WEALTH

FOCUS
WEIGHING UP THE
GLOBAL COST
“That which does not kill us, makes us stronger,” is a
platitude often used in times of stress, but it’s simply
untrue when it comes to non-communicable diseases.
They weaken us with chronic and sometimes concurrent
illnesses over many decades, then they kill
Mortality rates relating to non-communicable
diseases (NCDs) are rising worldwide. So are
morbidity rates – that is, the incidence of
disease. Most of this relates to four disease groups:
cardiovascular and chronic respiratory diseases, cancer
and diabetes. These diseases cause disability, suffering and
loss of opportunity for many millions worldwide.
Once seen as diseases of the rich world, a result of diet,
sedentary lives and aging societies, today NCDs are on
the rise in developing and middle-income countries –
significantly so in Asia. When the region was widely
impoverished, people were too busy eking out a living to
become obese; cigarettes and alcohol were expensive and
lifespans short. Rising living standards, along with the
broader availability of medication and vaccines, mean that
communicable diseases are being reduced. Yet, while far
fewer Asians are dying of infectious diseases, growing
numbers are living long enough to develop chronic NCDs.
By 2008, NCDs had become the world’s most common
cause of death, says Irina A. Nikolic, senior health specialist
in the World Bank Group Global Health Practice. Lead
author of Why NCDs Matter (2011), Nikolic says they
accounted for 36 million deaths, or 63% of the global total,
with 78% occurring in developing and middle-income
countries. Some 16 million of these deaths were premature,
with the vast majority again occurring in developing and
middle-income countries.
Since then, the trends have continued. While some highincome
countries have reduced death rates related to
cardiovascular disease, NCDs are becoming an ever larger
portion of the global burden of disease. “By 2030, they could
account for three-quarters of the disease burden in middleincome
countries, up from two-thirds in 2011 and
approaching the level of high-income countries.”
In developing countries, NCDs will increase more
rapidly, approaching the levels of middle-income countries
today. Meanwhile, some countries will still be contending
with significant rates of the communicable diseases that
ravage the poor, such as malaria, typhoid and diarrhea.
“These countries will be facing a double burden of
disease,” comments Nikolic. “Tuberculosis and water-borne
infections are still prominent in Southeast Asia, for
example, even as the level of NCDs is growing rapidly.”
ECONOMIC BURDEN OF DISEASE
Further, compared to higher-income counterparts, many
developing countries face high NCD levels at earlier stages
of economic development. People are contracting them at a
younger age, likely to suffer ill effects for longer and to die
more prematurely from them. This has consequences both
for individuals and entire societies.
The World Economic Forum estimates that over the
next 20 years, NCDs will cost more than $46 trillion,
representing 48% of global GDP in 2010. The costs
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