[Ip-health] The Economist: The poor world is getting the rich world's diseases

[Rosa Castro]

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[ Picked text/plain from multipart/alternative ]
The Economist' has an article on Globalisation and health, entitled "The ma=
ladies of affluence"

  http://www.economist.com/world/international/displaystory.cfm?story_id=3D=
9616897

  Among other things, it describes how misleading it can be to categorize c=
ertain types of diseases:

  "Yet the distinction between illnesses of affluence and illnesses of pove=
rty is misleading as a description of the world and doubtful as a guide to =
policy. Heart disease=97supposedly an illness of affluence=97is by far and =
away the biggest cause of global mortality. It was responsible for 17.5m de=
aths worldwide in 2005. Next comes cancer, another non-infectious sickness,=
 which caused more deaths than HIV/AIDS, tuberculosis and malaria put toget=
her (see chart 1). Chronic conditions such as heart disease took the lives =
of 35m people in 2005, according to the World Health Organisation (WHO)=97t=
wice as many as all infectious diseases"

  It highlights the relevance of chronic diseases for developing countries:

  "the poor suffer from chronic illnesses longer and are more likely to die=
 of them. The death rate from chronic disease in poor countries is obviousl=
y higher than in rich countries; more surprisingly, it is often higher than=
 the death rate from infections. India, Pakistan, Nigeria and Tanzania all =
have roughly the same death rate for cardiovascular disease: 400 per 100,00=
0. That is at least twice as high as the Western norm and, at least in Indi=
a and Pakistan, more than four times the average death rate from infections=
 (in Nigeria and Tanzania, HIV/AIDS, malaria and tuberculosis are still dea=
dlier)"

  And why shouldnt policy efforts be devoted exclusively or mainly to infec=
tious diseases:


  "In short, developing countries suffer more from =93rich world maladies=
=94 than the rich world itself. Overall in 2005, only a fifth of deaths att=
ributable to =93illnesses of affluence=94 (chronic conditions) actually too=
k place in the most affluent nations. Three-quarters happened in poor or lo=
wer-middle-income ones"

  "It is true that there are better reasons why poor countries might want t=
o concentrate on infections despite the growth of chronic disease. Infectio=
us illnesses are usually simpler to deal with than chronic ones, requiring =
inoculation campaigns rather than long-term care, changes of lifestyle and =
the uphill work of public education. Moreover, if you inoculate a child aga=
inst malaria, you considerably reduce his or her chances of dying from that=
 disease, since most deaths from malaria occur among children under ten. If=
 you lower someone's risk of getting a heart condition at 50, you might wel=
l find they get it at 60. The disease can only be managed.
  Still, it can be managed better: the contrast between death rates from he=
art attacks (falling in the West, rising elsewhere) shows that. Stalin said=
 a single death is a tragedy, a million deaths, a statistic. But millions o=
f avoidable deaths are millions of tragedies. Chronic disease is already th=
e biggest problem for poor and middle-income countries. To concentrate so m=
uch on infections is to add to the health burden of the next generation in =
what are already the world's poorest, unhealthiest places"


Rosa Castro B.
European Doctorate in Law and Economics. Bologna University.
Visiting Scholar (2006-2007). Erasmus Rotterdam University.
Kamer W-L5-070
Postbus 1738
3000 DR Rotterdam
The Netherlands

Tel: +31 10 4082754
Fax: +31 10 4089191
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