Dr. Roger I. Glass,
Director of the Fogarty
Opinion by Dr. Roger I. Glass
Director, Fogarty International Center
The human and economic costs of non-communicable diseases are staggering. Two out of every three deaths are attributable to NCDs, principally cardiovascular disease, diabetes, cancer and chronic respiratory disease. Lost productivity and health care costs may amount to trillions of dollars over the next few decades.
What’s more, 80 percent of these deaths - and the vast majority of such deaths in people under the age of 60 - occur in countries with developing economies or economies in transition. That represents untold pain, suffering, disability and hardship for millions of people.
The toll on the global economy is alarming. For each 10 percent rise in mortality from non-communicable diseases, annual economic growth is reduced by 0.5 percent. Unless action is taken to slow or reverse current trends, a World Bank study has estimated that the economic burden of the major non-communicable diseases will cost the global economy some $35 trillion from 2005 to 2030. For these reasons, the World Economic Forum has ranked these diseases as one of the top threats to global economic security.
We at Fogarty anticipated the growth of interest in NCDs. Awareness was stimulated five years ago by the Disease Control Priorities Project, which was designed to use cost effectiveness to improve health outcomes in developing countries. At that time, NCDs were identified as providing at least half of the “best buys” in health care, and we included it as a priority issue in Fogarty’s strategic plan.
September’s UN High-level Meeting on Non-Communicable Diseases provides an exceptional opportunity to focus attention on the worldwide surge in NCDs. But given the previous focus on infectious disease and HIV/AIDS, most developing countries don’t have expertise in NCDs. This is where Fogarty plays an important role. Our training programs are beginning to build capacity to cope with these diseases in low-resource settings.
Fogarty is training diabetes researchers in India and raising awareness of the disease in a country that has the greatest number of diabetics in the world. In South Africa, we’re leading research in cost-effective ways to screen for heart disease. Ongoing research in South Asia on the effects of household air pollution may lead to a reduction in chronic respiratory disease. Another collaborative effort brings together Egyptian and American investigators to find new drug pathways to treat inflammatory breast cancer.
Collaboration is vital and NIH is rising to meet the challenge. Our colleagues at the National Heart, Lung and Blood Institute have established Centers of Excellence in developing countries to combat NCDs. The National Cancer Institute and National Human Genome Research Institute have established a global cancer genome atlas and the NIH Director recently launched an effort to study the genetic basis for diseases across Africa, a project called H3Africa.
Many sectors of society will need to pull together to address this formidable foe, including healthcare organizations, agriculture, the food industry, educational institutions, governments and nonprofit organizations. And, to ensure the most effective and efficient use of very limited resources, it is imperative that these efforts are supported by a firm foundation of scientific data generated by well-designed research studies.
Innovation in medical research today is not the sole province of the developed world. Yes, advances made by U.S. researchers will help to reduce the worldwide burden of non-communicable diseases. But our nation’s health also stands to benefit from the creative, cost-effective ideas of researchers in developing nations. International partnerships are crucial to fighting this massive epidemic. The Global Alliance for Chronic Diseases, which includes NIH and the world’s major medical research agencies, recently launched an initiative to support research on hypertension in low- and middle-income nations.
All nations are feeling the devastating impact of cancer, heart disease and other non-communicable diseases and, consequently, must be part of the solution. This convergence of interests presents exceptional opportunities - and enormous responsibilities - to those of us in the medical research community.