Developing countries are ill-equipped to manage the growing chronic-disease burden

For Davos 2017 The Economist Intelligence Unit has released a new report on the impact of non-communicable diseases in developing countries. I was the lead editor of the study. Healthcare systems in many developing countries have evolved to cope with the burden of infectious diseases and to improve child and maternal health. There is now a pressing need to include the prevention and management of chronic diseases in these systems, requiring new thinking on how such medical services are financed.

Highlights from the research

  • The burden of disease attributable to chronic or non-communicable diseases (NCDs) in developing countries is increasing relentlessly.
  • Much could be achieved through preventive policy intervention, but there is no “one-size-fits-all” solution.
  • Delivering appropriate NCD care to patients requires addressing multiple challenges such as weak policy and access to medical care.
  • Developing countries face an acute financing constraint for healthcare in general, and for NCDs in particular.
  • Technological and organisational innovations as well as sustained, co-ordinated efforts across multiple stakeholders are required.

Non-communicable diseases (NCDs) such as cardiovascular disease, cancer, mental illness, diabetes and chronic respiratory disorders are posing a growing threat to healthcare systems in developing countries. This is highlighted in a report by The Economist Intelligence Unit (EIU), The next pandemic? Non-communicable diseases in developing countries, commissioned by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) on behalf of Access Accelerated, an initiative to address the NCD burden.

According to data from the Institute for Health Metrics and Evaluation, NCDs account for over half of the overall disease burden in lower-middle-income countries, and close to one-third in low-income countries. The evidence shows that, in absolute terms, this burden increased by nearly 30% between 2000 and 2015.

Existing healthcare systems in developing countries are ill-equipped to manage this rising burden. Challenges include insufficient access to medical care and to healthcare facilities and professionals, but also policy weaknesses. There are also major financing constraints; for example, on a per-capita basis, total spending on healthcare in low-income countries amounts to less than 1% of the expenditure of high-income countries. Meanwhile, only a tiny percentage of development assistance on health is allocated to NCDs.

In order to address the challenges, health awareness programmes, urban planning that facilitates physical activity, and taxation strategies that seek to reduce demand for tobacco are all good starting points, but there is no “one-size-fits-all” solution. Technological and organisational innovations as well as sustained, co-ordinated efforts across multiple stakeholders are required. The healthcare infrastructure developed to address Millennium Development Goals can be leveraged to face the NCD challenge.

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