Rise of Non-Communicable Diseases

Non-communicable diseases (NCDs) such as cancer and heart disease are becoming the dominant causes of death and disability worldwide; the incidence of long-term chronic conditions is rising faster and faster, which represents a major shift in global epidemiology.

 

These diseases are driven by forces that include ageing, rapid unplanned urbanisation and the globalisation of unhealthy lifestyles. At the same time, there is higher life expectancy across most of the world, meaning that the disease burden is increasingly defined by long-term conditions instead of premature mortality.

 

Though historically associated with the economic development and wealth attainment typically found in high-income countries, today NCDs are just as great a burden in low and middle-income countries. High treatment costs and lost productivity mean they have a staggering socio-economic impact. 1

 
 
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Current trajectory

  • NCDs are the leading cause of disability and death in Europe: cardiovascular disease, diabetes, cancer and respiratory disease account for 77% of the burden of disease and 86% of premature mortality. 1
 
  • NCDs are the leading causes of death (accounting for 63%) in all regions of the world except Africa. However, WHO’s 2013 projections indicate that by 2020 the largest increases in NCD deaths will probably occur in Africa due to the rise of the middle class. 2
 
  • The total mortality from infectious diseases fell from 25% in 1998 to less than 16% in 2010. 3
 
  • More than 16 million of the 38 million deaths attributed to NCDs each year occur before the age of 70; 82% of these ‘premature’ deaths occur in low and middle-income countries. 4
 
  • Over the next 20 years, NCDs are projected to cumulatively cost more than US$30 trillion (48% of global GDP in 2010), and push millions of people below the poverty line. Half of those who die of chronic non-communicable diseases are in the prime of their productive years; the loss of these lives is therefore endangering industry competitiveness. Mental health conditions will account for the loss of an additional US$16.1 trillion over this time span, with a dramatic impact on productivity and quality of life. 5
 
  • Rates of chronic diseases are increasing faster than anticipated. In 2001 it was predicted that chronic diseases would account for 57% of the global disease burden by 2020, yet they reached 63% of that burden in 2008. 6
 

Implications

  • The persistence of infectious diseases and the rise of middle classes in developing nations means they are facing a ‘double burden’ of chronic and infectious diseases. Increasing inequality in developed nations means they are also facing this double burden. In response, there has been a shift towards a more preventative model of care and tighter regulation of unhealthy food and drink, as well as cigarettes, in many countries – often driven by health conscious consumers. However, the sheer scale of the problem means many healthcare systems are still dangerously overstretched.
 
  • Even more stringent regulations may be introduced in future. This will impact upon a range of industries: the food and beverage industry, for example, may face greater pressure to shift their portfolio away from high-sugar and high-fat content foods.
 
  • There are opportunities for new business models that empower consumers to take more control over their health (e.g. smart health tracking devices), and reduce the chronic disease burden (e.g. diabetes prevention services).
 
  • Populations need to shift from calorie-dense and nutrient-poor diets to nutrient-dense diets and active living environments that discourage sedentary activities. 1
 
  • Health insurance claims for chronic diseases, and the absenteeism associated with them, already cost employers billions annually. These costs are likely to increase in the short to medium term, particularly in light of an ageing population. But there are also opportunities – one of the most rapidly growing occupational categories over the next decade is likely to be healthcare support.
 
  • 1. Diane T. Finegood, Lee M. Johnston, Suzanne Vander Wekken. (2013). Public-Private Partnerships to Prevent and Manage Obesity and Non-Communicable Diseases.

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