War on Growing Burden of Non-communicable Diseases

Due to the success of modern medicine and higher education, the burden of diseases has shifted towards non-communicable diseases. For many generations, the fight against communicable diseases seemed to be an up and down battle. Higher education and better practices eliminate the severe causalities that once were left by communicable diseases. In no regard will non-communicable diseases be such a roller coaster type battle because it is definitively an uphill war with great barriers to fight through. Some of these challenges are in lifestyle changes, population-based education, and better preventive medicine by means of an assimilated effort throughout the world in a cost-efficient manner. The war may be long, but the world cannot afford to take backward steps in reducing the burden of chronic illnesses.

An easy area to improve victories against non-communicable diseases is in the primary care network for countries. Primary care doctors are fighting in the trenches as the first line of defense in this war against non-communicable diseases. These trench fighters shape the populations’ impact on lifestyle changes and adoption of preventive measures. In a study done in rural Gambia on treatment of epilepsy and primary health care, choice of treatment was “shaped by beliefs in an external spiritual cause of epilepsy and commonly expected to be curative but not preventive” (Coleman, Loppy, & Walraven, 2002). With this mindset as a formidable opposition, researchers found that tackling non-communicable diseases in the rural Gambia would be best if tackled through the forum of a primary care program. This would create a systematic approach on handling the issue while strengthening and mobilizing all primary care workers along with recognizing the local health belief systems. The suggested program would include the management of epilepsy along with an integration of a chronic disease program covering other non-communicable diseases such as hypertension and mental health (Coleman, Loppy, & Walraven, 2002). This is just one example of how primary care can be used to implement lifestyle changes, population-based education, and preventive medicine. In addition, this shows how focusing on one chronic disease may not be the most efficient way to fight this war. An integrated program with major non-communicable diseases along with the specific health risks is better in increasing awareness because the population is receiving a complete view of possible illnesses with the upstream indicators. Using primary care as the vehicle to drive into the global battleground, the world has a good shot in this struggle against non-communicable diseases.

A problem with many interventions and programs is with money. Wasteful spending and inefficient groundwork in programs typically make many global initiatives unsustainable. Primary care is far more cost-efficient than other types of care. The evidence for this can be seen in America as discussed thoroughly in American College of Physicians’ white paper. This paper clearly summarizes the value and outcomes of primary care: “better quality of life, more productive longevity, and lower costs as a result of reduced hospitalization improved prevention and better coordination of chronic disease care” (American College of Physicians’, 2008). Primary care programs seemed to have a better chance of being sustainable in a cost-efficient manner. This is why establishing a better primary care network in countries will allow the fastest spread of latest preventable measures to be adopted. A creation of trust and understanding will emerge by having a primary doctor in each community, as citizens will start to regularly see with health professionals and join health related programs. Communities will turn for advice to their primary care networks and solutions from their primary care doctors will help prevent and/or help identify the emerging battles due to non-communicable diseases.

The upcoming war on non-communicable diseases seems to be spread throughout the world on many fronts. Global efforts are torn between disease-specific measures or overall strategy. For example in America, it is projected by 2015 that about 150 million Americans will have at least one chronic condition (Wu & Green, 2000). What is the strategy here? There does not seem to be a clear one that the population is exposed and/or identified. In this regard, American might be better off learning from Mark Zuckerberg’s growth plan of Facebook, in hopes to create a plan for this war against non-communicable diseases. It only took Mr. Zuckerberg roughly five years to reach 150 million users worldwide to adopt and use his site regularly (Zuckerberg, 2009). Nevertheless, 150 million is a huge toll in America and should not be trivialized as if one gets a new Facebook friend request. The played out saying that American problems need American solutions, is garbage here in this war. The solution is not country specific or disease specific, but a global overall strategy. For example, why not use Facebook and other networking innovations over the last couple of years to spread awareness, in hopes for increase adoption of better lifestyle changes. If it only took Mr. Zuckerberg about five years to reach that many users, why cannot the world do the same with a health message? For America, it should rely on using diffusion of knowledge as step one to prevent this massive toll by 2015 as it seems almost every student, their siblings, and their parents are on the Facebook site. Step two would probably be the slowest as now it is user-dependent on accepting the new measures and make lifestyle changes that will prevent chronic disease. Some of these changes would be better diet and more exercising. Another vital component is global acceptance through all the world leaders that non-communicable disease is a real threat. There must be a global acknowledgement of the high stakes in the war against non-communicable disease due to years of unresponsiveness. Differences must be put aside and treaties must be formed. No one country should be isolated from these efforts against non-communicable diseases. The war must be fought by all the countries collectively in order to ensure a world victory.

Another issue in this war is the history of previously attempts to manage and battle non-communicable diseases. The summary of the global and country specific efforts can be found in one word: terrible. In America, among reporting nonelderly adults, the number with one or more of seven major chronic conditions has increased from 28% in 1997 to 31% (about 58 million) in 2006 (Hoffman & Schwartz, 2008). That is unacceptable especially for a country who loves fighting wars. With an increase of three percent over a nine-year span, American adults have shown no remorse in lifestyle change nor heed to educational warnings. The government pays for campaigns and interventions on specific diseases or for specific high-risk populations such as children or Hispanics. The war on non-communicable disease is not something to take lightly; no matter what age, color, or creed the population may be. Many factors will influence the total outcome, but it starts with one individual taking action on behalf of himself or herself. There are many things that can be done to reduce non-communicable diseases in the next twenty years; however, it starts with lifestyle changes and maintained through preventive and educational efforts. By targeting upstream events, the number of people who develops chronic diseases will drop or at least have a lower DALYs.

Due to the growing burden of non-communicable diseases, each country needs to start collaborating and continuing measures of prevention and knowledge sharing throughout the world. It is important to spread the lessons learned by high-income countries on addressing non-communicable diseases in cost-effective ways to the rest of the world; as much as it is vital for the world to take and adopt promising measures as soon as it is known to prevent non-communicable diseases (Skolnik, 2008). The value of education in this modern world has been trivialized to who get the latest technology or most money to develop it. The emphasis is not on the easiest or simplest to solve the problems but on the gaudiest or most pompousness. Instead of trying to re-invent the wheel and being the first, why not step back and use principles already learned that works. Build on small victories seen throughout the war in order to devise a plan to win it all. For example, Facebook started as small coalition of college students and schools. Now about five years later, it is the same amount as the projection of the people with chronic diseases in 2015. Countries need to build a global coalition and create ways to defeat non-communicable diseases because dealing with belief systems and cultural traditions will be a delicate battle that shape similar populations in many different countries. It is hard to change a lifestyle that has been passed through generations especially if some lifestyles are preserved in certain countries and not in others. In addition, it is difficult to adjust habits when resources are scarce. What are countries to do then? Well again, coalition building seems to be the best option to tackle this problem. Where it may be difficult for one country to attain resources, others can lend a hand to help obtain and deliver the services. Sharing the burden of chronic diseases with other countries allow the world a slim fighting chance to win this impossible war. By building on small success of other countries and creating a supportive coalition, the world may lower the burden of non-communicable diseases.

References: (I tried to have perfect form such as make the indents and spacing, but I was not able to do so due to blog setup.)

American College of Physicians. How Is a Shortage of Primary Care Physicians Affecting the Quality and Cost of Medical Care?. Philadelphia: American College of Physicians; 2008: White Paper.

Coleman, Rosalind; Loppy, Louie and Walraven, Gijs. The treatment gap and primary health care for people with epilepsy in rural Gambia. Bull World Health Organ [online]. 2002, v. 80, n. 5 [cited 2009-02-21], pp. 378-383.

Hoffman C, Schwartz K. Eroding Access Among Nonelderly U.S. Adults With Chronic Conditions: Ten Years Of Change. Health Aff (Millwood). 2008 Jul 22.

Skolnik, R. (2008). Non-Communicable Diseases. In Essentials of Global Health (p. 228). Suddbury, MA: Jones and Bertlett Publishers.

Wu S, Green A. Projection of chronic illness prevalence and cost inflation. Santa Monica, CA: RAND Health, Oct. 2000.

Zuckerberg, M. (2009, January 7). A Great Start to 2009. Retrieved from The Facebook Blog: http://blog.facebook.com/blog.php?post=46881667130.