Preventing Chronic Disease November 10, 2006Posted by Hegemony in Health, Science.
This article is a summary of recent reports released by the the World Health Organization. I hope to characterize the WHO proposed framework for preventing chronic disease.
With over 58 million deaths each year chronic disease will account for over 35 million of them. These include heart disease, stroke, cancer, and other chronic diseases. 15 million of these deaths occur in people under the age of 70. Contrary to popular belief, these are not “diseases of affluence”. Four out of five deaths from chronic disease are seen in low to middle income nations. These figures are increasing, which is especially alarming considering much of it is avoidable. Over 80% of heart disease, stroke, and diabetes as well as 40% of cancer could be avoided through life style modifications. In many afflicted nations medical treatment is spotty at best and medications are hard to come by. The goal of a WHO initiative is to reduce deaths from chronic disease by 2% each year.
In fact physical exercise, avoidance of tobacco, and a reasonable diet are the most important first steps in reducing the death rate. This may seem a daunting task for many nations, but the WHO has developed a stepwise plan of action. There are three main planning steps and three main implementation steps.
In the planning steps the first part is the acceptance of this framework by the national government. Without this support the effort will inevitably fail. Indonesia’s attempt at implementation is evidence of this. Chronic disease rates doubled there between 1981 and 2001 but only when all government groups collaborated were they able to get a plan in place. The next step is to adopt a plan for combating chronic disease that will take action in the next 5-10 years. The final planning step is to evaluate which steps will provide the most benefit and where. Also, determining what groups will be responsible for what steps.
This implementation steps are often known as core, expanded, and desirable. It is up to each nation to decide what issues they want to focus on (the core). It is important that they not overextend themselves in the expansion phase. It is bet that they do fewer things well than many things poorly. Finally, those in charge must assure that these reforms fit with those already in place.
It is nearly impossible for a single group to institute a national framework in this way. It requires the cooperation of health-based and non-health sectors to function. Indeed, this process requires the involvement of the civil, private and international sectors. Several nations including Tonga, Vietnam, and the Philippines have used this framework to institute programs to combat chronic disease.
All nations could benefit from this process. If we were able to decrease the incidences of death from chronic disease by 2% a year 36 million lives would have been saved by 2015. It is a mater of fact that we must support these programs, especially in low-income nations. Many of these diseases are endemic in these areas and could be corrected with a small amount of political attention. It would not take decades to see a change as some would believe. Many heath benefits can be seen very quickly; for example, tobacco-free policies. People will eventually die of something but no one deserves to go through life with chronic disease.