The Disease Control Priorities Project (www.dcp2.org)www.dcp2.org and Chronic Disease Presentation to the Hemispheric Meeting of the Social Protection.

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Presentation transcript:

The Disease Control Priorities Project ( and Chronic Disease Presentation to the Hemispheric Meeting of the Social Protection and Health Network of the Inter-American Development Bank’s Regional Policy Dialogue Program, Santiago, Chile, 30 Sept-1 Oct 2010 Philip Musgrove Deputy Editor, Health Affairs Note: These figures and tables are taken, sometimes with modification, from Disease Control Priorities in Developing Countries, 2 nd edn., Their interpretation does not represent the views of Health Affairs or of Project HOPE, of which the journal is a part, but is the sole responsibility of the author, who was one of the editors of the Disease Control Priorities Project.

Major Causes of Death in Persons of All Ages in Low- and Middle-Income Regions

Estimated Number of Cancer Cases of All Ages, Developing Regions, 2002 (hundreds)

Estimated Numbers of People Age 20 to 79 with Diabetes, Mortality, DALYs, and Direct Medical Costs Attributable to Diabetes, by Regions Number of people (thousands) Prevalence (percent) Direct medical costs, 2003 (US$ million) Region Low estimate High estimate Deaths, 2001 (thousands) Disability- adjusted life years, 2001 (thousands) Developing countries 140,849264, ,30423, ,804 East Asia and the Pacific 31,36360, ,3682, ,930 Europe and Central Asia 25,76433, ,8845,336511,375 Latin America and the Caribbean 19,02636, ,5928, ,775 Middle East and North Africa 10,79223, ,3474, South Asia46,30994, , ,433 Sub- Saharan Africa 7,59516, ,448 Developed countries 53,33768, ,365217, ,192 World194,186332, ,669240, ,996

Figure 1.2: Distribution of Deaths by Cause in Chile, 1909 and 1999 Distribution of Deaths by Cause in Chile, 1909 and 1999

Percentage Change in Ischemic Heart Disease Death Rates in People Age 35 to 74, , Selected Countries

Changes in Lung Cancer Mortality at Age 35 to 44 in the United Kingdom and France,

Improving the Health of Populations: Lessons of Experience Cases Relevant to Chronic Disease Mineral fortification With Iron in Foodstuffs With Flouride in Salt With Iodine in Salt Tobacco Control Through Tax Increases Through Education and Behavior Change Interventions

Convincing and Probable Relations between Dietary and Lifestyle Factors and Chronic Diseases FactorsCVD Type 2 Diabetes Cancer Dental Disease FractureCataract Birth Defects Obesity Metabolic Syndrome Depression Sexual Dysfunction Avoid Smoking Exercise Avoid Overweight Eat healthy fats Eat fruits & vegetables Eat whole grains Limit sugar Limit calories Limit Sodium

Global CVD Burden Caused by High Blood Pressure, Cholesterol, and Bodyweight

Continuous Risks of Blood Pressure, Cholesterol, and Body Mass and Coronary Heart Disease Risk Continuous Risks of Blood Pressure, Cholesterol, and Body Mass and Coronary Heart Disease Risk

Number of events prevented with four- component medical regimen compared with no therapy a Number of incremental events prevented with CABG compared with medical therapy Region IHD deaths averted Stroke deaths averted Myocardial infarctions prevented Strokes prevented IHD deaths averted Stroke deaths averted Myocardial infarctions prevented Strokes prevented East Asia and the Pacific 1, , Europe and Central Asia 1,990893, Latin America and the Caribbean 1,913834, Middle East and North Africa 1,908954, South Asia1,930974, Sub-Saharan Africa 1,909914, Number of Deaths and CVD Events Prevented by the Use of a Four-Component Medical Regimen and CABG per 100,000 Myocardial Infarction Survivors over 10 Years, by Region

Use of Taxes and Subsidies to Promote Health by Type of Intervention

Intervention US$/DALYDALYs/Million US$ Preventing and treating noncommunicable disease Taxing tobacco products3-5024, ,000 Treating AMI (heart attacks) with an inexpensive set of drugs , ,000 Treating AMI with inexpensive drugs plus streptokinase (costs and DALYs for this intervention are in addition to what would have occurred with inexpensive drugs only) ,300-1,600 Treating heart attack and stroke survivors for life with a daily polypill combining four or five off-patent preventive medications 700-1,0001,000-1,400 Performing coronary artery bypass grafting (bypass surgery) in specific identifiable high-risk cases—for example, disease of the left main coronary artery (incremental to treatment with polypill) >25,000<40 Using bypass surgery for less severe coronary artery disease (incremental to treatment with polypill) Very highVery small Other Detecting and treating cervical cancer ,000-60,000 Operating a basic surgical ward at the district hospital level that focuses on trauma, high-risk pregnancy, and other common surgically treatable conditions ,000-15,000 How Much Health Will a Million Dollars Buy?