Lower-Income Countries That Face The Most Rapid Shift In Noncommunicable Disease Burden Are Also The Least Prepared

Abstract

Demographic and epidemiological changes are shifting the disease burden from communicable to noncommunicable diseases in lower-income countries. Within a generation, the share of disease burden attributed to noncommunicable diseases in some poor countries will exceed 80 percent, rivaling that of rich countries, but this burden is likely to affect much younger people in poorer countries. The health systems of lower-income countries are unprepared for this change. We examined the shift to noncommunicable diseases and estimated preparedness for the shift by ranking 172 nations using a health system capacity index for noncommunicable disease. We project that the countries with the greatest increases in the share of disease burden attributable to noncommunicable disease over the next twenty-five years will also be the least prepared for the change, as they ranked low on our capacity index and are expected to have the smallest increases in national health spending. National governments and donors must invest more in preparing the health systems of lower-income countries for the dramatic shift to noncommunicable diseases and in reducing modifiable noncommunicable disease risks.

The effect of family doctor–contracted services on noncommunicable disease self‐management in Shanghai, China

“…As a result, NCDs are exerting increasing pressure on health care systems, especially in developing countries, leading to vast inflation in health care expenditures. Problematically, the health systems of the lower‐income countries have been mostly unprepared for this shift, as indicated by the fact that NCDs accounted for over 80% of the disease burden in some poor countries, rivalling that in rich countries . A study in Mongolia revealed that a significant proportion of expenditures for NCDs (69%) was borne by households in the form of out‐of‐pocket payments .…”

Strengthening health technology assessment systems in the global south: a comparative analysis of the HTA journeys of China, India and South Africa

“…Low- and Middle-Income Countries (LMICs) face difficult decisions regarding resource allocation, due to scarce resources and large disease burdens [1,2]. Lack of systematic priority setting can lead to inefficient resource allocation and poor-quality healthcare [3].…”

Body mass index and movement behaviors among schoolchildren from 13 countries across a continuum of human development indices: A multinational cross‐sectional study

“…A previous multinational study showed higher deaths related to cardiovascular events in low-income countries despite their low-risk burden (Yusuf et al, 2014), suggesting that as epidemiologic transitions progress, cardiovascular events related to obesity will only add to the already stressed health care systems in these countries. Results from the current and other previous studies (Bollyky et al, 2017;Mendis, 2010), provide evidence for governments and policy makers of LMICs, and international organizations to prioritize interventions and policy strategies designed to manage epidemiological and lifestyle transitions.…”

“…Our research group has previously reported such epidemiologic transition patterning in the relationships between childhood obesity and household income (Broyles et al, ), physical activity and socioeconomic status (Barreira et al, ), but not for sleep duration and socioeconomic status (Manyanga et al, ). The impact of accelerated epidemiologic transitions for childhood adiposity, and physical activity may be excessively burdensome, especially in LMICs, where infectious and other enteral diseases are still prevalent (Remais, Zeng, Li, Tian, & Engelgau, ), and resources to adequately address the dual burden of both communicable and non‐communicable diseases may be unavailable (Bollyky, Templin, Cohen, & Dieleman, ). A previous multinational study showed higher deaths related to cardiovascular events in low‐income countries despite their low‐risk burden (Yusuf et al, ), suggesting that as epidemiologic transitions progress, cardiovascular events related to obesity will only add to the already stressed health care systems in these countries.…”