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NCDs cause 7 out of 10 deaths worldwide — 186 country analysis

Seven out of 10 deaths worldwide were caused by non-communicable diseases (NCDs) in 2016, particularly cancer, cardiovascular diseases, chronic respiratory diseases, and diabetes. Health-e News reports that people living in low-income and middle-income countries, especially in sub-Saharan Africa, central Asia and eastern Europe, had the highest risk of dying from NCDs.

This is according to an analysis of 186 countries by “NCD Countdown 2030”. NCD Countdown 2030 is a collaboration led by The Lancet, World Health Organisation, Imperial College London and the NCD Alliance.

The report says the research comes shortly before next week’s UN High-Level Meeting on NCDs on 27 September, 2018, which will review national and global progress towards the prevention and control of NCDs.

More than half of all countries are predicted to fail to reach the UN target to reduce premature deaths from the four major NCDs by 2030. Women living in Sierra Leone and Cote d’Ivoire were most at risk of dying of NCDs, while Lesotho and Swaziland featured in the 10 most risky countries. Curiously, South Africa featured at 41 despite diabetes being the biggest killer of women. South Korea and Japan held the lowest risk for women.

For men, Mongolia, Kazakhstan, Russia and Fiji were the most-risky countries, while South Africa was 17th worst. The safest countries for men were Iceland, Switzerland, Sweden and Norway.

Professor Majid Ezzati, from Imperial College London, who led the study, is quoted in the report as saying: “NCDs are the main cause of premature death for most countries. Poverty, uncontrolled marketing of alcohol and tobacco by multinational industries, and weak health care systems are making chronic diseases a larger danger to human health than traditional foes such as bacteria and viruses.”

Ezzati explained that, while much of the world is failing to alleviate the burden of chronic diseases, “dozens of countries could meet this goal with modest acceleration of already-favourable trends”.

“Treatment of hypertension and controlling tobacco and alcohol use alone can prevent millions of deaths from cancer, heart disease, stroke and other NCDs. But there is also a need for affordable high-quality care to diagnose and treat chronic diseases as early as possible,” said Ezzati.

“We are sleepwalking into a sick future because of severely inadequate progress on NCDs,” said Katie Dain, who heads the global NCD Alliance. “Post the UN High Level Meeting, NCD Countdown 2030 will assist in holding governments and donors accountable and help to ensure that the opportunity before us next week to renew, reinforce, and enhance commitments to reducing the burden of NCDs, translates the rhetoric into reality.”

Summary
The third UN High-Level Meeting on Non-Communicable Diseases (NCDs) on Sept 27, 2018, will review national and global progress towards the prevention and control of NCDs, and provide an opportunity to renew, reinforce, and enhance commitments to reduce their burden. NCD Countdown 2030 is an independent collaboration to inform policies that aim to reduce the worldwide burden of NCDs, and to ensure accountability towards this aim. In 2016, an estimated 40·5 million (71%) of the 56·9 million worldwide deaths were from NCDs. Of these, an estimated 1·7 million (4% of NCD deaths) occurred in people younger than 30 years of age, 15·2 million (38%) in people aged between 30 years and 70 years, and 23·6 million (58%) in people aged 70 years and older. An estimated 32·2 million NCD deaths (80%) were due to cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes, and another 8·3 million (20%) were from other NCDs. Women in 164 (88%) and men in 165 (89%) of 186 countries and territories had a higher probability of dying before 70 years of age from an NCD than from communicable, maternal, perinatal, and nutritional conditions combined. Globally, the lowest risks of NCD mortality in 2016 were seen in high-income countries in Asia-Pacific, western Europe, and Australasia, and in Canada. The highest risks of dying from NCDs were observed in low-income and middle-income countries, especially in sub-Saharan Africa, and, for men, in central Asia and eastern Europe. Sustainable Development Goal (SDG) target 3.4—a one-third reduction, relative to 2015 levels, in the probability of dying between 30 years and 70 years of age from cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes by 2030—will be achieved in 35 countries (19%) for women, and 30 (16%) for men, if these countries maintain or surpass their 2010–2016 rate of decline in NCD mortality. Most of these are high-income countries with already-low NCD mortality, and countries in central and eastern Europe. An additional 50 (27%) countries for women and 35 (19%) for men are projected to achieve such a reduction in the subsequent decade, and thus, with slight acceleration of decline, could meet the 2030 target. 86 (46%) countries for women and 97 (52%) for men need implementation of policies that substantially increase the rates of decline. Mortality from the four NCDs included in SDG target 3.4 has stagnated or increased since 2010 among women in 15 (8%) countries and men in 24 (13%) countries. NCDs and age groups other than those included in the SDG target 3.4 are responsible for a higher risk of death in low-income and middle-income countries than in high-income countries. Substantial reduction of NCD mortality requires policies that considerably reduce tobacco and alcohol use and blood pressure, and equitable access to efficacious and high-quality preventive and curative care for acute and chronic NCDs.

Authors
NCD Countdown 2030 collaborators

[link url="https://www.health-e.org.za/2018/09/21/ncds-cause-70-percent-of-deaths/"]Health-e News report[/link]
[link url="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31992-5/fulltext"]The Lancet article summary[/link]

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