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The newspaper of The Johns Hopkins University February 26, 2007 | Vol. 36 No. 23
Low-Income Countries Require More Aid for Chronic Conditions

By Tim Parsons
School of Public Health

In an article published in the Jan. 18 issue of The New England Journal of Medicine, Gerard Anderson, a professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, highlights the need for more international assistance to address chronic noncommunicable conditions affecting people living in low- and middle-income countries.

According to Anderson, chronic conditions such as cardiovascular disease and cancer result in more deaths and account for more years of healthy life lost than most communicable diseases, yet little international aid is focused on preventing or treating these conditions. For instance, cardiovascular disease is the cause of 30 percent of all deaths globally and 27 percent of deaths in low-income countries. By comparison, HIV/AIDS, tuberculosis and malaria combined account for 10 percent of all deaths globally and 11 percent of deaths in developing countries. Prevention and treatment programs for noncommunicable chronic diseases are possible at relatively low cost-per-life saved or disability prevented.

"It's a myth that chronic diseases affect only rich countries. Despite the fact that a substantial burden of disease in the world's poorer countries is caused by noncommunicable chronic diseases, most international aid is focused primarily on preventing and treating infectious diseases," said Anderson, author of the article, which he co-authored with Ed Chu, a medical student at Johns Hopkins. "Treating infectious diseases must remain a priority, but additional resources should be committed toward treating and preventing noncommunicable chronic conditions if we want to address global health needs effectively and address the major reasons for premature mortality in the world."

Anderson suggests a number of reasons why international aid has historically focused on controlling infectious diseases. For one, infectious diseases pose an international threat if they spread uncontrolled. Another is that many donors want a permanent solution such as a vaccine, which may not be possible with noncommunicable chronic diseases. Also, chronic conditions are rarely viewed as urgent problems in low-income countries and generally do not attract the attention of celebrities.

"The treatment and prevention of noncommunicable chronic conditions need to be added to our list of global health priorities," Anderson said. "There are many effective and affordable interventions."


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