1. noncommunicable diseases
Magnitude and trends of
noncommunicable diseases I

2. Distribution of deaths by leading cause groups (males and females, world, 2004)

3. NCDs cause premature deaths in LMICS3

4. Projected deaths by cause and income (2004 to 2030)
WHO
Intentional injuries
Other unintentional
Road traffic accidents
Other NCD
Cancers
CVD
Mat//peri/nutritional
Other infectious
HIV, TB, malaria

5. Noncommunicable Diseases Burden of disease in disability adjusted life years (2004)
Launched October 2008

6. Noncommunicable Diseases Global burden of disease attributable top 20 risk factors (2002)
Underweight
Unsafe sex
High blood pressure
Tobacco
Alcohol
World Health Report, 2002)
Unsafe water, S&H
High cholesterol
Indoor smoke from solid fuels
IIron deficiency
High BMI
Zinc deficiency
Low and middle income
Low fruit and vegetables
High income
Vitamin A deficiency
Physical inactivity
Occupational injury risks
Lead exposure
Illicit drugs
Unsafe health care injections
Lack of contraception
Childhood sexual abuse 0% 1% 2% 3% 4% 5% 6% 7% 8% 9%
10%
Attributable DALYs (% total 1.44 billion)

7. Noncommunicable Diseases Tobacco is a risk factor for 6 of the 8 leading causes of death
(World Health Statistics, 2008)

8. Tobacco Rising production and consumption in developing countries8

9. Tobacco: The poor and uneducated are the ones who smoke the most
Smoking prevalence in Bangladesh (1995)
Source: Sen, B & Hulme D, 2004

10. Overweight and obesity in people over 15 selected countries

11. The epidemiological transition in this region is already well advanced; all countries are at risk irrespective of income and socioeconomic development

12. Adult mortality (2004)

13. Prevalence of tobacco use among males in the Eastern-Mediterranean Region
Launched February 2008

14. Noncommunicable Diseases Adult Overweight and Obesity in Arab Countries

15. Noncommunicable Diseases Overweight among school children (13-15 yrs old)*
% overweight or at
risk of overweight**
Djibouti
12.3
Egypt
20.6
Jordan
16.8
Lebanon
18.4
Libya
21.7
United Arab Emirates
33.2
*Results from the Global School-based Student Health Survey (
**overweight or at risk of becoming overweight=above the 85th percentile
T this is becoming an issue of major concern when we look at trends in school children where you see worrying figures

16. Noncommunicable Diseases Age-adjusted estimates of diabetes prevalence in the Eastern-Mediterranean Region
(Source: Comparative DM prevalence, table 1.12 and 1.13 of Diabetes Atlas)
I mentioned diabetes. Top is GCC. This does not show the prevalence of the so called prediabetes- sometimes on third of the adult population
Adults (20-79)

17. SOCIOECONOMIC ASPECTS

18. Impact of increasing medical costs and the need for prevention
Total Health Expenditure per capita ranges between US$ 325 to 2750
Out of pocket spending ranges between 18-23% THE
Advanced epidemiological and demographic transitions are expected to result in a several fold increase in health care spending in Gulf Cooperation Countries in the coming 2 decades
Prevention has to be taken seriously
Sources: WHO WHR 2008,- WHO NHA database, WHO-EMRO, Mapping health care financing, EMR countries
Forecasts are made on the increase in health spending as a result of advanced epidemiological and demographic transitions. Calculations based on current data including a recent study done forecasting a five fold increase in health care spending in Gulf Cooperation Countries in the coming 2 decades.
This means an enormous increase in spending which may overwhelm even high income countries. Cost containment strategies and programs have to be considered seriously but the main realistic approach should be based on taking prevention seriously.

19. Catastrophic Expenditures
Studies in some Arab countries show that % of the population face catastrophic expenditures – meaning spending 40 % or more from their disposable income (excluding food), when a member of the family becomes sick
millions individuals may face such situation every year
1-1.4 % of the households are pushed into poverty when a member of the family becomes ill, resulting into 2.5 to 4 millions of poor individuals for the whole region
(Source: B. Sabri – WHO/EMRO)
There is a higher prevalence of catastrophic expenditure in people with CVD. Studies in some Arab countries including Morocco and Tunisia have shown that % of the population face catastrophic expenditures – meaning spending 40 % or more from their disposable income (excluding food), when a member of the family becomes sick. Extrapolating these figures to the whole Arab World – excluding GCC countries, one finds that from 5.5 to 13 million individuals face such situation every year.
This can be impoverishing.
Another WHO study showed that % of the households are pushed into poverty when a member of the family becomes ill, resulting into 2.5 to 4 millions of poor individuals for the whole region.

20. Proportion of family income devoted to diabetes care
Tis is just an example from a country outside the region showing how a considerable part of the family income in LICs is spent on chronic diseases like CVD and diabetes . The impact is much more among low income group. Up to 25% of income is spent on management of diabetes in tis case
Source: Ramachandran A Diabetes Care 2007

21. In Conclusion: Barrier to Development
CVDs and other NCDs Will Further Widen the Health Gap between Rich and Poor Countries
They Are Killing and Disabling People at Their Peak Productivity
They Will Slow Economic Growth Rates in Poor Countries 21