~ Chronic Disease Prevention Could Save 36 Million Lives Worldwide by 2015: World Health Organization

Canadian Press, 10-05-05

TORONTO (CP) - The lives of 36 million people worldwide could be saved in the next 10 years if deaths from chronic conditions such as cardiovascular disease, diabetes and some cancers were reduced by two per cent a year, the World Health Organization says.

Chronic illnesses are the leading cause of death in the world - far beyond that of infectious diseases like HIV-AIDS, tuberculosis and malaria - and their impact is growing, says a lengthy WHO report released Wednesday.

In fact, the report says 17 million people die prematurely around the globe each year because of diseases that are largely preventable.

"The key message is that there is a global epidemic of chronic diseases; the good news is that it can be stopped," Dr. Robert Beaglehole, WHO's director of chronic diseases and health promotion, said from Geneva.

Beaglehole said heart disease, stroke, diabetes, some cancers and respiratory diseases, which can be prevented through lifestyle changes, will kill 388 million people by 2015, half of them under age 70.

"If we get serious, we can save at least 36 million lives," he said of the global strategy, stressing that national governments working with industry and citizens must move forward with prevention programs to stem the tide of chronic disease.

Canada has shown major gains in the last 30 years, said Dr. Sylvie Stachenko of the Public Health Agency of Canada. She noted that the rate of cardiovascular deaths decreased by more than half between 1970 and 2000, representing one million lives saved.

"We're considered a country where there's been some success," although there's still much prevention work to be done in Canada, she said. "The number 1 cause of death still is cardiovascular disease, even though (the death rate has) declined."

Stachenko agreed that Canada's strategies to reduce chronic disease through prevention programs could be a model for other countries.

The WHO report estimates that of the 58 million deaths from all causes projected for this year worldwide, 35 million will be due to chronic conditions.

And the strain of these diseases is borne primarily by poorer countries, says WHO. Eighty per cent of chronic disease deaths occur in low-and middle-income countries, where most of the world's population lives.

"They're no longer the privilege of wealthy men and wealthy countries," said Beaglehole, explaining that women and children and the less well-off are also increasingly subject to cardiovascular disease, some cancers and diabetes - all once considered the scourge of affluent males - because of unhealthy diets, insufficient physical activity and tobacco use.

A whopping one billion people around the world are overweight and hundreds of millions smoke, the report says.

"In India and other countries featured in this report, there is a huge explosion of diabetes which has the potential to cripple not only individuals, families, communities and whole countries, but also health systems with big impacts on national economies," he said.

"Diabetes is exploding largely, but not entirely, as overweight and obesity increases in all countries of the world except the very, very poorest."

What's most worrying about the global weight gain is that adult-onset, or Type 2, diabetes is being seen for the first time in children, Beaglehole said.

"And this is a very serious omen because diabetes increases the chances of heart disease, of stroke in later age. And the fact children and adolescents are developing diabetes because they're overweight . . . is a tragedy which surely should be prevented."

Smoking is taking a terrible toll in tobacco-related cancers, respiratory conditions and cardiovascular disease, he said.

In some wealthy western countries, anti-tobacco legislation has reduced the percentage of smokers, causing some decline in tobacco-related disease and deaths, Beaglehole said.

"But in countries like China, where they have 300 million smokers, the full extent of those epidemics are yet to evolve, and I think already there are five million approximate deaths (each year) around the world from tobacco smoke," he said, estimating that that number will rise to 10 million annually by 2020.

Yet, among poorer nations, little effort has been made to control tobacco consumption, he said.

"Whereas in Canada, you have excellent smoke-free laws . . . So there's a lot that we know that could be done in low-and middle-income countries, learning from the example of Canada, and these lessons have yet to be applied."

Stachenko agreed that getting many Canadians to butt out has been "our success story."

In the mid-1960s, more than half of Canadian adults smoked; today less than 20 per cent light up regularly.

WHO says chronic conditions can drain a country's economic lifeblood: in the agency's first analysis of the dollars-cents impact, it estimates that over the next decade, chronic disease will cost China at least $558 billion US; the Russian federation, $303 billion; and India, $236 billion. Canada will lose $500 million this year alone.

In a commentary in The Lancet, which is publishing a series of papers on the issue to coincide with the report's release, editor Richard Horton calls chronic disease the "neglected epidemic."

"Without concerted and co-ordinated political action," Horton writes, "the gains achieved in reducing the burden of infectious disease will be washed away as a new wave of preventable illness engulfs those least able to protect themselves."

Here are some facts about chronic diseases around the world.

Each year at least:
  • 4.9 million people die from tobacco use
  • 2.6 million people die as a result of being overweight or obese
  • 4.4 million people die due to raised cholesterol levels
  • 7.1 million people die because of high blood pressure
Common, modifiable risk factors underlie the major chronic diseases. They include:
  • Unhealthy diet
  • Physical inactivity
  • Tobacco use
Deaths from infectious diseases, maternal and perinatal conditions, and nutritional deficiencies combined are projected to decline by three per cent over the next 10 years.

In the same period, deaths due to chronic illnesses - cardiovascular disease, some cancers, diabetes and respiratory conditions - are projected to rise by 17 per cent.

This means that of the projected 64 million people worldwide who will die in 2015, 41 million will die of a chronic disease unless urgent action is taken, says the World Health Organization.

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