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