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  • Developing nations 'must fight chronic diseases'


Developing countries could prevent millions of premature deaths every year by encouraging people to exercise, eat a balanced diet and not smoke, say public health specialists.

In four articles published online today (5 October) by The Lancet, the specialists say that these and other low-cost methods could reduce deaths from chronic diseases such as diabetes and heart disease by two per cent every year.

The journal’s editor Richard Horton says this target should be added to the eight UN Millennium Development Goals, which aim to tackle global poverty and disease by 2015.

Although chronic diseases kill nearly 30 million people a year in low- and middle-income countries, they receive much less attention there than infectious diseases such as HIV/AIDS and malaria.

Writing in The Lancet, a team led by Robert Beaglehole of the World Health Organization's department of chronic diseases attempts to dispel some 'myths' about chronic diseases.

They say chronic diseases are often wrongly perceived as “diseases of affluence", despite 80 per cent of deaths they cause being in low- to middle-income countries. Also, methods to prevent these deaths — such as public health programmes to reduce tobacco use — are far less costly than is widely believed.

Beaglehole's team says statistics from rich countries, where death rates from heart disease have dropped by up to 70 per cent in the past 30 years because of public health efforts, prove that deaths from chronic disease can be cut.

These efforts need not be beyond the means of poorer nations, says Beaglehole, pointing out that in countries such as Indonesia, the Philippines and Vietnam, governments are successfully adopting a 'stepwise' approach to tackling chronic diseases.

Such an approach allows heath authorities to make best use of their limited resources by carefully planning action and implementing each step in turn, starting with those steps that are possible immediately and will have the biggest impact relative to the investment.

Beaglehole and colleagues say national governments should coordinate the activities of all stakeholders and ensure that all relevant sectors are involved at each stage of planning and implementation.

According to the paper, policies should focus on factors such as smoking that are associated with a variety of diseases.

Included in The Lancet's articles are detailed case studies of India and China, where chronic diseases account for 53 per cent and 80 per cent of all deaths, respectively.

Both countries have many smokers, and high rates of heart disease and cancer.

Although control programmes for tobacco use and cancer are already underway in each country, these efforts need to be coordinated nationally, and expanded to include diet and exercise, say the authors.

To effectively tackle these diseases, they add, local healthcare capacity also needs to be bolstered to include health promotion and to better analyse the risk of chronic diseases.

The articles' publication coincides with the launch of a World Health Organization report Preventing Chronic Diseases: A vital investment.

Articles in The Lancet:
Preventing chronic diseases: how many lives can we save?
Preventing chronic diseases: taking stepwise action
Preventing chronic diseases in China
Responding to the threat of chronic diseases in India
Editorial by Richard Horton

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