The ‘big three’ diseases – HIV/AIDS, tuberculosis and malaria – may be posing the greatest global health threat, but according to the World Health Organisation (WHO) there are three growing dangers that should not be ignored.
Cardiovascular disease, tobacco-related illness and road traffic hazards are killing millions of people every year, the WHO warns in The World Health Report 2003, released in Geneva this week.
It cautions that the burden of deaths and disability in developing countries caused by non-communicable diseases, particularly cardiovascular conditions, outweighs that imposed by long standing communicable (infectious) diseases.
For many years heart disease and stroke were considered diseases of the industrialised, Western countries. Priorities centred around delivering adequate nutrition, safe water and basic sanitation, maternal and child health care, immunisation against the major infectious diseases, the prevention and control of local endemic diseases, and the provision of essential drugs to the poorer countries of the world.
The reality is quite different. Cardiovascular diseases have not only emerged in all but the very poorest countries, but are already well advanced.
In today’s world, most deaths are attributable to non-communicable diseases (32 million) and just over half of these (16,7 million) are the result of cardiovascular disease.
The report calls for a ‘double response’ which integrates prevention and control of both communicable diseases and non-communicable diseases within a comprehensive health care system.
In terms of tobacco, the report states that the globalisation of tobacco-related diseases can be countered through the WHO Framework Convention on Tobacco Control. The framework comprises many diverse aspects of tobacco control, including: advertising; promotion and sponsorship; packaging and labeling; price and tax measures; sales to and by young persons; passive smoking and smoke-free environments; and the treatment of tobacco dependence.
The consumption of cigarettes and other tobacco products and exposure to tobacco smoke are the world’s leading preventable cause of death, responsible for about five million deaths a year, mostly in poor countries and poor populations.
Total tobacco consumption is also on the rise. The number of smokers in the world, estimated at 1,3 billion today, is expected to rise to 1,7 billion by 2025 if the global prevalence of tobacco use remains unchanged. Every second smoker will die from a tobacco-related disease.
Simultaneously, a ‘hidden epidemic’ severely injures or kills more than 20 million people on the world’s roads each year.
But the WHO believes that the ‘hidden epidemic’ of road traffic casualties and traffic related environmental hazards could be reduced if developing countries adapt successful road safety campaigns and other improvements from elsewhere to meet their own needs.
Once again, the burden falls most heavily on developing countries, where it will grow heavier still because of the rapid increase in the number of vehicles.
The report ends with the statement that all of these subjects have one point in common: they represent major issues that cannot be successfully resolved without the benefit of a strong health system.
‘The fate of the child with malaria in Africa, the middle-aged man with diabetes in Latin America, and the mother infected with HIV in Asia may all depend on the strength of their national health system. Sadly, many such systems are inadequate to cope with the challenges they face.’
To read the full report go to www.who.org
E-mail Anso Thom