Showing posts with label World Health Organization. Show all posts
Showing posts with label World Health Organization. Show all posts

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.
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http://www.bworldonline.com/weekender/content.php?id=70310

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.

Thursday, March 21, 2013

Health Spending 6: Health/GDP Ratio 2010

In my blog post the other day, On Inequality and Inclusive Business in HC, I wrote:

On government health spending, I think the ADB, WHO, UN, etc. data on PH public health spending is understated and wrong. They usually count only DOH + PhilHealth spending. They do not include some or all of other govt spending such as:
1. LGUs, with provincial and city health centers and hospitals. Manila City alone has six city-owned hospitals.
2. Philippine General Hospital (PGH), budget about P2 billion a year, part of the UP annual budget; hence, it is not counted as health spending but education spending…. 

This table is from the World Health Organization (WHO)  which I copied today. It says that the Philippines’ health spending / GDP ratio as of 2010 was only 3.6 percent.

Table 1. Philippines Basic Health Stats, from WHO 
  
source: http://www.who.int/countries/phl/en/


I posted the above observation (in italics) in the email loop among members of the Medicines Transparency Alliance (MeTA) Philippines, where an official of the WHO West Pacific Regional Office (WHO-WPRO), Ms. Klara Tisocki, is among the members.

Klara was kind enough to reply. She said, 
Regarding your comments  please note that WHO collects health expenditure related data in countries via the  national health accounts (NHA).  NHA constitute a systematic, comprehensive and consistent monitoring of resource flows in a country’s health system for a given period. NHAs use classification schemes, which are designed to be compatible with those practiced internationally; most importantly, the System of national accounts (SNA), to make cross-national comparisons possible.  
The International Classification for Health Accounts (ICHA) is a comprehensive system which classifies NHA into four dimensions: Financing sources (FS)-contributions by different actors; Financing agents (HF)-entities who manage health expenditures; Providers (HP)-entities that provide health care services and goods; and Functions (HC)-types of health care activities. You can read more about NHA at WHO webpage: http://www.who.int/nha/what/en/index.html  
More specifically  regarding the Philippines health expenditures these are collected via the Philippines National Health Account  (PNHA)  (which in turn reports to WHO for inclusion of Philippines data in WHO databases).   
The methodology and current statistics of PNHA are available on the website of  Philippines National Statistical Coordination Board  http://www.nscb.gov.ph/stats/pnha/.  
I would also like to refer you to the technical notes,  http://www.nscb.gov.ph/stats/pnha/technotes.asp on sources of data for the Philippines health financing, with regard to  your assumption that WHO, ADB, UN etc. count only DOH and Philhealth spending.  In these notes you will find the detailed description of Data Sources and Estimation Procedures as approved by NSCB Resolution No. 8 Series of 2011, that shows  what data  from which sources  are included under the different sectors and you can see the wide range of data sources considered.  

I thanked Klara for her reply as it provided useful links. From the NSCB link, here are the numbers:

Table 2. Philippines Health Expenditures by Sources of Funds