Chronic Disease in Developing Countries: Not Just Americans are Getting Fat

Health relief efforts in poor, developing countries abound.  From organizations like the Bill and Melinda Gates Foundation funding malaria research to Catholic Relief Service's $48 billion global effort to prevent and treat HIV, organizations across the globe throw resources towards eradicating acute illness and infection in places like Africa.  But is focusing on infectious disease still the best approach for addressing health care needs of individuals living in poor, developing countries?

Traditionally, chronic diseases like heart disease and diabetes have affected wealthy nations.  Living in excess, wealthy individuals consume diets high in fat as well as large amounts of alcohol.  They are able to find poor heath habits such as smoking.  But this trend is beginning to change.  As many countries continue to develop, the diets of westerners are creeping into new cultures.  Cigarettes and alcohol are becoming more prevalent.  Individuals in poor countries are living longer thanks to efforts to stamp out infectious disease.  however, now individuals living in these countries must face the diseases associated with aging.

According to The Economist developing countries are ill-prepared to deal with growing numbers of individuals suffering from chronic disease.  In Uganda, for example, there is only one hospital that treats cancer in a country of 34 million.  By the time patients save enough money to afford treatment, "it is too late" states the hospital's director.  Most patients die within weeks of being admitted.  Kidney failure, a complication of diabetes, is also described as a death sentence in Uganda; the country is home to only seven dialysis machines.  Similarly, in India, medical resources are lacking.  Resources are so limited that competition has driven the price of a kidney transplant to $40,000, an exorbitant amount in a country where 27% of the population earns less than 40 cents a day.

The World Health Organization reports that 80 percent of deaths related to chronic disease now occur in low and middle income countries.  In some African countries, half of the population is suspected to have hypertension.  Obesity rates have doubled in every region around the world from 1980 to 2008.  While inexpensive medications and easily accessible medical resources have helped to decrease risk of death related to chronic disease, these resources and medications have not yet reached developing countries. 

In Africa, chronic illness is expected to surpass infectious disease as the leading killer by 2030 reports The Economist.  However, only 3% of health aid to developing countries goes toward combating chronic disease.  Some drug companies have attempted to help in the relief effort by donating free insulin, but this aid is a drop in the ocean compared to the growing need for chronic health services and medications.

Are you involved in any non-profit health care organizations?  Perhaps nurse practitioners can help raise awareness of the need for chronic disease management in developing countries and encourage non-profit organizations to fund this cause.