Non-Communicable Diseases and Poverty: Needs Attention

The physical pain inflicted by NCDs may be unbearable for rich and poor alike but it certainly has lot of negative impact on the poor.

"World leaders noted with grave concern the vicious cycle whereby NCDs and their risk factors worsen poverty, while poverty contributes to rising rates of NCDs, posing a threat to public health and economic and social development."

Let us first take a look at numerous ways in which NCDs contribute to poverty.

[ ] Treatment cost :

Once diagnosed with major NCDs such as cardiovascular disease (CVD), cancers, respiratory disease and diabetes; the vicious cycle of hospital visits, expensive treatments and emotional repercussions begins. The cost of treatment is of little concern to the rich but drains all the resources from the poor. According to National Sample Survey Organization (NSSO) there were nearly 2.5 billion outpatient visits and 30.6 million hospital stays in India in the year 2004. These numbers are considerably greater than similar categories for 1995-96. NCDs accounted for nearly 40 percent of all hospital stays and 35 percent of all outpatient visits in 2004.

[ ] Mortality rate:

Once a poor is diagnosed with NCD, he either ends up in getting extremely poor or dying. Dying contributes to the poverty as well. If the bread-winner of the family dies the income of the family is disturbed leading to poverty.

An annualized measure of the indirect costs (income losses) associated with morbidity/disability and premature mortality from NCDs that are borne by households is important. More than one-third of all income losses are due to CVD and hypertension. Another 15 percent are accounted for by diabetes, so that nearly half of all income losses from NCDs occur on account of a fairly narrow range of conditions and their co-morbidities. Another significant chunk (roughly in the region of 20 percent)of all income losses are related to asthma and other respiratory conditions. Accidents and injuries make up for about 6-7 percent of all annual income losses.

[ ] Lifestyle The major NCDs, diabetes, cardiovascular diseases, cancers and chronic obstructive pulmonary disease (COPD), have common risk factors such as smoking, unhealthy diet, alcohol consumption and low levels of physical activity. These risk factors are high among poor people and poor nations.

Many of the issues highlighted here are not specific to NCDs. An efficient and equitable health care system becomes a key tool for NCD control as it is for control of other health conditions. However, with the NCDs becoming more common, improving efficiency, quality, and access to a sound healthcare system is good strategy for NCD control. Likewise, efforts to improve health care delivery and access for NCDs will improve the infrastructure for the broader health care system. The ultimate challenge is to strategically focus on policies that will yield the best returns.

A significant role here can be played by clinical pharmacist:

Notable number of deaths in India are caused by NCDs. We lack adequate human resources to prevent and manage NCDs, but the skills and expertise of pharmacists in India are underused. There is evidence from many countries that pharmacists can contribute substantially to the prevention and management NCD. We aim to describe the opportunities and challenges for pharmacists to prevent and manage NCDs. Pharmacists can contribute by 1. Screening and monitoring NCDs 2. Counseling on lifestyle 3. Providing medication therapy 4. Providing management service

Written By:

Jesty Patel (Doctor of Pharmacy)