Rising disease burden

According to data from the Institute for Health Metrics and Evaluation, NCDs account for over half of the overall disease burden in lower-middle-income countries, and close to one-third in low-income countries. The evidence shows that, in absolute terms, this burden increased by nearly 30% between 2000 and 2015 and impacts people at a younger age than in wealthier countries, exacerbating social and economic costs. Cardiovascular disease is the main contributor to the increase.

Note: The NCD burden, as measured in total disability-adjusted life years (DALYs), has risen significantly in a number of developing countries since 2000.

 

Existing healthcare systems in developing countries are ill-equipped to manage this rising burden. Challenges include insufficient access to medical care and to healthcare facilities and professionals, but also policy weaknesses. Developing countries also face an acute financing constraint for healthcare in general, and for NCDs in particular. On a per-capita basis, total spending on healthcare in low-income countries amounts to less than 1% of the expenditure of high-income countries, and in lower-middle-income countries it amounts to less than 2%. Out-of-pocket expenditure still represents the largest proportion of spending in developing countries, exposing most households to catastrophic healthcare expenditure.

No “one-size-fits-all” solution

In order to address the challenges, health awareness programmes, urban planning that facilitates physical activity, and taxation strategies that seek to reduce demand for tobacco are all good starting points, but there is no “one-size-fits-all” solution. Countries need to develop policy frameworks that reflect the national burden of disease, funding constraints and the nature of the healthcare system while also taking cultural factors into account.

Meanwhile, technological and organisational innovations as well as sustained, co-ordinated efforts across multiple stakeholders are required. The healthcare infrastructure developed to address the UN's Millennium Development Goals can be leveraged to face the NCD challenge. For example, there is an opportunity to leverage primary-care clinics established to deliver reproductive, maternal and child health to extend the provision of screening and treatment for cervical cancer and hypertension, as well as patient education programmes. Innovative business models offer the opportunity to create incentives for patients and healthcare providers to pursue prevention programmes. In both cases initiatives are in their infancy and warrant scaling up, an effort that will require financing.

The EIU has developed a data visualisation tool that highlights the growing NCD burden in developing countries. The data viz tool and the full report can be accessed .

 

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views of The Economist Intelligence Unit Limited (EIU) or any other member of The Economist Group. The Economist Group (including the EIU) cannot accept any responsibility or liability for reliance by any person on this article or any of the information, opinions or conclusions set out in the article.

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