Every two seconds someone under 70 dies of a non-communicable disease (NCDs), the majority of them in low- and middle-income countries (LMICs), according to a new report by the World Health Organization.
The WHO study, released today at the UN general assembly in New York, said that LMICs account for 86% of these premature deaths, most of which could be avoided or delayed if people had access to prevention, treatment and care.
The diseases pose one of the greatest health and development challenges of the century but they are “overlooked and underfunded”, according to the report, entitled Invisible Numbers.
Only a few countries remain on track to meet global development targets to reduce premature deaths from NCDs by a third by 2030, showing that the world is failing to take heed of the true extent of these diseases, which cause about 41m deaths each year, or 74% of all deaths globally.
At least 17 million people die prematurely before the age of 70 every year due to NCDs, including heart disease, cancer, diabetes and respiratory disease.
“The data paint a clear picture. The problem is that the world isn’t looking at it,” said the report, due to be presented at the UN for the first heads of state group focused on the prevention of NCDs, chaired by Nana Akufo-Addo, the president of Ghana.
Even though people “instinctively understand why NCDs matter to individuals and families … this understanding of the individual health consequences has not translated into adequate action, either nationally or globally”, the report said.
“This inaction is partly due to a failure to understand the scale of the toll that NCDs take on health, on equity and on economies.”
Cardiovascular diseases (heart disease and stroke) kill more people than any other disease, accounting for one in three deaths a year or nearly 18m deaths. “Two-thirds of the people with hypertension live in LMICs, but almost half of the people with hypertension are not even aware they have it,” researchers said.
About one in six deaths occur due to cancer, one in 13 due to chronic respiratory diseases and one in 28 are caused by diabetes.
The human toll of non-communicable diseases (NCDs) is huge and rising. These illnesses end the lives of approximately 41 million of the 56 million people who die every year – and three quarters of them are in the developing world.
NCDs are simply that; unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioural factors. The main types are cancers, chronic respiratory illnesses, diabetes and cardiovascular disease – heart attacks and stroke. Approximately 80% are preventable, and all are on the rise, spreading inexorably around the world as ageing populations and lifestyles pushed by economic growth and urbanisation make being unhealthy a global phenomenon.
NCDs, once seen as illnesses of the wealthy, now have a grip on the poor. Disease, disability and death are perfectly designed to create and widen inequality – and being poor makes it less likely you will be diagnosed accurately or treated.
Investment in tackling these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and communities is staggeringly high.
In low-income countries NCDs – typically slow and debilitating illnesses – are seeing a fraction of the money needed being invested or donated. Attention remains focused on the threats from communicable diseases, yet cancer death rates have long sped past the death toll from malaria, TB and HIV/Aids combined.
'A common condition' is a new Guardian series reporting on NCDs in the developing world: their prevalence, the solutions, the causes and consequences, telling the stories of people living with these illnesses.
Tracy McVeigh, editor
Tobacco use, unhealthy diets, harmful use of alcohol and physical inactivity are among the major risk factors leading to NCDs. More than 8m deaths every year are attributed to tobacco use; unhealthy diets account for a similar number.
An NCD data portal containing the latest global data on NCDs, risk factors and policy implementation for 194 countries was released alongside the report.
“NCDs undermine social development and are a handbrake on global development,” said Bente Mikkelsen, director of NCDs at WHO. “World leaders recognised the critical importance of NCDs in the sustainable development goals, aiming to reduce premature death from NCDs by one-third by 2030. But currently, just 14 of 194 countries globally are on track to achieve this goal.”
Mikkelsen added that poorer people, especially women and young people, are often aggressively targeted by industry to use tobacco and alcohol, key risk factors for NCDs. “Millions don’t have access to the prevention, treatment and care that could save lives or give years of life back,” she added.
Leanne Riley, one of the report’s authors, said NCDs do not get the attention and funding that is commensurate with their devastating impact. She said people living with NCDs face additional complications at the time of humanitarian crisis, such as during the conflict in Ukraine.
“Russia’s invasion of Ukraine disrupted many health services – including insulin access for people with diabetes. About 9% of Ukrainian adults have raised blood sugar and, as the conflict escalated, millions of people living with diabetes were at risk of not being able to access the daily lifesaving medication they need,” she said.
Riley referred to Rwanda’s success with its HPV vaccine rollout to tackle cervical cancer. In 2011, the country became the first African country to introduce a national HPV vaccination programme.
Nearly 40m deaths could be averted by 2030 if countries adopted the interventions that are known to work, the report said. Only 5% of external aid for health in LMICs goes to prevention and control of NCDs.
“This report confirms what we’ve long suspected – that chronic diseases are now beginning to outstrip infectious diseases as the main driver of mainly preventable ill health and death in lower- and middle-income countries,” said Katie Dain, CEO of the NCD Alliance. “We urgently need a major financial and public health reset by national governments and the global health community before it is too late.”
“The imperative for action is clear and urgent,” Dain said. “NCDs will cost more suffering and lives this decade than any other health issue; will drain the global economy and impede human capital; will both fuel and be fuelled by the growing inequalities in our countries and globally; and will undermine any efforts to ensure the world is better prepared for future pandemics after Covid. Inaction and paralysis is not a viable option.”
