What image pops into your head when you hear the words: non-communicable diseases? The name probably tells you a bit about the type of diseases that fall into this category, even if you may not be familiar with the term. Are you more familiar with obesity, diabetes or stroke? These are more likely to hit closer to home – you may have friends and relatives who suffer from one or more of these problems or associated complications such as heart attacks – but the term NCDs can hardly be called catchy.
Infectious diseases on the other hand have a certain je ne sais quoi. We see headlines for HIV or Malaria and dread their call. But when it comes to obesity, are we more likely to picture a fat, lazy, middle-aged white guy nursing a beer on the couch who shoulders much of the blame for his situation.
Public enemy #1
I don’t imagine that guy. I’m haunted by the shadowy outline of the world’s number one serial killer, which is more insidious because he’s usually dressed up in advertising. But the ugly truth is that the average Joe doesn’t worry too much about NCDs.
NCDs are the leading cause of premature death across the globe. Historically thought to be a group of diseases from within high-income countries, NCDs are a leading cause of death in most low or middle income countries. Heart disease alone, for example, is the second biggest killer on the African continent and number one for those aged over 30. Sadly the poorer you are, the more likely you will suffer from an NCD.
Despite the huge impact on everyone’s lives (including the costs of treating these diseases), in my experience, many of these so-called “lifestyle” diseases are received as either “a result of modern society” or “gluttonous behaviour” or “what is an NCD again?” Or to phrase it another way: too hard, too bad or too inexplicable. And this is probably why we don’t treat them with the respect they deserve, instead opting for indifference or blame.
It’s too hard, I might hear you say. But imagine how hard it’s going to become if we don’t act? Premature death, huge pressures on our healthcare system and extraordinary economic burden. Instead of failing to act, governments should include “healthy living” as a central pillar of all policy. The World Health Organization also has gold standard, innovative strategies that are ready and waiting for governments to adopt.
Women bear the the brunt
But it’s just too bad. Is it? Four out of five NCD deaths are in low or middle income countries and kill twice as many globally as from HIV, malaria and tuberculosis, combined. Worse still, 80% are preventable and underprivileged people are more likely than rich people to develop chronic diseases, and much more likely to die as a result.
Sadly, it’s impoverished women that tend to bear the brunt. NCDs are the biggest direct threat to women’s health worldwide, increasingly impacting on women in developing countries in their most productive years. It’s clearly a far cry from the picture of a fat, lazy guy on a sofa with a can of beer – and has far reaching consequences.
And finally, too inexplicable? NCDs pose a greater threat to global economic development than any fiscal crisis, natural disaster or pandemic flu. NCDs are a barrier to development and you’ll save a fortune by investing in NCD prevention.
In 2009, the UN Secretary General Ban Ki-moon described the global NCD epidemic as a “public health emergency in slow motion” – but like the tale of the frog in boiling water that hasn’t realised because the temperature has only slowly been rising, it doesn’t mean the worst won’t happen if we don’t jump out.
Too hard, too bad, too inexplicable. These are the big three barriers we must first confront and apply effort to fixing if we’re to live in an NCD-free world.
AIDS faced a similar test in the 1980s. Yet thanks to relentless work by early activists and public health leaders (and the odd rock star), they made certain that this terrible disease wouldn’t be ignored.
It feels to me that NCDs are currently facing up to the same tribulations. We need to ensure that we, and our public health leaders (and the next generation), keep fighting the good fight for the tide to eventually turn. Saying it’s too challenging, someone else’s fault, or too much a part of 21st century living, only hurts us all in the end.