Preventable Chronic Diseases Are Now the World's Biggest Killers

The chronic health problems of post-industrial societies have now spread to the developing world, says a new report by the World Health Organization.

Diabetes, heart disease, and cancer now cause more deaths worldwide than all other diseases combined, according to the first global status report on noncommunicable diseases (NCDs) released at the WHO Global Forum in Moscow today. Communicable diseases such as malaria and AIDS are now outpaced by NCDs in every region except Africa. Chronic diseases, many of which are preventable, accounted for 63% of the 57 million deaths worldwide in 2008. Of those 36 million deaths, 80% occurred in low- or middle-income countries.

Health leaders from around the world are continuing to meet in Moscow the rest of this week to prepare for the United Nations summit on NCDs in September. It will be only the second U.N. summit convened to address a health issue; the first, held in 2001, focused on AIDS and led to the creation of the Global Fund.

The 100-page report aims to establish a baseline for the risks of NCDs, measure their prevalence, examine the progress various countries are making in dealing with NCDs, and outline what steps countries can take to both prevent and combat NCDs.

"The good news," WHO Director-General Margaret Chan said in a press conference today, "is that these diseases are preventable." The report identified smoking, alcohol use, insufficient physical activity, and poor diet as the major risk factors. The report predicts that even African countries will suffer more deaths from NCDs by 2020 than from transmissible diseases and poverty-related issues such as malnutrition and maternal deaths. A 15% increase in mortality from NCDs is expected worldwide in the next decade.

The report also examines the devastating impact of NCDs on a nation's economy. It says 100 million people are driven into poverty each year by health care costs. In the press conference, WHO Assistant Director-General Ala Alwan cited a World Bank report that found half of families who have a family member with cancer spend more than 30% of their income on treatment, driving 50% of these families below the poverty line as a result.

A 2009 survey of 187 U.N. member states found that many governments are unprepared to deal with the combined effects of more NCDs, a growing population, and rising health care costs. A poor medical infrastructure, lack of access to health care, and, in some cases, inadequate education on good health practices are contributors. "Some countries are telling me they are very worried," Chan said. "A big proportion of their health expenditure is absorbed by these diseases. Where is the money left to do other health services?"

The WHO Global Forum plans a follow-up report in 2013.