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Monday, Oct. 10, 2011
Beating noncommunicable disease
Why do most people die? That was the question addressed by a special summit meeting of the United Nations in New York City in mid-September. The final report from the first-time summit identified noncommunicable diseases (NCDs) as the leading cause of death worldwide.
Every year, 36 million people die from diseases such as cancer, cardiovascular diseases and diabetes, most of which are preventable.
Following the summit, the World Health Organization announced a massive effort aimed at preventing and reducing NCDs and issued recommendations to tackle this global disaster. The recommendations were surprisingly cost-effective.
With an investment of a mere $1.20 per person per year, 80 percent of the cases of premature heart disease, stroke and diabetes can be prevented. By allocating a meager 4 percent of their health budgets, countries could increase information campaigns, preventive screening, early treatment, immunization programs, and availability of generic drugs. This is an investment in people that the world cannot afford to miss.
The massive loss in income, productivity, investment and social well-being that result from 36 million deaths every year is hard to calculate.
The World Economic Forum and the Harvard School of Public Health estimate economic losses associated with NCDs to be at least 4 percent of GDP for low-and middle-income countries. In every country in the world, losses from NCDs are greater than the entire public spending on health.
Put simply, a small investment in health would prevent massive losses in the economy.
NCDs are a serious threat to global economic growth and development. The worst effects will increasingly fall on poorer, rapidly urbanizing nations. NCDs cause prolonged disability, diminished income, reduced productivity and a lower quality of life that add to other socio-economic problems.
Poor health and chronic diseases push millions of families into poverty every year. The U.N. summit report emphasizes that most NCDs result from unhealthy diet, poor exercise, and tobacco and alcohol use, in short behavioral factors that can be changed. When health problems are unavoidable, it is a tragedy; but when they are preventable and nothing is done, it is an outrage.
The two main obstacles to progress are government reluctance to allocate resources and industry profits from sales of harmful products.
Over the next 15 years, WHO estimates that inaction by government and industry will cost low- and middle-income countries more than $7 trillion on health care and related costs. Budgets for treatment and care of people with NCDs pre-empt valuable resources that governments could otherwise use for investments, economic stimulation and other public initiatives. The serious effect of health issues on both individuals and the whole economy can no longer be ignored.
Japan has done better than some countries in its health policies. However nearly 1 million people died in 2008 from NCDs in Japan. Tobacco smoking and physical inactivity contribute to many of these NCDs. Metabolic risk factors such as blood pressure and blood glucose levels remain high.
Health problems resulting from obesity and cholesterol issues are increasing. As in other countries, NCDs in Japan hit most people before the age of 60, reducing the chance to live and participate actively in society and the workplace.
The Japanese government should immediately implement what WHO identified as the most cost-effective interventions for NCDs: promoting awareness of the dangers of unhealthy diet and physical inactivity; establishing preventive screening and early treatment for cardiovascular diseases, diabetes and cancer; pushing industries to cut back on salt and sugar in their food products; and raising taxes on tobacco and alcohol.
Japan has already made progress in some of these areas, but much more remains to be done. Japan could become a model for developing countries by clarifying its policies and establishing specific goals and deadlines.
Japanese industries need to shift their policies or be made to pay their share. Ignoring science and putting profits first is a business approach that can no longer be considered rational. The government does not need to become an intrusive nanny state in order to constrain the sale of unhealthy products and restrict their overconsumption.
Instead, the government needs to help — or force — Japanese businesses to re-establish their mission as contributing to a healthier nation. Making business decisions without considering the social effects is neither sensible nor socially minded.
Japan should not only focus on itself, however. Japan needs to help increase financial and practical support for low- and middle-income countries, especially those with close relations. Health issues, like the performance of economies, are increasingly international. Since the rate of NCDs is likely to double in the next 20 years, the burden of overall health care and the effects of slow economic recovery will extend beyond national boundaries.
The death rates, economic losses, health costs and general quality of life for millions around the world depend on what preventions are taken now. The cost of doing nothing is incalculable.