11 February 2013
London — UNDP Administrator Helen Clark called Monday for swift, firm measures to halt a global surge in diseases such as cancer and diabetes, saying they belong “permanently on the global development agenda.”
“Failure to curb the growing epidemic of non-communicable diseases (NCDs) now will lead to a significant toll on human life and well-being, and great strain on health systems and family and public budgets,” she said, speaking at the launch of a new series on NCDs by UK medical journal The Lancet.
“By placing NCDs permanently on the global development agenda, people’s lives, opportunities, and future prospects will improve—advancing sustainable human development overall,” she said, adding that the global response to HIV/AIDS suggests early intervention can decisively alter the trajectory of an epidemic.
“Just as health shapes development, development shapes health. Poor health impedes lifting human development, while the conditions in which people live and work impact health and well-being,” she said. “Inequalities in health outcomes tend to mirror inequalities and inequities more broadly everywhere.”
“At UNDP we believe NCDs pose a significant threat to improving and sustaining human development progress in the 21st century,” she said. “NCDs, and their associated illnesses and suffering, stand in the way of people’s aspirations, freedoms, and capabilities to lead lives they value.”
NCDs moreover can quickly push families into poverty when adequate health care and social protection are unavailable, forcing children to leave school, sapping productivity, and imposing a tremendous economic burden at every level.
One recent World Economic Forum-Harvard School of Public Health study suggests that over the next 20 years NCDs will cost more than US$30 trillion, representing 48 percent of global economic output in 2010 and pushing millions of people below the poverty line.
‘Small set of clear targets’ needed
The Lancet argues that prevention and control of NCDs should be one of the forthcoming benchmarks, now widely under discussion, that will succeed the eight Millennium Development Goals (MDGs), which aimed to eradicate global poverty and associated ailments by 2015.
Clark, a former Health Minister and Prime Minister from New Zealand, suggested a broad goal such as “universal health” or “maximizing healthy life,” comprising clear targets such as progress in assuring universal health coverage and tackling the specific drivers of ill health.
“A key lesson from the experience of working with the MDGs is the need for focus on a small set of clear targets,” she said.
In addition to universal health coverage, this might include addressing socio-economic determinants of health, as stigma and discrimination rooted in law and policy “have profound impacts on health status and whether people access health services when they are readily available.”
Policy affects risk patterns such as consumption of tobacco, alcohol, and unhealthful foods, and relevant policies cut broadly across agriculture, trade, law, and taxes, she said. “Similarly, preventive behaviours such as physical activity can be impacted by public policy in areas as wide-ranging as sport and recreation, transport, and urban planning.”
A UN General Assembly High-Level Meeting in 2011 declared NCDs a major challenge to development and threat to achieving the MDGs. Leaders agreed these diseases—from diabetes and heart disease to cancer, depression, asthma, and addiction—threaten economies and “may lead to increasing inequalities between countries and populations.”
The 2010 Global Burden of Disease study cites a 32 percent decline in the burden from MDG-related disorders from 1990-2010 and suggests this is largely the result of increased global attention to these issues, including child mortality. But it also noted that in 2010, 65 percent of 52.8 million deaths could be attributed to NCDs, while 54 percent of disability-adjusted life years worldwide were caused by NCDs in 2010—up from 43 percent in 1990.
“We are now beginning to appreciate that controlling chronic diseases will not succeed only with a focus on conventional risk-factor prevention and a concerted global and national multi-sectoral response,” The Lancet’s editor, Richard Horton, writes. “Addressing early childhood exposures and experiences will also make a contribution in the longer term…”