It is not surprising that so much attention is directed towards fighting infectious diseases in developing countries. They are a very visible problem, afflicting people of all ages, and the disparity between developed and developing countries is especially tragic and seemingly unjust. In fact, approximately 70% of deaths in sub-Saharan Africa are caused by infectious disease. However, focusing solely on communicable diseases ignores health problems that are just as, if not more, important to address in order to improve health in Africa and the rest of the world.
No health problem is as large as cardiovascular disease (CVD). CVD is the number one cause of death worldwide, responsible for 17.3 million deaths, or 30% of all deaths, in 2008 alone. That’s over 3 times as many deaths as HIV/AIDS, tuberculosis, and malaria combined (approximately 5 million). While CVD certainly affects individuals across the globe, 80% of CVD deaths take place in developing countries. Despite the importance of addressing CVD, it has largely been put on the side burner in global health efforts. This neglect is reflected by, and perhaps even partially caused by, a failure to address CVD and other chronic diseases in the United Nation’s Millennium Development Goals. The United Nation’s Millennium Development Goals, or MDGs, is a plan with 8 goals aimed at improving the lives of the world’s poorest individuals. Three of the 8 goals are targeted at improving health – specifically, reducing child mortality, reducing maternal mortality, and preventing the spread of infectious diseases – but none of the goals mention chronic diseases or CVD. Leaving non-communicable diseases out of these goals is a huge problem. Not only does it deprive funding from efforts to combat CVD, but it misses a critical opportunity to bring attention to such an important issue. Non-communicable disease, in particular CVD, is an issue that can no longer be ignored.
A different type of problem
CVD is very different than the infectious diseases that so heavily afflict Africa. For one, much of the risk for the disease is, at least theoretically, in the hands of the individual. According to the INTERHEART study, “over 90% of the population attributable risk of acute myocardial infarction [heart attack] were accounted for by nine modifiable risk factors.” That does not mean that these risk factors are easy to change, or that it is the fault of those who are at increased risk. But they are modifiable- they can be changed. Smoking, obesity, fruit and vegetable intake, exercise, and alcohol consumption are all risk factors that can, and must, be addressed in order to fight this deadly disease.
A growing problem
Another important aspect of CVD is that it is not going away any time soon. Unlike many infectious diseases which will, hopefully, become less severe as African countries continue to develop and improve their medical capacity, CVD is a so-called “man-made disease” that might become even more deadly as African nations develop. Along with urbanization and globalization come changes in lifestyle that can actually increase the prevalence and severity of CVD. As the USA, Western Europe, parts of China, India, and the Middle East developed, people began to eat more calories, use more tobacco products, exercise less, and consume more alcohol, leading to a large increase in CVD incidence. If the same changes occur in African nations, CVD will only become a more pressing health issue. Even worse, researchers claim that new risk factors, including rising air pollution, climate change, and high rates of HIV infection, might come into play that make CVD an even bigger challenge.
A problem with solutions
The CVD epidemic is certainly not an easy problem to solve, but it is not a hopeless fight either. In many ways, it is quite clear what needs to be done. People need to eat healthier, get more exercise, and reduce harmful behavior such as smoking and alcohol consumption. For those who are already in trouble, we need to get them the medication they need to avoid a fatal event. In order to both prevent CVD from occurring in the first place, and treat those who are in need, efforts have to be made on the global, national, community, and individual levels. Groups need to step in and raise awareness about the risks of obesity and the importance of a healthy diet. Community health systems need to become stronger to address troubling health trends before they become serious problems. And individuals need to encourage their friends, family, and community members to recognize CVD as the deadly killer it is.
“Cardiovascular Disease.” World Health Organization. n.p., 2013. 1 August 2013.
Fuster V, Voute J, Hunn M, Smith Jr SC. Low Priority of Cardiovascular and Chronic Disease on the Global Health Agenda: A Cause for Concern. Circulation 2007; 116: 1966-70.
Gersh BJ, Sliwa K, Mayosi BM, Yusuf S. The epidemic of cardiovascular disease in the developing world: global implications. European Heart Journal 2010; 31: 642-48.