Everybody knows that HIV and AIDS, malaria, and tuberculosis cause deaths worldwide, but few realize that such ailments kill only half the number of people that chronic diseases like stroke, cancer, and diabetes do, according to a recent World Health Organization (WHO) report (http://www.irinnews.org/report.aspx?reportid=84925).
And poor countries suffer disproportionately. Of the deaths in 2005 from chronic diseases, four out of five occurred in low- and middle-income countries. "These diseases can push a low-income family into poverty," says WHO partnership advisor Janet VoUte. "So they need to be part of any poverty-reduction strategies." Yet currently only 13% of WHO funding goes to such ailments. "It's a mismatch," VoUte says. And it's mirrored by how charities channel their money: in 2005, major donors gave about 12 times more money to HIV and AIDS ($2.5 billion) than to chronic diseases ($200 million). But VoUte suspects this inequity will change once the United Nations (UN) Millennium Development Goals- eight objectives to spur international progress-are updated. WHO and UN Economic and Social Council member states are pushing for chronic diseases to be incorporated into the Millennium Development Goals when they come up for reevaluation in 2010; the sixth goal, which addresses infectious diseases, could be broadened to include noncommunicable diseases.
"We believe there are workable, affordable solutions," says VoUte. One of many examples: taxing tobacco. Combating chronic diseases such as heart disease and cancer requires making lifestyle changes, including increasing physical activity and stopping smoking. "Taxing tobacco products reduces their use, which helps to reduce the risk of many diseases and respiratory illnesses," she says. And the WHO advocates integrating diet and exercise programs into schools, workplaces, and primary health care settings. "Here the role of nurses is critical," VoUte says. "There's an urgent need for nurses' involvement in communities, where they can help with early screening and detection and with risk-reduction strategies."
Bunny Wong