SEATTLE — Communicable, or contagious, diseases have plagued developing countries forever, sparking public health efforts to increase vaccinations and prevent infection. However, noncommunicable or chronic diseases are the current leading cause of mortality worldwide and are increasingly making an impact in developing countries.
Diseases of long duration and slow progression with no infectious agent can be classified as noncommunicable in nature. The most prevalent of these noncommunicable diseases (NCDs), and the biggest killers, are heart disease and stroke, chronic obstructive pulmonary disease and diabetes. Diabetes alone is responsible for more than 1.6 million deaths annually, hitting both developed countries as well as developing areas in Asia and Africa.
Noncommunicable diseases in developing countries are distinct from other medical conditions in that they are mostly caused by lifestyle choices including poor eating habits, sedentary lifestyles and tobacco use. Further, it comes as no surprise that developing countries with populations that adopt these modern lifestyle habits often acquire the chronic diseases that accompany them.
The World Health Organization estimates that by 2020, NCDs will account for 80 percent of the global burden of disease. This number dwarfs any statistic associated with the number of communicable diseases, which is often the focus of public health efforts in developing countries. Due to the recent influx of noncommunicable diseases in developing countries, health professionals and policymakers are unprepared to address the systematic changes that need to be made to counteract this major public health issue.
Rural and underdeveloped areas within these countries often have the least access to treatment and prevention services especially because of the relatively new introduction of noncommunicable diseases to these areas. Results from Bangladesh data show that between 1986–2006, deaths from NCDs increased from 8 percent to 68 percent in a rural area. This dramatic increase in disease burden must be addressed with major changes in the health systems in developing countries.
Perhaps the biggest discrepancy between NCDs in developed versus developing countries is the difference in identification of risk factors early on and in treatment methods following the onset of the condition. Most NCDs are preventable or treatable; however, health systems in developing countries are usually inadequate and unprepared to combat the threat of NCDs.
Further, unhealthy habits and processed foods do not generally have the same negative stigma in developing countries that they have in the U.S. or in Europe. As a result, sugar-laden and calorie-dense foods are consumed without knowledge of their potentially harmful effect on one’s health. Further, citizens in developing countries may not be educated on the importance of living an active lifestyle and refraining from potentially harmful habits like binge drinking and smoking. This cultural difference and lack of health prevention programs will continue to perpetuate the issue in Bangladesh and other developing countries.
In order to achieve health improvements in these regions, public health programs must address not only treatment options, but also the social determinants and risk factors for NCDs. They must also be accessible to individuals in rural areas at an affordable cost. Further, commitment from local governments and stakeholders is crucial to combat the growing burden of noncommunicable diseases in developing countries.
The Global Strategy on Diet proposes collaboration with local governments in order to increase healthy lifestyle education and combat the powerful influence of multinational corporations like the tobacco industry to improve lifestyle habits. These tactics will contribute to a more global effort to reduce and treat chronic illnesses.
The increased prevalence of noncommunicable diseases in developing countries paired with a lack of health system organization to treat these diseases calls for major changes in global health initiatives. Nonprofit organizations and local governments must work together to challenge traditional beliefs about the lack of noncommunicable diseases in developing countries and work to prioritize the issue within health systems. Both education on healthy lifestyle choices and government programs and policy must be implemented to effect change.
– Sarah Coiro