Chronic Diseases: A Global Challenge..!!

Sixty percent of all deaths are caused by chronic diseases such as heart disease, strokes and diabetes. And it is not just a rich-country phenomenon. Some 80% of cases of chronic disease are occurring in developing countries. So, the question is: how can public and private sectors work together more effectively to manage chronic diseases?

Key Points
• Chronic disease is treatable, but new strategies are needed; the reasons behind the surge in chronic disease levels must also be understood
• Any new strategy requires far greater coordination of patient care; a new delivery model is needed with more emphasis on preventive measures
• For many developing countries, the rising challenge of chronic disease comes on top of an unfinished fight against acute diseases; but funding is often more easily available for the latter
• The economic cost to countries and companies of chronic disease and mental illness is enormous
• Public-private partnerships must be forged to implement new strategies
• New technologies, such as mobile phones, can play a role in implementing new strategies

Synopsis
The world is in the midst of a major health transformation, with chronic diseases, both communicable and non-communicable, posing a greater challenge to public health systems than the more traditional acute diseases. Every year sees 13 million new cases of cancer and 7 million deaths. Heart disease and diabetes are major killers, while over 1.6 million people suffer from some sort of mental disorder, such as depression. Even in some African countries, such as Tanzania, cancer is killing more people each year than AIDS and tuberculosis. With the world’s population ageing, dementia will come to be an increasing health burden. The economic cost of this is huge. In the European Union alone, the direct cost of depression to the economy in terms of lost output is some 41 billion euros a year. So, good health strategies make good business sense. But, health systems are still too often more oriented towards tackling acute diseases.

One major deficiency in the treatment of chronic disease is care coordination. Large numbers of people suffer from more than one chronic ailment, but there is often little coordination between caregivers. The answer is greater connectivity in healthcare. There should be a core team and a core plan for each patient. More emphasis also needs to be put on prevention. In the European Union, 97% of health spending goes towards dealing with disease, with only 3% on prevention. Spending on prevention within the EU should currently be closer to 10%.

Inactivity and obesity are clearly linked to chronic diseases such as diabetes and heart problems. Tactically, it is probably better to put more emphasis on increasing the amount of exercise a person takes than on getting them to change diet. A better diet will often follow naturally once a person has adopted a more active lifestyle. But health is not just a matter for health authorities; other areas of government must also be involved. Tax increases on tobacco, for example, have been shown to be effective in cutting smoking, which is a major cause of preventable death. Countries need to develop a national culture of health. For example, buildings could be designed in such a way that people are obliged to walk more rather than always taking the lift.

Nearly 5 billion people are using cell phones, offering tremendous opportunities for improving health services. In developing countries, for example, doctors can be consulted over long distances or remote clinics can be connected. Telecommunications devices can be developed to monitor disease indicators, such as glucose levels. But, so far, research and development into the medical use of telecommunications is under-funded. Telecommunications – mobile phones, the Internet – can also be used to form communities of people who encourage each other to live healthier lives and promote social change.

But, tackling the diseases is not enough. Part of the rising incidence of chronic disease is directly related to our way of working. Studies show that disorders such as stress and depression have a strong correlation with working hours, the setting of unreasonable demands and tasks, and a lack of autonomy. Managers can, in other words, be a danger to health. Solutions include more flexible working practices and better training of managers. Where such approaches have been adopted, productivity has risen and insurance claims have fallen.