COLORADO SPRINGS, Colorado —The eight existing Millennium Development Goals have helped the world gauge its progress in alleviating global poverty. While world hunger has nearly been cut in half, there are still seven MDGs that remain unreached along with a significant global health issue that remains unmentioned.
The sixth Millennium Development Goal focused on halting and reversing the spread of the communicable diseases HIV/AIDS and malaria. However, no MDG specifically addressed the growing risk and severity of various types of noncommunicable diseases – namely, the most prominent and fatal: cardiovascular disease, or CVD.
The U.N.’s new Sustainable Development Goals seek to reevaluate and regroup unreached MDGs and address new global health issues but fail to give cardiovascular disease sufficient attention.
The third SDG, which seeks to “ensure healthy lives and promote well being for all at all ages,” contains a subsection that groups communicable and non-communicable diseases together in the context of research and development of methods and vaccines.”
Just as the U.N. narrowed its communicable disease focus on two specific epidemics in the MDGs, the U.N. must adopt the specific SDG of reducing the burden of cardiovascular disease before adopting the broad and general resolution of combating noncommunicable diseases, or NCDs.
On a global scale, cardiovascular disease poses substantial health and financial threats to a disproportionate amount of people. Although most heart disease and strokes are preventable, cardiovascular disease is the number one cause of death globally and the leading killer of women in the world, comprising a shocking one-third of all female deaths worldwide.
In 2008, cardiovascular disease comprised 30 percent of all global deaths, 7.3 million due to coronary heart disease and 6.2 million due to stroke. Like other NCDs, cardiovascular disease is a growing epidemic that transcends race, socioeconomic status and country of origin.
To provide more of a focus, low- and middle-income countries are disproportionately affected, as over 80 percent of cardiovascular disease deaths occur in developing countries. In 1990, cardiovascular disease accounted for 108,802 disability-adjusted life years, or DALYs, lost in developing regions. This indicates that the contribution of developing countries to the global burden of cardiovascular disease was 2.8 times higher than that of the developed countries. Compared to 26.5 percent in developed countries, the portion of CVD deaths occurring below the age of 70 years was a striking 46.7 percent in developing countries.
The high prevalence of CVD in low- and middle-income countries also has financial implications. The WHO estimated that the projected lost output from 2011 to 2025 associated with cardiovascular disease in low- and middle-income countries is $3.76 trillion. Because of inadequate food and resources as well as weak health care and political systems, many developing nations lack the necessary skills to prevent and detect cardiovascular disease in their populations.
There exists an obvious connection between cardiovascular disease prevalence, the health of the general population and economic instability. A population that is crippled from heart disease, strokes or other cardiovascular issues cannot positively contribute to the social or economic sectors of a country. The productivity of a country takes an enormous toll because as the mortality rate rises, the number of employed citizens decreases.
In addition, the economic burden on the health care system causes inordinate increases in government expenses and taxes.
Dr. K. Srinath Reddy, MD, DM, professor of cardiology at the Cardiothoracic Centre in All India Institute of Medical Sciences, said that “nations that must invest their scarce resources in programs of industrial growth and sustainable development may ill afford the escalated health care expenditure imposed by the technology intensive management of manifest CVD.”
Such devastating diseases create an enormous economic burden on countries already suffering from low productivity and financial instability; thus, the societal, political and financial need for reducing the risk of cardiovascular disease is astronomically important for developing countries.
A reduction in the burden of cardiovascular disease necessitates addressing various risk factors including: tobacco use, unequal access to fruits and vegetables, obesity and lack of physical activity and stress relief practices. Countries also much improve access to mental health and counseling centers.
Reducing cardiovascular disease is a realistic goal for which public health officials and members of the WHO have consistently campaigned. The sheer size of this epidemic is predicted to cost the world economy – both developed and developing countries alike – over $47 trillion over the next twenty years, accounting for 75 percent of the global GDP.
Countries clearly have a financial incentive to prioritize the reduction of CVD, but ensuring that health care systems shift their focus to the epidemiological reality, so as not to exclude NCDs like cardiovascular disease from overall disease reduction, will be a welcomed challenge.
– Paulina Menichiello
Sources: WHO 1, WHO 2, Circulation, WHO 3, NCD Alliance, The Guardian