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Non-Communicable Diseases Explained (Extended)

A presentation prepared by Dr Alessandro Demaio, http://www.healthmetricsandevaluation.org/gbd/visualizations/country

Alessandro Demaio

on 29 April 2016

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Transcript of Non-Communicable Diseases Explained (Extended)

NCDs Explained
What are NCDs?
6 Facts About NCDs

85% of NCDs occur in the worlds POOREST populations. NCDs cause poverty, and entrench people in poverty.
More than 50% of global NCDs occur in people younger than 70.

NCDs now pose the single biggest threat to women’s health & development, causing 65 % of all female deaths.

The inter-generational burden of chronic disease & its treatment are often greatest on women.
NCDs are not diseases of the lazy.

80% of heart disease and diabetes, and a third of cancers are currently preventable!
These diseases are caused by similar determinants and therefore share mitigation and prevention opportunities.
NCDs are deeply rooted in social determinants of health.
Assistant Professor in Global Health & NCDs
Copenhagen School of Global Health, Denmark
Global Health Fellow, Harvard Global Equity Initiative
Co-Founder, NCDFREE
NCDs are the leading cause of global deaths - 36M in 2008 alone.
NCDs are not diseases of the rich.
NCDs are not a disease only of the aged.
NCDs do not just affect men.
These deaths can be averted today.
CVDs are the number one cause of death globally
17.3 million people died from CVDs in 2008, representing 1 in 4 deaths - 23M by 2030
LMIC are disproportionally affected: over 80% of CVD deaths
Chronic respiratory diseases cause approximately 7% of all deaths worldwide
Most of the 250K deaths from asthma each year can be attributed to lack of proper treatment
Deadly synergies exist between diseases such as tuberculosis and HIV/AIDS, COPD and lung cancer
1 in 9 deaths globally
Rates could further increase by 50% in the year 2020
Linked to infections, nutrition & environmental pollutants
285 million people, corresponding to 6.4% of the world's adult population in 2010, up to 10.2% in the Western Pacific
70% of the current cases of diabetes occur in low- and middle income countries
In Mozambique, diabetes care for one person requires 75% of the per capita income
Heart Disease & Stroke
Lung Diseases
Around 20% of the world's children and adolescents are estimated to have mental disorders or problems
Depression is ranked as the leading cause of disability worldwide
90 people suicide every hour of every day, almost 90% of them in low- and middle-income countries
A threat...
An Opportunity
Healthier cities.
Stronger economies.
More sustainable living.
Synergies with other disease.
Dr Alessandro Demaio
Tackling NCDs: a different approach is needed.
The Lancet. Beaglehole et al. 2012.
NCDs are a poverty cycle catalyst.
A group of diseases characterised by their non-communicability

Once the left-over agenda, now the leading cause of global deaths and DALY

The harmful use of alcohol results 280 deaths every hour
1 in 10 death of young people between the age of 15 and 29 result from alcohol-related causes
Alcohol is the world’s third largest risk factor for disease burden; leading risk factor in the Americas
Mental Illness
Dramatic transformation in global diets over the past century
Major life-expectancy gains to now the number one risk factor for DALY globally
Risk for secondary risk factors, and also NCDs
Outcome of a globalised food system controlled by a few multi-nationals
Unhealthy Diet
The main cause for approximately 1 in 4 cases of breast and colon cancers, and a third of diabetes and heart disease burden
1 in 20 deaths globally
Physical Inactivity
Tobacco use remains legal, although it kills more than 5M people each year, including one person who dies every minute from second-hand smoke exposure

Prediabetic & Diabetic (Adults): 25%

Prediabetic or diabetic: 50% (500M – 100x all DK)

1980: 1%
Today: 7%
1980: 1%
Today: 12%
Impaired Glucose Tolerance
Gestational Diabetes
And yet, NCDs already cost India the equivalent of 12.5 per cent of the nation's GDP in lost productivity
Indian Government currently spends 2% of GDP on healthcare
Healthcare costs for a person with diabetes in Vietnam can be 75% of a family's income
Where has the epidemic come from?
Major gains in '20th century agenda'
An ageing and urbanising population
Globalisation of the food system
Political neglect
What can be done?
Responding to NCDs is a political issue rather than a technical one
Support moves to reduce Tobacco and Harmful Alcohol Use
Lobby for early education about foods, their origins and their contents
Support urban environments which promote healthy lifestyles and physical activity
Support & participate in screening programs for early detection and treatment of NCDs
Reduction of tobacco consumption. It remains the most important avoidable cancer risk. In the 20th century, approximately 100 million people died world-wide from tobacco-associated diseases
We have cost effective solutions and many know what must be done.

It is now translating this into political action through scientific evidence (which we largely have) and societal advocacy & support
Support progressive policies ensuring all communities have access to affordable, healthy food options
Be aware of Big Food, its power and its intrinsic conflicts of [fiscal] interests.
What do we know about diabetes?

What are the risk factors?
What are the outcomes?
Strengthen and value primary care as a platform for delivering prevention and treatments.
"We have a broken system.

Our economic system values endless growth at any cost; our food system is built for profit and not populations; our healthcare systems are designed for the wrong conditions; and our cities are built for cars and not the people who live there."
Seven Things You Need to Know About NCDs Thus Far
PLOSmed Series on Big Food
2013 (IV) Lancet Series on NCDs
2015 Series on Obesity
2011 UN HLM
25x25 Target
of the 2012 WHA
NCDs in the formal drafts of the SDG
2013 Global Action Plan
2014/5 Global Status Report

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