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11 - Benefits and Costs of the Noncommunicable Disease Targets for the Post-2015 Development Agenda
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- By Rachel Nugent, Vice President, Global NCDs RTI International, Seattle WA, USA and Affiliate Faculty, Department of Global Health, University of Washington, Seattle, WA, USA., Elizabeth Brouwer, Pharmaceutical Outcomes Research and Policy Program, University of Washington, USA
- Edited by Bjorn Lomborg, Copenhagen Business School
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- Book:
- Prioritizing Development
- Published online:
- 30 May 2018
- Print publication:
- 07 June 2018, pp 231-243
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- Chapter
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Summary
Introduction
We discuss the role of noncommunicable diseases (NCDs) in the development goal discourse, especially how NCDs fit into the overall health goal and why it is essential to have an NCD target to meet Goal 3 of the proposed SDGs: Ensure healthy lives and promote well-being for all at all ages. The interventions presented and analyzed here will reduce mortality by 28.5 percent in 2030, primarily from cardiovascular and respiratory diseases, as well as some cancers.
Rationale for Addressing NCDs in Development
NCDs are the largest cause of mortality both globally and in the majority of low- and middle-income countries (LMICs). NCD mortality exceeds that of communicable, maternal, perinatal, and nutritional conditions combined (Commission, 2013). NCDs account for 65 percent of global deaths (Murray and Lopez, 2013), accounting for a majority of deaths in all regions except Africa. Eighty percent of NCD deaths (28 million people) occur in LMICs, making NCDs a major cause of poverty and an urgent development issue. Bloom et al. (2011) estimated that $47 trillion in economic output would be lost due to NCDs by 2030, concluding that “inaction would likely be far more costly [than interventions for NCDs].”
NCDs are wrongly perceived as diseases only of the rich. There has been a dramatic transition from infectious disease to NCD burden – in Mexico, for example, NCD was the cause of death in 45.4 percent of cases in 1980, but this increased to 74.4 percent by 2009. The reach of NCD risk factors is striking: a study in Argentina, Chile, and Uruguay found that 43.4 percent of the population has high blood pressure, 11.9 percent has diabetes and 35.5 percent are obese. Nineteen percent of Kenyan HIV patients are obese and 8.2 percent have high blood pressure. Ninety percent of NCD deaths before age 60 are in LMICs, resulting in loss of household heads, wasted education investments, and huge out-of-pocket costs to families. Most of these deaths are from preventable causes, and lack of access to affordable medicines and health care services are also major contributors.
Chapter 11 - Benefits and Costs of the Noncommunicable Disease Targets for the Post-2015 Development Agenda
- Edited by Bjorn Lomborg, Copenhagen Business School
-
- Book:
- Prioritizing Development
- Published online:
- 30 May 2018
- Print publication:
- 07 June 2018, pp 231-243
-
- Chapter
- Export citation
-
Summary
We discuss the role of NCDs in the development goal discourse, especially how NCDs fit into the overall health goal and why it is essential to have an NCD target in order to meet Goal 3 of the proposed SDGs: Ensure healthy lives and promote well-being for all at all ages. The interventions presented and analyzed here will reduce mortality by 28.5% in 2030, primarily from cardiovascular and respiratory diseases, as well as some cancers.
3 - Chronic Disease
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- By Prabhat Jha, University of Toronto, Rachel Nugent, University of Washington, Stéphane Verguet, University of Washington, David Bloom, Harvard University, Ryan Hum, University of Toronto
- Edited by Bjørn Lomborg
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- Book:
- Global Problems, Smart Solutions
- Published online:
- 05 June 2014
- Print publication:
- 14 November 2013, pp 137-185
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Summary
Eighty percent of global deaths from heart disease, stroke, cancer, and other chronic diseases occur in low- and middle-income countries. This chapter discusses priorities for control of these chronic diseases as an input into the 2012 Copenhagen Consensus. This chapter and the accompanying Chapter 7 on infectious disease control build on the results of the 2008 Copenhagen Consensus chapter on disease control (Jamison et al., 2008), and is best read as an extension of the latter chapter.
This chapter also draws on the framework and findings of the Disease Control Priorities Project (DCP2). The DCP2 engaged over 350 authors and among its outputs were estimates of the cost-effectiveness of 315 interventions, including about 100 interventions for chronic diseases. These estimates vary a good deal in their thoroughness and in the extent to which they provide regionally-specific estimates of both cost and effectiveness. Taken as a whole, however, they represent a comprehensive canvas of chronic disease control opportunities. This chapter identifies five key priority interventions for chronic disease in developing countries which chiefly address heart attacks, strokes, cancer, and tobacco-related respiratory disease. These interventions are chosen from among many because of their cost-effectiveness, the size of the disease burden they address, their implementation ease, and other criteria. Separate but related 2008 Copenhagen Consensus chapters dealt with other major determinants of chronic diseases such as nutrition, (Behrman et al., 2007), air pollution (Larsen et al., 2008) and education (Orazem et al., 2008). The health-related chapters for the 2012 Copenhagen Consensus focus on infectious diseases (Jamison et al., 2012), sanitation and water (Rijsberman and Zwane, 2012), education (Orazem, 2012), hunger and undernutrition (Hoddinott et al., 2012) and population growth (Kohler, 2012).
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