Sandra Rosenhouse

Capitalizing on the Demographic Transition: Tackling Noncommunicable Diseases in South Asia

This book looks primarily at Cardio Vascular Disease (CVD) and tobacco use because they account for a disproportionate amount of the Non Communicable Disease (NCD) burden the focus is strategic rather than comprehensive. It considers both country and regional level approaches for tackling NCDs, as many of the issues and challenges of mounting an effective response are common to most South Asian countries. The prevention and control of NCDs constitute a development issue that low-income countries in South Asia are already facing. Both country and regional-level strategies are important because many of the issues and challenges of mounting an effective response to NCDs are common to most South Asian countries, even though their disease burden profiles vary. Hence, the rationale for this book is that strategic decisions for prevention and treatment of NCDs can effectively address the future burden of disease, promote healthy aging, and increase the potential benefit from the demographic transition, thus contributing to economic development. This books goal is to encourage countries to develop, adopt, and implement effective and timely country and regional responses that reduce the population-level risk factors and NCD disease burden.

The Economic Effect of Noncommunicable Diseases on Households and Nations: A Review of Existing Evidence

In developing countries, the noncommunicable disease (NCD) and risk factor burdens are shifting toward the poor. Treating chronic diseases can be expensive. In developing countries where generally much health care costs are borne by patients themselves, for those who live in poverty or recently escaped severe poverty, when faced with large, lifelong out-of-pocket expenses, impoverishment persists or can reoccur. These patterns have implications for national economic growth and poverty-reduction efforts. NCDs can change spending patterns dramatically and result in significantly reducing non–medical-related spending on food and education. In India, about 40% of household expenditures for treating NCDs are financed by households with distress patterns (borrowing and sales of assets). NCD short- and long-term disability can lead to a decrease in working-age population participation in the labor force and reduce productivity and, in turn, reduce per capita gross domestic product growth. To fully capitalize on the demographic dividend (i.e., aging of the population resulting in less dependent children, not yet more dependent elderly, and greater national productivity), healthy aging is necessary, which, in turn, requires effectively tackling NCDs. Last, from an equity standpoint, the economic effect of NCDs, evident at the household level and at the country level, will disproportionately affect the poor and vulnerable populations in the developing world.