[ Nutrition ]

Choosing HIV over Diabetes: The Non-Communicable Disease Epidemic – Foreign Policy Blogs

In 2006, the World Diabetes Foundation received an application to support a project entitled The Global Micro-Clinic Project: Community Ownership and Awareness in Jordan. Anecdotally, little information or literature was available on this subject. The Association was re-registered in 2006 under society Act No.6 of 1995 with the registration No.446 dated 16/11/2006. Project HOPE has embarked on and continues to direct major initiatives to meet the challenges of managing symptoms of NCDs and forestalling their spread with education programs consistent with its long-term global mission to create sustainable health education programs that enable communities to help others to help themselves. It can damage the heart, blood vessels, eyes, kidneys and nerves, negatively affecting quality of a life over many years. According to the World Health Organization (WHO) Report of the Global Tobacco Epidemic in 2008, over 300 million Chinese men were cigarette smokers and 100 million men currently under the age of 30 years will die from tobacco use if such a smoking pattern continues [6]. NCDs are the leading cause of death in every region besides Africa.

Moreover, this study suggests that the tool used might be of value in assessing progress in health system strengthening as well as in conducting the initial needs assessment. This burden is especially pronounced in countries of the former Soviet Union. There is similarly little evidence that readily digested starchy foods increase the risk of developing NIDDM. Diabetes is a chronic disease that occurs either when the pancreas does not produce enough of the blood sugar-regulating hormone insulin or when the body cannot effectively use the insulin it produces. Public health affects every business, every employee, every customer and every citizen. But there are no strong, time-bound commitments in there, so it’s a great disappointment from that point-of-view.”  Sara Reardon of Science Insider, citing a source who has seen the HLM document, reports that it includes a pledge to institute a UN-led global monitoring framework for trends in NCDs and country efforts, as well as a recommendation that the WHO and UN give recommendations for government action on NCDs at the end of 2012. Urbanisation and economic growth has driven this change.

A recent study authored by PATH, with support from Novo Nordisk, showed that, in some cases, just one-third of public health facilities had insulin in stock, and only one in four had testing strips available to monitor diabetes. Looking at the statistics, it is clear that increased consumption of unhealthy foods, tobacco use, harmful use of alcohol and declining physical activity are major risk factors for the NCD epidemic. Dr. The recommendations presented in this report aim to build on these successes, reinforce and expand existing initiatives as well as develop new programmes to address new and existing deficiencies. Given the magnitude of the NCD epidemic and its implications for global health, human rights, and economic success, stronger action must be taken now. With globalization and a lack of legal social protections and health awareness programs in many lower-income countries, cheap, processed foods and tobacco products are widely available. Lack of physical activity was associated with increased risk of having NCDs, corroborating with the findings of several studies conducted before [25, 26].

While a wealthy person in the US may be able to afford insurance that will cover his or her diabetes treatment, a person in  a lower-income country may not. Communicable diseases, especially HIV/AIDS, are sometimes covered under national health programs or by global health organizations working in-country because a strong public outcry forced a widespread, funded global commitment. This lack of support for NCDs, which are often chronic, prompted a Cambodian man to tell UN Representative Princess Dina Mired of Jordan: “I wish I had AIDS and not diabetes.”  While a communicable disease may be covered (universal access for HIV/AIDS, TB, etc. In its 2009-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases, the World Health Organization identifies international partnerships as paramount in the global struggle against NCDS. The expanding incidence of NCDs will have an effect on national economic productivity, as a 2007 study by Abegunde et al in The Lancet found. Abegunde et al calculated that in 23 countries studied, an estimated $84 billion in economic productivity would be lost due to NCDs between 2006 and 2015. According to the HBM, perceived severity of and vulnerability to a disease, as well as perceived benefits and barriers to changing health behavior, will decide an individual’s attitude and decisions about the disease (14).

That’s a tall order to fill, especially in the midst of an economic recession and in the context of the widespread nature of the epidemic. Hence, there has been growing interest in the study of self-rated health as an indicator for the health status of a population. Keeling said: “I think that what will really turn this epidemic around…is when people with these diseases stand up and demand the right to health and the right to universal access to medicines.” There is no denying that the burden of NCDs falls unequally on the developing world and lower-income populations (like most other morbidities) and that treatment options in high-income countries are more accessible. Health infrastructure in the developing world cannot handle most NCD treatment. For example, there are few cancer treatment options in West Africa outside of Ghana or Nigeria, or going all the way down to South Africa. Beyond that, however, the solutions, such as better urban planning, restrictions on tobacco and alcohol advertising, better nutrition in schools, and general public awareness campaigns add another dimension of complexity and cost. Although at least one study has calculated that the funding spent on prevention and risk reduction are cheaper, and may even result in a return-on-investment of $3 for every $1 spent on such programs, the political will does not exist to make it a reality.

This is a human rights issue, but it will take time, and more awareness, before prevention and treatment of NCDs is an accepted development issue. However, once we create access, once we open the door, ours becomes the ethical responsibility to identify and overcome barriers to care in order to obtain excellent outcomes. Food availability, education, poverty levels, and a host of factors can contribute to NCDs, and NCDs contribute to poverty, poor national economic development, overburdened health systems, and another host of results. Although there has been some success with vertical, or single-issue, interventions, integrated programs are key to overall public health. These figures are comparable to our study (12%). All the same, the global community must first try. The UN’s (reported) inability to create a stronger resolution and to put itself at the head of efforts to prevent and treat NCDs and their risk factors is disappointing but in keeping with the way in which most global health epidemics are handled: inaction and hand-wringing until the crisis reaches a breaking point, which usually means that many people have died.

As with so many health (and other) interventions, an unwillingness to make a high up-front investment results in more costly fixes. When these up-front preventative measures are funded, they often mean more money and more lives saved. Although this may be a well-established truth, it won’t change the fact that little will be done at present to stem the non-communicable disease epidemic.

Tags: , ,