Silent killers: pandemic of the 21st century

Noncommunicable diseases like diabetes, high blood pressure and cancer are the leading cause of death worldwide. All the same, infectious or communicable diseases such as HIV, tuberculosis and malaria, have dominated the attention of policy makers, funders, public health practitioners and the general public alike, for the last few decades. With this attention, we have gained some control on these types of disease and people are living longer. Also, urbanization is occurring at an unprecedented scale – individuals are being exposed to richer diets and being given fewer opportunities for exercise with vehicles for transportation and crowded living spaces. Given these factors, the silent killers, noncommunicable diseases, are taking over. 

The Institute for Health Metrics demonstrated that between 1990 and 2013, those diseases amongst the top ten causes of death that were due to NCDs, cardiovascular disease, neoplasms (cancers), chronic respiratory disease (such as asthma and chronic obstructive pulmonary disease, COPD), diabetes, and neurologic disorders (such as seizures), all remained the same in terms of disease burden or increased in prevalence.

{mosads}I have seen the repercussions of this shift in disease burden in my own personal experience, being Kenyan-American, and having the vast majority of my extended family back in this developing country in East Africa. Over the last decade, I’ve had two family members that lost their lives to easily preventable complications of diabetes, a grandmother who died due to complications of heart disease, a dear friend that lost her life to brain cancer, another that lost her life as a result of mental illness and suicide, a close family friend that received a kidney transplant due to complications of kidney disease, and my own mother has dealt with breast cancer twice. Most of these afflictions occurred while the individuals were under the age of 60, and all of them were still economically active. All of them either affected, or left behind loving families, friends and communities.

Late last month, the United Nations released their current development goals, the first new round since fifteen years ago.  As a result of the UN’s previous goals, we have realized some of the greatest improvements in public health issues ever seen. Past goals have contributed to a reduction of 17,000 fewer child deaths per day, nearly half the rates of maternal death, 10 million people receiving HIV medications, and 3 million more deaths from malaria prevented. However, NCDs were slighted in this agenda-setting scheme by the UN in 2000.  Finally, this time around, NCDs were brought up in this round of goals including promoting mental health, addressing substance abuse and deaths due to injury. This is an encouraging start but we have a long way to go given the burden of disease that has already accumulated, lacking attention for the last two decades. 

The reality of the burden of NCDs cannot be ignored, and deserves the attention that is being allotted to other diseases. Policies need to be constructed that provide resources for treatment centers, guidelines and ensure appropriate access to medications for treating these diseases. Health providers need training and equipment to be able to diagnose and treat them. Individuals, the recipients of healthcare, need to become more involved. We need increased awareness on how bad the situation really is, education on risk factors associated with these diseases and information on how to reduce one’s risk of progressing to debilitating complications including stroke or heart attack. Early action is paramount for these types of illnesses, we know what to do, and the tools for solutions are readily available. The time for action is now.

Ngaruiya  is a faculty member in Global Health and International Emergency Medicine at Yale, and a Public Voices fellow with the OpEd Project.