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The Growing Global Burden of Non-Communicable Diseases
– Implications for Health Systems
Joseph Perriëns MD, PhDDept of HIV/AIDS
World Health Organization
Leading Causes of Mortality and Burden of Disease - World, 2004
%
1. Ischaemic heart disease 12.2
2. Cerebrovascular disease 9.7
3. Lower respiratory infections 7.1
4. COPD 5.1
5. Diarrhoeal diseases 3.7
6. HIV/AIDS 3.5
7. Tuberculosis 2.5
8. Trachea, bronchus, lung cancers 2.3
9. Road traffic accidents 2.2
10. Prematurity, low birth weight 2.0
%
1. Lower respiratory infections 6.2
2. Diarrhoeal diseases 4.8
3. Depression 4.3
4. Ischaemic heart disease 4.1
5. HIV/AIDS 3.8
6. Cerebrovascular disease 3.1
7. Prematurity, low birth weight 2.9
8. Birth asphyxia, birth trauma 2.7
9. Road traffic accidents 2.7
10. Neonatal infections and other 2.7
Mortality Burden of Disease
Source: slides 2-8: http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html
DALYs lost/1000 inhabitants, by cause and by region, 2004
Western Pacific
America
E. Meditaranean
S E Asia
Europe
Africa
Cardiovascular
Cancer
Other non-communicable
Injuries
HIV/AIDS
Tuberculosis
Other infectious and parasiticdiseases incl. resp inf.Maternal conditions
Perinatal conditions
Nutritional deficiencies
Global projections for selected causes, 2004 to 2030
0
2
4
6
8
10
12
2000 2005 2010 2015 2020 2025 2030
De
ath
s (
mil
lio
ns
)
Updated from Mathers and Loncar, PLoS Medicine, 2006
Cancers
Stroke
Perinatal
Road trafficaccidents
HIV/AIDSTBMalaria
Acute respiratoryinfections
Ischaemic HD
HIV 15MCH 15Malaria 7Immunizations 7TB 5Family planning 9NCD 9Infrastructure, equipment, vehicles91Health care workers62Supply chain/logistics15Financing 9Governance 6HIS 3
HIV6%
MCH6%
Malaria3%
Immunizations3% TB
2%
Family planning4%
NCD4%
Governance2%
Financing4%
HIS1%
Supply chain/logistics6%
Other23%
Infrastructure, equipment, vehicles
35%
Health care w orkers24%
Incremental costs to reach the MDGs in 49 low income countries – 2009-2015
Health systems: $ 186 billion – 74% Health services: $ 66 billion – 26%
Incremental costs to reach the MDGs in 49 low income countries – 2009-2015 – by year
Looking forward
• In public health, HIV has become a major force • The expectation is now that other health outcomes
should also benefit from HIV
• HIV should deliver on this expectation
• National Health Planning offers the opportunity to maximize both output and synergies between HIV, other MDGs and NCD
0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%
Cardiovascular
Cancer
Other non-communicable
Injuries
HIV/AIDS
Tuberculosis
Other infectious and parasitic diseases incl. resp inf.
Maternal conditions
Nutritional deficiencies
Women
Men
Causes of burden of disease among 15 to 59 year olds, 2004
Projected deaths by cause and income
2004 to 2030
0
5
10
15
20
25
30
2004 2015 2030 2004 2015 2030 2004 2015 2030
De
ath
s (
mill
ion
s)
High income Middle income Low income
HIV, TB, malaria
Other infectious
Mat//peri/nutritional
CVD
Cancers
Other NCD
Road traffic accidents
Other unintentionalIntentional injuries
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