Capitalizing on the Demographic Transition

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ImageFor decades, the leading causes of mortality have differed between low income countries and high income countries. Those who have worked their careers in health and development probably never thought they would see the day when maternal/child health and communicable diseases would not be the leading health burden in many low income countries.

The new actor is non-communicable diseases (NCDs), which are characterized by chronic diseases (cardiovascular disease, diabetes, cancer, and chronic respiratory disease), along with injury and mental health which are now responsible for half the health burden in South Asia. Thus, the challenge now is how best to juggle this “double burden”.

Currently, many compelling reasons are pushing countries toward starting to tackle NCDs. From both a social and political standpoint, South Asians are 6 years younger than those in the rest of the world at their first heart attack. This type of trend threatens a country’s ability to fully capitalize on the demographic dividend from a larger mature working force because healthy aging is necessary, which in turn, requires tackling NCDs.

NCDs have gain attention across the spectrum with the World Economic Forum’s Global Risks Report for both 2009 and 2010 has put chronic NCDs and their impact on both advanced and developing economies high on its Global Risk Matrix because of their connection to other global risks such as financial crises and underinvestment in infrastructure.

While the future increase in the disease burden and risk factors will both put a strain on service delivery and stress budgets, many opportunities for their prevention and control are available. Experience from developed countries indicates that the increase in cardiovascular disease during a similar phase of the epidemiologic transition could be blunted and even dramatically reduced by changes in risk levels within the population and through improving primary care for NCDs.

Until now, there has not been a holistic work exploring the factors and solutions to NCDs in the region. This is why the World Bank’s first South Asia Report on the issue will be launched on Wednesday, February 9th across the region. We will keep you updated on its findings through this blog throughout the next two months and will include specific issues and solutions for Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka.

For now, we have three questions in mind:

• What has been your experience with non-communicable diseases in South Asia?

• What lifestyle choices would you suggest people adopt to live longer, healthier lives?

• What policies would you like to see countries adopt to respond to this issue?

What do you think? Do let us know if you have any questions.

Read the Report here


Michael Engelgau

Senior Health Specialist

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