Monday, May 20, 2013

Lifestyle Diseases 21: NCDs Alarmism vs. Rising Lifespan

From the WHO website, this update on NCDs is shown:

Noncommunicable diseases
Fact sheet
Updated March 2013

Key facts
  •  Noncommunicable diseases (NCDs) kill more than 36 million people each year.
  •  Nearly 80% of NCD deaths - 29 million - occur in low- and middle-income countries.
  •  More than nine million of all deaths attributed to NCDs occur before the age of 60; 90% of these "premature" deaths occurred in low- and middle-income countries.
  •  Cardiovascular diseases account for most NCD deaths, or 17.3 million people annually, followed by cancers (7.6 million), respiratory diseases (4.2 million), and diabetes (1.3 million1).
  • These four groups of diseases account for around 80% of all NCD deaths.
  • They share four risk factors: tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets.

The alarm bells about NCDs have been sounded by the WHO for several years now. The message is something like "Let us reduce deaths from NCDs, pour more public money into the problem."

So the Department of Health (DOH), PhilHealth and local governments have been pouring more money on reducing or preventing diseases and death from NCDs. PhilHealth for instance reported of Rising Claims for NCD. If PhilHealth will raise further spending for NCDs, the reserve fund can  evaporate soon, or PhilHealth will ask for higher monthly premium from members, especially those employed in the formal sector. Why?

People with NCDs are sort of "patients forever". Unlike treating infectious diseases like dengue or malaria, once the disease inside a patient's body is killed, the patient gets well and will not need medication or hospitalization for the next few years or ever decades. For patients with NCDs though, they have to visit a physician monthly or even more frequently. For instance, a hypertension patient, according to a physician or pharmacist who spoke during the MeTA forum at the AIM last April said will need a combination of 2-3 medicines per day.

The WHO I think is pulling health alarmism here, the same way they alarmed the world with the dangers of HIV/AIDS in the 90s. It turned out that the warning was exaggerated because if their projections were true, the population of Africa by now should be less than its population in the 90s, but this did not happen.

If an average Filipino dies of stroke or cancer or hypertension or other NCDs at age 75 or 80 or older, is it a problem?

WHO and DOH say Yes, because about 2/3 of deaths in the Philippines and worldwide now are due to NCDs.

For me it is not a problem. We will all die. If not of NCDs, we can die of infectious diseases or accidents or some crime.

The average lifespan of Filipinos now is 70 years old; 67 for men, 73 for women, so average of 70. If a person dies at 75 or older due to NCDs, there should be NO cause for alarm except alarmism itself. Ala "man-made warming" alarmism.

Even if death from NCDs rise from 66 to 80 percent, or even 90 percent of all deaths, but life expectancy has increased from 70 to 80 or 90 years old, then it is not a problem.

Perhaps the WHO and various government health agencies want people to die at 100 or 200 years old on average, so they play God to keep prolonging average life span? Which means governments will tax-tax-tax the rest of us further so it will have more money to play and act like a God.

I think governments should focus more on reducing morbidity and mortality from infectious and communicable diseases. Give more vaccines to children for instance to limit deaths from preventable diseases.

For adult NCDs, governments should step back and allow people to buy private health insurance, to augment existing government health insurance programs. As the WHO pointed out above, NCDs are closely related with unhealthy lifestyle, like people who over-eat, over-sit, over-drink and over-smoke. I know of some people who are fat and irritable, they don't even want to admit that they are fat, and yet all they want to do is sit down and eat, rest and sleep or watch TV for hours.

It will be a criminal act of the government to over-tax people who take care of their body more responsibly, so that government will have more money to subsidize the deteriorating health of this type of people. NCDs are essentially lifestyle related, with a minor factor due to genetics.

Meanwhile, Reiner Gloor of PHAP made a good discussion about NCDs in his article last week, below.

Posted on 05:16 PM, May 16, 2013
Medicine Cabinet -- Reiner W. Gloor

The global burden of NCDs

(First of a series)

EACH DAY, about 100,000 people around the world die from major non-communicable diseases (NCDs) namely cardiovascular disease, diabetes, asthma, chronic respiratory infections and cancers.

An estimated 36 million people succumb to these diseases each year, or some two out of three deaths globally. About nine million of these were people under the age of 60.

Many of the losses occur in low and middle-income nations to include the Philippines which had cardiovascular diseases as the number one cause of death among Filipinos, according to the Department of Health (DoH). With the sheer number of lives lost, major NCDs are no doubt the world’s biggest killer diseases.

NCDs place a heavy burden on individuals, families, and communities and public health systems that often rely on out-of-pocket payments.

The World Health Organization (WHO) said that out-of-pocket payments could cause households to incur catastrophic expenditures, which in turn push them into poverty. A WHO technical report, "Designing Health Financing Systems to Reduce Catastrophic Diseases," said that when people have to pay fees or co-payments for health care, the amount can be so high in relation to income that it results in "financial catastrophe" for the individual or the household.

Another study published at the Lancet explained that catastrophic health expenditure is not always synonymous with high health care costs. "A large bill for surgery, for example, might not be catastrophic if a household does not bear the full cost because the service is provided free or at a subsidized price, or is covered by third-party insurance. On the other hand, even small costs for common illnesses can be financially disastrous for households with no insurance cover," the study said.

Every year, the WHO said that about 44 million households, or more than 150 million individuals, around the world face catastrophic expenditures, and about 25 million households or more than 100 million individuals are pushed into poverty by the need to pay for services.

Thus, the system of paying directly from one’s own pocket could also mean that households will have to delay or totally ignore the necessary care when it is needed. Such high expenditures could also mean that people would have to cut down on other equally important priorities such as food, clothing or education, the WHO added.

NCDs and other illnesses such as Alzheimer’s and HIV/AIDS, among many others, requiring long-term care or hospitalization can be considered catastrophic especially if patients use 40% to 50% of their non-food expenditure on health care.

On the other hand, these catastrophic diseases and their consequences are largely preventable through programs aimed at reducing high-risk behaviors and environments and through improved treatment delivery for patients who need chronic care, observed the Johns Hopkins University’s Institute for Applied Economics, Global Health and the Study of Business Enterprise. It added that cost-effective interventions to reduce the burden of these diseases exist and sustained action can prevent millions of premature deaths.

The global community has started to take notice of the growing threat of NCDs. For instance, the UN General Assembly passed a resolution on the prevention and control of NCDs in 2010, followed in September 2011 by a High-Level Meeting that led to the adoption of a political declaration whose aim is to craft a plan for the prevention and control NCDs. It is to be noted that this is only the second time in the history of the UN that the General Assembly met on a health issue following HIV/AIDS.

That declaration acknowledged that the global burden and threat of these diseases constitutes one of the major challenges for development in the 21st century, which undermines social and economic development throughout the world. NCDs also threaten the achievement of internationally agreed development goals.

The declaration likewise recognized that NCDs are a threat to the economies of many nations and may lead to increasing inequalities between countries and populations. It highlighted the primary role and responsibility of governments in responding to the challenge of NCDs and the essential need for the efforts and engagement of all sectors of society to generate effective responses for the prevention and control of NCDs.

The declaration also recognized the urgent need for greater measures at the global, regional and national levels to prevent and control NCDs in order to contribute to the full realization of the right of everyone to the highest attainable standard of physical and mental health (For more information on the declaration, go

The publication, "Addressing the Gaps in Global Policy and Research for Non-Communicable Diseases," a set of policy briefs by Johns Hopkins University’s Institute for Applied Economics, Global Health, and the Study of Business Enterprise, said that policy makers need to decide how best to incorporate NCD responses into existing funding streams and programs given the recent financial crisis].

The set of policy briefs, commissioned by the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) proposed recommendations for action that are sustainable in the current political and economic landscape.

(To be continued)

See also:
Lifestyle Diseases 17: On Cancer, COPD and NCD Risk Factors, March 05, 2012

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