Asia Faces 'Slow-Motion Disaster'

A UN plan calls for a war on chronic diseases but lacks tangible targets.
An analysis by Parameswaran Ponnudurai
A Chinese heart patient undergoes a test before surgery at a hospital in Wuhan, central China's Hubei province, Dec. 20, 2008.

Asia is to be a key battleground in the world's biggest fight against deadly chronic diseases since the assault on HIV/AIDS began in earnest a decade ago.

But the region is hardly prepared to take on the gargantuan task.

In a landmark move, world leaders agreed at the United Nations General Assembly last week that an all-out war has to be fought against noncommunicable diseases such as heart ailments, cancer, asthma, and diabetes—so-called "lifestyle" illnesses that are stunting development, impacting economic growth, and altering demographics in Asia.

The global fatality figures are stunning. About three out of five people worldwide die of these diseases, making them the number-one killer in the world. And these people usually perish in the prime of their lives, robbing countries of vital human resources needed to fuel economic growth.

The Asian numbers are equally disturbing.

In China, nearly eight million people succumbed in 2008 to four main diseases—cardiovascular illnesses, diabetes, cancers, and respiratory ailments—the latest World Health Organization (WHO) figures show.

They accounted for a hefty 85 percent of all deaths in the country.

In Vietnam, the four illnesses accounted for 75 percent of all deaths, while in impoverished North Korea, they made up 65 percent.

The problem is also growing in Burma, Cambodia, and Laos, although the percentages have been hovering below 50.

"The prognosis is grim," warned U.N. Secretary-General Ban Ki Moon.

Only once before had the General Assembly of the world body convened at the ministerial level to sound the alarm on a global health issue —when it held its first summit on HIV/AIDS in 2001.


WHO chief Margaret Chan calls the trend in noncommunicable diseases a "slow-motion disaster."

"These are the diseases that break the bank," she said.

Over the next 20 years, the diseases will cost the global economy more than 30 trillion dollars, or nearly half of last year's global gross domestic product (GDP), a Harvard University study says.

Even for rapidly growing China, which has more than three trillion dollars in foreign reserves, the problem may burn a deep hole in the country's pocket.

"The rapid growth of chronic diseases will lead to the shortage of healthy workforce, the decline of life quality, and the increase of socioeconomic burdens," said Chinese Health Minister Chen Zhu.

There are now more than 260 million Chinese patients grappling with the diseases, which "have become a huge potential obstacle for economic and social development," Chen Zhu said.

Part of the problem is a lack of timely diagnoses and intervention.

For instance, a Harvard University study found that only one-third of hypertension patients in China are aware of their illness before diagnosis, and only one-fourth receive medical treatment.

Fueling the crisis in China are the problems of smoking and obesity.

"With more than 300 million smokers and 30 percent of the world’s most populous nation overweight and 12 per cent obese, the sedentary lifestyles of the emerging middle class cast a gloomy shadow on the nation’s public health and economy,” said Lily Hsu, program director for Project HOPE's Shanghai office.

In China, Project HOPE, a U.S.-based global health education and humanitarian aid group, is implementing a five-year program through 2013 to expand diabetes care in the country together with corporate partnership.

It also teaches daily disease management skills to high-risk cardiac and cerebral vascular patients and offers rehabilitation service to stroke patients.

Project Hope is also involved in a program designed to help health care workers in India combat diabetes. India is the world diabetes capital, with about 50 million people living with the disease and one million dying from it every year.

In Southeast Asia, the number of people dying from noncommunicable diseases is expected to increase rapidly—some 4.2 million people could fall prey to them in 20 years from 2.6 million in 2005, according to WHO projections.

Largely preventable

The region has spent few resources in combating the diseases, which are largely preventable and share common risk factors, such as tobacco use, unhealthy diet, lack of physical inactivity, and harmful use of alcohol, research shows.

"A health crisis is transpiring right here before our eyes," said a wide-ranging study on the problem in Southeast Asia this year published by the British medical journal The Lancet.

"Unless nations recognize the problem and take appropriate action, premature death and disability will continue, hindering development where development is needed most," it said.

The Association of Southeast Asian Nations (ASEAN) said its 10 member countries will give priority to preventive measures in addressing the threat but sought international help, especially in funding research on health problems in the region.

"Prevention is and will be our priority," Indonesian foreign minister Marty Natalegawa said.

As was noted early on in the fight against HIV/AIDS, the upcoming battle will not be won without a war chest, a U.N. document summarizing the General Assembly proceedings acknowledged.

"Non-communicable diseases by their very nature were complicated, and only a very few countries currently had the capacity to address their 'NCD' burden," the document said.

Indeed, a recent IMF report warns that rising health costs and the need to control expenditures will in the coming years become a fiscal policy challenge that could dwarf the fiscal crisis now gripping many countries.

No targets

The U.N. meeting last week adopted a declaration calling for quick implementation of strategies to promote healthy diets and physical activity, but did not set out time-bound goals or targets.

WHO was asked only to submit "options for strengthening and facilitating multisectoral action" by the end of 2012, and to prepare a review in 2014.

Some groups charged that the declaration had come under pressure from governments and lobbyists, leading to a watered-down document.

"The declaration was met with disappointment by consumer and public health campaigners," said Consumers International (CI), the world federation of consumer groups.

"Crucially, the declaration lacks tangible targets," The Lancet journal said.

The Union for International Cancer Control, part of the NCD Alliance network of more than 2,000 nongovernmental organizations, had proposed a commitment by 2025 to reduce avoidable deaths from noncommunicable diseases by 25 percent—a target WHO believes is achievable.
"[It] is more a politically correct declaration than a political declaration of war," The Lancet said.


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