Cardiovascular disease is a far greater public health problem in developing countries than previously realised, particularly in younger people, says a report published this week.
Figure 1.
Tobacco consumption has to be tackled to reduce heart disease in developing countries
Credit: P VIROT/WHO
The report combined population estimates for five lower to middle income countries—Brazil, South Africa, the Russian republic of Tatarstan, India, and China—with current death rates and workforce data to calculate the effects of cardiovascular disease on society and on the workforce.
Results showed that heart disease and stroke were far more urgent threats to global health than previously thought. A conservative estimate showed that at least 21 million years of future productive life were lost each year in the five countries because of cardiovascular disease. Future predictions were even more disturbing, with the number set to rise to 34 million years of life lost by 2020.
Mortality from cardiovascular disease among working age people in India, South Africa, and Brazil was found to be one and a half to two times as high as that of the United States. Age adjusted death rates for the disease fell by a fifth during the 1990s in the United States but increased by 36% in Tatarstan.
The report showed a major impact of cardiovascular disease on younger people. Death rates for people aged 35-64 years were substantially higher in Brazil, South Africa, Tatarstan, and India than in the United States. In South Africa, 41% of all deaths from heart disease occurred in people aged 35-64 during 2000-3, with a similar high figure (35%) in India.
The report suggested that the solution was to make greater efforts to prevent cardiovascular disease. It recommended several measures: a reduction in tobacco production and consumption; strategies to improve nutrition, including food production subsidies; and educational strategies, including school programmes on healthy nutrition and physical activity.
Derek Yach, a representative of the director general of the World Health Organization, said: “Very little international aid goes into CVD prevention and control.” Only 0.1% of a total of $2.9bn (£1.6bn; €2.4bn) funding from overseas development agencies for 2002 went on chronic diseases such as cardiovascular disease. He suggested this should greatly increase, but not to the detriment of acute programmes such as malaria and tuberculosis prevention.
A Race Against Time: The Challenge of Cardiovascular Disease in Developing Economies is available at www.earthinstitute.columbia.edu