Posted on Feb 10, 2011 by Sergio Ulloa
The burden of heart disease, diabetes and other non-communicable illnesses are taking their toll on the vulnerable members of society in the South Asian region according to a recent report by the World Bank.
The report highlights the worrying increase of illness impacting the populations of South Asian countries, with impoverished people being affected by consequential out-of-pocket payments for subsequent healthcare services. The report covers studies undertaken in Afghanistan, Bangladesh, Bhutan
, the Maldives
and Sri Lanka
and identifies alarming health concerns across South Asia.
Heart disease is the biggest killer in the region for those people aged between 15 and 69; the studies also found that non-communicable diseases are responsible for 55 percent of all diseases in the region.
South Asia is at a cross roads: while the region is developing from an economic viewpoint, there is a substantial proportion of society still living in poverty. The urbanization of populations in the region has increased bringing more pressurized lifestyles and a resultant heightening of risks to health from heart disease, diabetes and obesity. The average life expectancy is 64 years of age for a person living in South Asia.
Problems arise from poor nutrition and smoking causing exposure to obesity, high blood pressure and high cholesterol and glucose levels. This has, consequently, placed enormous pressure on healthcare systems as more people seek treatment for chronic illness and disease. However, as economic and social change in the region evolves, the state run healthcare systems have failed to develop to meet changing patient needs. This has placed even more pressure on inadequate services - also required to deal with communicable diseases such as tuberculosis and water and vector-borne diseases - with vulnerable members of the community being most severely affected.
A major concern highlighted in the report covers the impact of out-of-pocket payments required to be made by patients seeking medical treatment; impoverished patients being unable to fund proper medication for rehabilitation in order to return to work.
Speaking on the findings from the study, co-author, Michael Engelgau, a World Bank senior public health specialist, highlighted to concerns by saying: "This unfair burden is especially harsh on poor people, who, after heart attacks, face life-long major illnesses, have to pay for most of their care out of their savings or by selling their possessions, and then find themselves caught in a poverty trap where they can't get better and they can't work."
The World Bank's reports recognizes that efforts to control the growing burden of heart disease, diabetes and other non-communicable illnesses, could cost an additional 4 to 10 percent of South Asia's gross domestic product (GDP); however, the report did acknowledge that this was an unrealistic goal.
It is recognized that action needs to be taken to control the impact of non-communicable diseases in South Asia, with a pro-active approach being adopted including measures such as reducing the use of tobacco and cutting alcohol and unhealthy food consumption. In India, Bangladesh and Pakistan, it is estimated that a 10 percent reduction in the consumption of salt would prevent 70 deaths per 100,000 people over the next 10 years. If such health strategies can be implemented across South Asia there would undoubtedly be a significant improvement in the standard of health.
In evaluating the findings, the World Bank said that the South Asian healthcare system needs to overcome a number of challenges to ensure health services improve in the region. These include: collaboration to enable the group purchasing of medications, establishing a health technology assessment network, combining education and training in the region and the creation of a surveillance and burden assessment hub.
The report states that 71 percent of the South Asian population live in rural areas, and that the gross domestic product (GDP) in the region has increase by 6 percent annually over the last two decades. However, even though there has been steady economic growth in the region, and a decline in poverty rates, South Asia has the highest density of poor people in the world - reaching over 1 billion in number. Among these 1 billion people, it is estimated two-thirds live on less than US$2 a day and two-fifths on less then US$1.50 a day. It is this element of the South Asian population most at risk because of inadequate access to healthcare services and the subsequent financial burden from treatment provided.
As average life expectancy ages rise, and more elderly people require treatment, there are growing concerns surrounding the current standard of healthcare available in the region. The major issue is the future accessibility and quality of healthcare, with proper education and resources to meet the needs of vulnerable elements of society in South Asian countries. The report identifies concerns about the potential for worsening health burdens developing across South Asia.