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Prioritizing Development Published online by Cambridge University Press: 30 May 2018
Introduction
We discuss the role of noncommunicable diseases (NCDs) in the development goal discourse, especially how NCDs fit into the overall health goal and why it is essential to have an NCD target to meet Goal 3 of the proposed SDGs: Ensure healthy lives and promote well-being for all at all ages. The interventions presented and analyzed here will reduce mortality by 28.5 percent in 2030, primarily from cardiovascular and respiratory diseases, as well as some cancers.
Rationale for Addressing NCDs in Development
NCDs are the largest cause of mortality both globally and in the majority of low- and middle-income countries (LMICs). NCD mortality exceeds that of communicable, maternal, perinatal, and nutritional conditions combined (Commission, 2013). NCDs account for 65 percent of global deaths (Murray and Lopez, 2013), accounting for a majority of deaths in all regions except Africa. Eighty percent of NCD deaths (28 million people) occur in LMICs, making NCDs a major cause of poverty and an urgent development issue. Bloom et al. (2011) estimated that $47 trillion in economic output would be lost due to NCDs by 2030, concluding that “inaction would likely be far more costly [than interventions for NCDs].”
NCDs are wrongly perceived as diseases only of the rich. There has been a dramatic transition from infectious disease to NCD burden – in Mexico, for example, NCD was the cause of death in 45.4 percent of cases in 1980, but this increased to 74.4 percent by 2009. The reach of NCD risk factors is striking: a study in Argentina, Chile, and Uruguay found that 43.4 percent of the population has high blood pressure, 11.9 percent has diabetes and 35.5 percent are obese. Nineteen percent of Kenyan HIV patients are obese and 8.2 percent have high blood pressure. Ninety percent of NCD deaths before age 60 are in LMICs, resulting in loss of household heads, wasted education investments, and huge out-of-pocket costs to families. Most of these deaths are from preventable causes, and lack of access to affordable medicines and health care services are also major contributors.
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