INCREASING longevity, urbanization and poor lifestyles are contributing to a massive increase in non-communicable diseases (NCDs) in South-East Asia.
According to the World Health Organization, 55 per cent of all deaths in the region are due to NCDs – that is nearly 8 million people every year. More worryingly, one-third of those dying as a result of NCDs are younger than 60. Such premature mortality causes immense social and economic loss.
The growth in NCDs has also led to a “dual burden of disease” for these countries – having to transform health systems built to fight infectious diseases and provide acute care to ones which can manage the silent epidemic of chronic diseases like diabetes, heart disease, respiratory illnesses and cancer. What are the policy and operational implications of addressing this dual burden?
Four important aspects stand out. The first is health systems integration. Many infectious disease programmes were developed in so-called “vertical” formats, with different silos for diseases like HIV/AIDS, TB and malaria.
These now need to be integrated in order to provide care across diseases, beyond specific conditions with a patient rather than just a disease focus.
An example is HIV, where the need for long-term antiretroviral treatment has led to the upgrade of supply chains to minimize stock-outs in lower-income countries. Similarly, treatments for chronic disease require well-managed supply chains.
Research is another critical area. For instance, too little is known about how HIV interacts with cardiovascular disease, or what happens to patients with TB if they develop diabetes.
Education is the third element, and this means education not just for healthcare workers (though they need to be equipped to diagnose and treat NCDs), but also for communities and young people. Adolescence and young adulthood are when NCD risk factors are typically initiated. These risk behaviours are increasing among young Asians, setting them up for poorer health in adulthood compared to today’s adults.
Surveys conducted by the WHO show some very troubling statistics
● Over a third of Indonesian boys aged 13-15 have smoked or used tobacco products in the last month
● In the Philippines, Thailand and Vietnam, over a fifth of boys have drunk alcohol
● A quarter of boys in Malaysia and Thailand are obese or overweight. Across much of Sout-East Asia, secondary schoolchildren show alarming levels of physical inactivity
The trends for the four key risk factors – tobacco, alcohol, inactivity and poor diet – are up. These are statistics to give policy-makers concern. Bad habits established now will support an epidemic of NCDs when these young people hit middle age. By 2050, the over-45 population is projected to double in South-East Asia compared to its size today.
The fourth element is good policy. School curricula need to include education on healthy lifestyles. Secondary school children are naturally active, but they need access to parks, green spaces and playgrounds.
Young people should be prevented from having access to alcohol and tobacco products, and ideally such products should be taxed to become unaffordable for schoolchildren. Promotion of high-fat and high-sugar products to young people should be restricted.
What can the pharmaceutical industry do here? We are obviously not in schools or playgrounds. But we can play a role in educating healthcare professionals about NCD diagnosis and treatment, and about the fact that some risk factors are, in effect, inherited – obese parents are likely to have obese children, for example.
Talking to 40-old patients with diabetes or respiratory illness is an opportunity for a doctor or nurse to educate them, and ideally get them to talk to their own children about the importance of healthy lifestyles. We can also help with health system transformation – my own company, Novartis, is doing a lot to improve supply chains in lower-income countries, and partners with organisations on the ground to provide education around NCD diagnosis and treatment.
The future of South-East Asia’s youth is in the balance. Wise decisions now will make a significant difference to the future burden of NCDs on South-East Asia’s health systems and economies.
* Mr Harald Nusser will participate in the World Economic Forum on ASEAN event, from 10-12 May 2017
** The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the position of Astro AWANI.
Dr Harald Nusser
Wed May 10 2017
A HIV-positive girl is seen lying in a bed at the paediatric hospital in Hanoi July 29, 2010. Of the 300,000 people infected with HIV/AIDS in Vietnam, about 1,200 are children, according to government statistics. - Photo Reuters/Kham
ISIS Malaysia's perspective of Budget 2025
An excellent rakyat-centric budget under the overarching principle of a caring and humane economy.
Budget 2025: Record increase in STR, SARA aid initiatives
The government will provide a significant boost to the Sumbangan Tunai Rahmah (STR) and Sumbangan Asas Rahmah (SARA) initiatives next year.
Budget 2025: EPF contributions to be made mandatory for foreign workers – PM Anwar
The government plans to make it compulsory for all non-citizen workers to contribute to the Employees Provident Fund (EPF).
What policies to expect from Indonesia's new President Prabowo
Prabowo will be open to foreign investment, his aide has said, such as by offering investors management of airports and sea ports.
Budget 2025: Govt allocates RM470 mil to empower women's participation in PMKS
The Women's Leadership Apprenticeship Program will be intensified as an effort to produce more female corporate personalities.
Israel sends more troops into north Gaza, deepens raid
Residents of Jabalia in northern Gaza said Israeli tanks had reached the heart of the camp, using heavy air and ground fire.
Indonesia ramps up security ahead of Prabowo's inauguration
Prabowo Subianto will be sworn in as Indonesia's president on Sunday with Vice President-elect, Gibran Rakabuming Raka, also taking office.
Immediate allocation of RM150 mil for local authorities, DID to tackle flash floods
Datuk Seri Anwar Ibrahim said this allocation is intended to address the recent flash floods that hit the capital and several major towns.
Budget 2025: Sabah, Sarawak to continue receiving among highest allocations - PM
Sabah and Sarawak continues to be prioritised under Budget 2025, with allocations of RM6.7 billion and RM5.9 billion respectively.
NFOF will be operational in November 2024 with funding of RM1 bil
PM Anwar Ibrahim said NFOF will support venture capital fund managers to invest in startup companies with RM300 million set aside for 2025.
Minimum wage to increase to RM1,700 effective Feb 1, 2025
The Progressive Wage Policy would be fully enforced next year with an allocation of RM200 million, benefiting 50,000 workers.
Bursa Malaysia ends higher on Budget 2025 optimism
The benchmark index, which opened 1.85 points higher at 1,643.29, moved between 1,641.71 and 1,649.31 throughout the trading session.
Five important aspects relating to people’s lives in Budget 2025 - PM
The focus is on driving the MADANI Economy, speeding reforms, cutting red tape, raising wages, and tackling the cost of living.
Economic outlook: Govt plans to leverage, expand existing city transit system
The expansion aims to provide a more efficient and reliable public transportation network, reduce congestion, and improve accessibility.
Economic outlook: Budget 2025 to lay foundation for a digital-driven economy
The report said Budget 2025 will entail efforts to position Kuala Lumpur as a top 20 global startup hub by 2030 through the KL20 initiative.
Economic outlook: Corruption and lack of accountability hinder economic progress
Special Cabinet Committee on National governance is established to curb corruption, law reforms to modernise outdate regulations, MoF said.
National Wages Consultative Council will be strengthened
The govt will also incentivise hiring women returning from career breaks, offer job matching and improve care services facilities.
Economic outlook: Ensuring 11 years of compulsory education for all children
Budget 2025 will continue prioritising upskilling and retraining initiatives to equip workers with the latest skill sets necessary.
Consolidated public sector projected to record lower surplus of RM41.7 bil 2024
The MoF said the consolidated general government revenue is estimated to increase slightly to RM384.7 billion in 2024.
PM announces substantial Budget 2025 hastening Malaysia to become Asian economic powerhouse
Datuk Seri Anwar Ibrahim said it would create jobs and also tackle financial leakages to enhance public spending efficiency.