Testing blood pressure. Photo by Chris Hondros/Getty Images.
The escalating epidemic of non-communicable diseases could could cost the world $47 trillion over the next two decades, according to a report published Monday as United Nations representatives open a two-day, high-level meeting on the issue.
Diabetes, cancer and heart and lung disease — the four conditions the U.N. is targeting — account for more than $30 trillion of the total projected by the World Economic Forum and the Harvard School of Public Health, while mental illness alone amounts to $16 trillion.
“It’s the current youth of today that is going to be most affected by this incredible cost and loss of income and productivity,” said Sandeep Kishore, co-chair of the Young Professionals Chronic Disease Network, which held a rally near the U.N. headquarters Monday morning to push for strong action against the diseases. “What we are effectively doing is consigning our children to a world of poverty.”
In the face of these dire predictions, the World Health Organization is recommending a set of “best buy” interventions that would help prevent and treat non-communicable diseases, with an average annual price tag of about $11.4 billion spread among all low- and middle-income countries.
It’s a well-known argument in the United States’ own health care debate: Invest in care and prevention now to save money in the long run. But the economic costs extend far past medical bills, according to the World Economic Forum. Non-communicable diseases cause more deaths each year than all infectious illnesses combined, and they are debilitating and disabling for people living with the chronic symptoms.
“When so many of the workforce is sick and dies in their productive years, national economies lose billions of dollars in output. And millions of families are pushed into poverty,” said Jean-Pierre Rosso, chairman of the World Economic Forum in a statement released with the findings.
The estimated economic burden factors in medical costs, personal costs to patients — such as lost income — and broader economic losses from lost years of life and productivity, among other elements.
Amanda Glassman, director of global health policy at the Center for Global Development, said projections like this must make many assumptions about how a health infrastructure will grow and respond, but that other research also shows costs could double, if not triple, in this time period, especially for middle-income countries where non-communicable diseases are growing fastest.
“I think it’s reasonable to expect huge increases in health expenditure,” Glassman said as a result of this growth. Confronting the problem will take an enterprise “much larger” than what the world has seen for HIV/AIDS, she said, but prevention of non-communicable diseases can be very cheap, such as limiting access to tobacco and alcohol.
“There are affordable interventions that could be scaled up if countries are committed,” Glassman said.
The short list of recommended “best buy” interventions all countries should carry out includes increasing taxes on alcohol and tobacco, banning advertising on both products and creating restrictions on availability and use of alcohol and tobacco. The organization also advocates starting public awareness campaigns about the benefits of exercise and reducing salt content in processed foods. These approaches are preventative and the cheapest part of the equation, costing $2 billion a year for all low- and middle-income countries.
The other suggestions include care recommendations like cancer screening, responding to easily treatable cancers like cervical cancer and providing drug therapy to people with heart disease. These medical interventions account for the bulk of the annual estimate of $11.4 billion.
But Kishore argues the WHO should have been stronger setting minimal requirements that countries provide life-saving medications for each non-communicable disease.
“Ensuring that medicines we take for granted in high-income countries and making sure they are available in poor countries, that’s an omission, particularly for cancer,” he said.
Glassman agreed the WHO recommendations are a good starting point, but was less optimistic that countries would achieve even this base level.
“Middle-income countries, if you look at China for example, they just have different priorities for public spending,” she said. “It’s only when they reach a certain level of wealth that you start seeing the investment.”