A new report from the Oxford Health Alliance (OxHA), a global organisation promoting chronic disease prevention by focusing on lifestyle risk factors, demonstrates that chronic diseases - heart and lung disease, cancer and diabetes - are having a negative economic impact on both the developed and developing world and should thus be adequately addressed by domestic and international policy makers. The report, Chronic disease: an economic perspective, synthesises extensive evidence from across the world and sends out two main messages: first, chronic diseases should be far more prominent on the international development agenda of donors and international organisations, and, second, from an economic perspective, governments are justified to act to prevent chronic diseases.
The economic relevance of chronic diseases has long been ignored, not least because they were deemed to be a problem affecting mostly the elderly and the wealthy. However, today's report offers evidence to show that not only are chronic diseases affecting the poor in developed as well as developing economies, but that they are also taking a heavy toll on working age adults across the globe. In low- and middle-income countries, chronic diseases currently account for about 40% of deaths and 80% of the disease impact for those aged below 60. The report also takes cost of illness studies into account and looks at the economic impact at every level down to households and individuals.
According to economic reports, chronic diseases can exact a toll of up to 6.8% of a country's GDP. In many countries in the developed world, heart disease alone can account for between 1% and 3% of GDP. In developing countries, where there is less evidence, the economic losses also appear to be significant. In China, for example, tobacco consumption and obesity in 1995 imposed costs of 1.5% and 2.1% of GDP, respectively.
Rachel Nugent, director of health and economics at the Population Reference Bureau, Washington DC, and a co-author of the report, stresses: "Given the economic evidence, the role of chronic diseases as both a marker of poverty and as a potential determinant of economic outcomes is becoming increasingly difficult to ignore. Chronic diseases are predicted to become the most common causes of death by 2015 in both the developed and developing world. Despite this, the Millennium Development Goals, which aim to improve the economies of the world's poorest countries, have failed to include them in their list of health priorities."
Along with demonstrating the significance of chronic diseases in economic terms, the OxHA report also discusses the economic rationale for why government is justified to interfere in what many might consider to be the exclusively private sphere of the individual, that is, how people decide to lead their lives, such as in the case of smoking, alcohol consumption, physical inactivity and diet.
As Marc Suhrcke, an economist with the World Health Organization and another author of the report, says: "Personal choice is a great principle that we as economists whole-heartedly support - as long as a few conditions are met (e.g. these actions do no harm to other, people are well-informed, they act rationally, etc.) When these conditions are not met - which is what is happening in a number of chronic disease-relevant areas - then there is a justification for government to step in to improve on the market's failure. This is solely a question of efficiency and has nothing whatsoever to do with the ideologically driven call for the 'nanny state'."
The report also points out that there are many cost-effective interventions available to address the chronic disease burden, with particular focus on developing countries.
Dr Derek Yach, Director of Global Health at the Rockefeller Foundation and a member of the Oxford Health Alliance Board, concludes, "This report should be a wake up call to governments, economists and philanthropists alike to move chronic diseases up their agenda, if not simply for public health reasons, then because of the negative impact they could have on the economy if unchecked. This is never to downplay the huge importance of communicable, child and maternal health conditions such as HIV/AIDS or under-nutrition, but it is to make the point that we cannot continue to ignore chronic disease as a global health priority."
Members of the Oxford Health Alliance's network will meet in Cape Town in two weeks (20-22 November) to formulate strategies for confronting the fast-growing epidemic of chronic disease. To view or listen to the conference live or on demand, visit 3four50.
Notes:
Chronic disease: an economic perspective was authored by Marc Suhrcke, Rachel Nugent, David Stuckler and Lorenzo Rocco on behalf of the Oxford Health Alliance.
The Oxford Health Alliance
Founded in 2002, the Oxford Health Alliance enables experts and activists from different backgrounds to collaborate in order to confront the epidemic of chronic disease through prevention by focusing on three risk factors - tobacco use, diet and physical activity.
OxHA's five focus areas:
The economic argument for prevention: the costs of chronic disease are already vast, and without urgent investment in health preservation the costs will continue to increase. Better health contributes to economic growth.
Prevention in the workplace: chronic disease risk reduction in the workplace can have a major impact on the health of employees and their families, while improving productivity and workforce participation.
Youth, children and future health: the insights and enthusiasm of young people can change perceptions and lifestyles of future generations. Overweight and obese children develop low self-esteem; poor diet causes behaviour problems.
Environmental design for prevention: designers, architects and urban planners can assist in creating an environment in which the healthy choices are the easy choices.
Industry's role in prevention: prevention efforts by companies and industries can have a far-reaching effect on consumers and communities.
Spokespeople
Marc Suhrcke is an economist with the WHO European Office for Investment for Health and Development in Venice, Italy, where he is in charge of the Health and Economic Development workstream.
Rachel Nugent is director of health and economics at the Population Reference Bureau. She is a contributor to the Disease Control Priorities Project in Developing Countries, published in 2006.
Derek Yach is Director of Global Health at the Rockefeller Foundation. He is a former executive director at the World Health Organization.
Contact:
Marisa Pulaski, PR Officer
Oxford Health Alliance
28 Margaret Street
London
W1W 8RZ
For more information please visit: The Oxford Health Alliance.
Комментариев нет:
Отправить комментарий