Age Old Disease Crises in South Asia

The developing world may have arrived a little late to the developed world non-communicable disease party, but countries in South Asia are now taking the lead, according to a new World Bank report available in April. ‘Capitalizing on the Demographic Transition: Tackling Non-communicable Diseases in South Asia’ highlights the rising non-communicable disease health crises in South Asia, and reflects a growing burden of diseases such as heart disease and diabetes in the region. As in high income countries a decade ago, these diseases now account for over half of the disease burden in the region.

In the absence of the better living conditions, higher nutritional standards, rising incomes and increased access to adequate healthcare that benefited older people in developed countries, South Asian adults can expect to live for 64 years and continue to remain in poverty. Suffering their first heart attacks 6 years earlier than adults in other parts of the world, heart disease has become the leading cause of death for adults in the region (which includes Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka). The report’s co-author Michael Engelgau, considers these disease burdens “especially hard on poor people… [who] find themselves caught in a poverty trap where they can’t get better and they can’t work”. Reductions in poverty have not kept pace with increasing life expectancy in South Asia; with increasing age increasing rates of non-communicable diseases have also arrived.

Risks factors such as low birth weight in infancy, tobacco use, obesity, high blood pressure and high cholesterol all remain significant challenges for South Asian countries, as do many of these same factors in developed countries. The report aims to provide some framework for policies to tackle the challenges; to plan, prevent and control the impact of non-communicable diseases by measures to strengthen health systems and effectively implement tobacco advertising bans. It serves to emphasise the situation of “rising inequality” according to Michel Rutkowski, World Bank’s South Asia Director for Human Development, in which “a growing share of the population [ages] unhealthily; and with health systems that are failing to adjust to people’s needs”.

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