Magnitude and trends of
noncommunicable diseases
Distribution of deaths by leading cause groups
(males and females, world, 2004)
NCDs cause premature deaths in LMICS
Projected deaths by cause and income (2004 to 2030)
WHO
30
Intentional injuries
Other unintentional
Road traffic accidents
Deaths (millions)
25
Other NCD
20
Cancers
15
CVD
10
Mat//peri/nutritional
5
Other infectious
HIV, TB, malaria
0
2004
2015
2030
High income
2004
2015
2030
Middle income
2004
2015
2030
Low income
Noncommunicable Diseases
Burden of disease in disability adjusted life years (2004)
Launched October 2008
Noncommunicable Diseases
Global burden of disease attributable top 20 risk factors (2002)
Underweight
Unsafe sex
High blood pressure
Tobacco
World Health Report, 2002)
Alcohol
Unsafe water, S&H
High cholesterol
Indoor smoke from solid fuels
IIron deficiency
High BMI
Zinc deficiency
Low and middle income
Low fruit and vegetables
High income
Vitamin A deficiency
Physical inactivity
Occupational injury risks
Lead exposure
Illicit drugs
Unsafe health care injections
Lack of contraception
Childhood sexual abuse
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
Attributable DALYs (% total 1.44 billion)
10%
Noncommunicable Diseases
Tobacco is a risk factor for 6 of the 8 leading causes of death
(World Health Statistics, 2008)
Tobacco
Rising production and consumption in developing countries
Tobacco: The poor and uneducated are the ones who smoke the most
Smoking prevalence in Bangladesh (1995)
Source: Sen, B & Hulme D, 2004
Prevalence of overw eight (BMI>25)
100
90
80
70
60
50
40
30
20
10
0
Prevalence of obesity (BMI>30)
Kyrgyzstan
Swaziland
Kazakhstan
Dr Korea
Georgia
Ukraine
Turkmenistan
Lesotho
Russia
Armenia
Albania
Azerbaijan
Belarus
Brunei
Egypt
Kuwait
Nauru (1st in
the global
USA
%
Overweight and obesity in people over 15 selected countries
The epidemiological transition in this
region is already well advanced; all
countries are at risk irrespective of
income and socioeconomic development
Adult mortality (2004)
Cardiovascular diseases
High income
Cancers
Other noncommunicable diseases
Western Pacific
Injuries
HIVAIDS
Americas
Other infectious and parasitic diseases
Maternal and nutritional conditions
Eastern Mediterranean
South East Asia
Europe
Africa
0
2
4
6
8
10
Death rate per 1000 adults aged 15–59 years
12
Prevalence of tobacco use among males in the
Eastern-Mediterranean Region
Launched February 2008
Noncommunicable Diseases
Adult Overweight and Obesity in Arab Countries
Noncommunicable Diseases
Overweight among school children (13-15 yrs old)*
% overweight or at
risk of overweight**
Djibouti
12.3
Egypt
20.6
Jordan
16.8
Lebanon
18.4
Libya
21.7
United Arab
Emirates
33.2
*Results from the Global School-based Student Health Survey
(http://www.who.int/chp/gshs/factsheets/en/index.html)
**overweight or at risk of becoming overweight=above the 85 th
percentile
(Source: Comparative DM prevalence, table 1.12 and 1.13 of Diabetes Atlas)
Noncommunicable Diseases
Age-adjusted estimates of diabetes prevalence in the
Eastern-Mediterranean Region
Adults (20-79)
SOCIOECONOMIC ASPECTS
Impact of increasing medical costs and the need
for prevention
• Total Health Expenditure per capita ranges between US$ 325 to
2750
• Out of pocket spending ranges between 18-23% THE
• Advanced epidemiological and demographic transitions are
expected to result in a several fold increase in health care spending
in Gulf Cooperation Countries in the coming 2 decades
• Prevention has to be taken seriously
Sources: WHO WHR 2008,- WHO NHA database, WHO-EMRO, Mapping health care financing, EMR
countries
Catastrophic Expenditures
• Studies in some Arab countries show that 2-4.5 % of the population
face catastrophic expenditures – meaning spending 40 % or more
from their disposable income (excluding food), when a member of
the family becomes sick
• 5.5 - 13 millions individuals may face such situation every year
• 1-1.4 % of the households are pushed into poverty when a member
of the family becomes ill, resulting into 2.5 to 4 millions of poor
individuals for the whole region
(Source: B. Sabri – WHO/EMRO)
Percent
Proportion of family income devoted to diabetes
care
40
35
30
25
20
15
10
5
0
1998
2005
Hi
Upper Mdl
Middle
Income level
Source: Ramachandran A Diabetes Care 2007
Low
In Conclusion: Barrier to Development
• CVDs and other NCDs Will Further Widen the Health
Gap between Rich and Poor Countries
• They Are Killing and Disabling People at Their Peak
Productivity
• They Will Slow Economic Growth Rates in Poor
Countries