doha

1. Magnitude and trends of
noncommunicable diseases

2. Distribution of deaths by leading cause groups
(males and females, world, 2004)

3. NCDs cause premature deaths in LMICS

4. Projected deaths by cause and income (2004 to 2030)
WHO
0
5
10
15
20
25
30
2004 2015 2030 2004 2015 2030 2004 2015 2030
Deaths(millions)
High income Middle income Low income
HIV, TB, malaria
Other infectious
Mat//peri/nutritiona
l
CVD
Cancers
Other NCD
Road traffic
accidents
Other unintentional
Intentional injuries

5. Launched October 2008
Noncommunicable Diseases
Burden of disease in disability adjusted life years (2004)

6. 0% 1% 2% 3% 4% 5% 6% 7% 8% 9% 10%
Underweight
Unsafe sex
High blood pressure
Tobacco
Alcohol
Unsafe water, S&H
High cholesterol
Indoor smoke from solid fuels
IIron deficiency
High BMI
Zinc deficiency
Low fruit and vegetables
Vitamin A deficiency
Physical inactivity
Occupational injury risks
Lead exposure
Illicit drugs
Unsafe health care injections
Lack of contraception
Childhood sexual abuse
Attributable DALYs (% total 1.44 billion)
Low and middle income
High income
Noncommunicable Diseases
Global burden of disease attributable top 20 risk factors (2002)
WorldHealthReport,2002)

7. Noncommunicable Diseases
Tobacco is a risk factor for 6 of the 8 leading causes of death
(WorldHealthStatistics,2008)

8. Tobacco
Rising production and consumption in developing countries

9. Smoking prevalence in Bangladesh (1995)
Source: Sen, B & Hulme D, 2004
Tobacco: The poor and uneducated are the ones who smoke the most

10. Overweight and obesity in people over 15 selected countries
0
10
20
30
40
50
60
70
80
90
100
Nauru(1stin
theglobal
USA
Kuwait
Egypt
Brunei
Belarus
Azerbaijan
Albania
Armenia
Russia
Lesotho
Turkmenistan
Ukraine
Georgia
DrKorea
Kazakhstan
Swaziland
Kyrgyzstan
%
Prevalence of overweight (BMI>25) Prevalence of obesity (BMI>30)

11. The epidemiological transition in this
region is already well advanced; all
countries are at risk irrespective of
income and socioeconomic development

12. Adult mortality (2004)
0 2 4 6 8 10 12
Africa
Europe
South East Asia
Eastern Mediterranean
Americas
Western Pacific
High income
Death rate per 1000 adults aged 15–59 years
Cardiovascular diseases
Cancers
Other noncommunicable diseases
Injuries
HIVAIDS
Other infectious and parasitic diseases
Maternal and nutritional conditions

13. Prevalence of tobacco use among males in the
Eastern-Mediterranean Region
Launched February 2008

14. Noncommunicable Diseases
Adult Overweight and Obesity in Arab Countries

15. Noncommunicable Diseases
Overweight among school children (13-15 yrs old)*
% overweight or at
risk of overweight**
Djibouti 12.3
Egypt 20.6
Jordan 16.8
Lebanon 18.4
Libya 21.7
United Arab
Emirates
33.2
*Results from the Global School-based Student Health Survey
(http://www.who.int/chp/gshs/factsheets/en/index.html)
**overweight or at risk of becoming overweight=above the 85th
percentile

16. Noncommunicable Diseases
Age-adjusted estimates of diabetes prevalence in the
Eastern-Mediterranean Region
(Source:ComparativeDMprevalence,table1.12and1.13ofDiabetesAtlas)
Adults (20-79)

17. SOCIOECONOMIC ASPECTS

18. Impact of increasing medical costs and the need
for prevention
• Total Health Expenditure per capita ranges between US$ 325 to
2750
• Out of pocket spending ranges between 18-23% THE
• Advanced epidemiological and demographic transitions are
expected to result in a several fold increase in health care spending
in Gulf Cooperation Countries in the coming 2 decades
• Prevention has to be taken seriously
Sources: WHO WHR 2008,- WHO NHA database, WHO-EMRO, Mapping health care financing, EMR
countries

19. Catastrophic Expenditures
• Studies in some Arab countries show that 2-4.5 % of the population
face catastrophic expenditures – meaning spending 40 % or more
from their disposable income (excluding food), when a member of
the family becomes sick
• 5.5 - 13 millions individuals may face such situation every year
• 1-1.4 % of the households are pushed into poverty when a member
of the family becomes ill, resulting into 2.5 to 4 millions of poor
individuals for the whole region
(Source: B. Sabri – WHO/EMRO)

20. Proportion of family income devoted to diabetesProportion of family income devoted to diabetes
carecare
0
5
10
15
20
25
30
35
40
Hi Upper Mdl Middle Low
Income level
Percent
1998
2005
Source: Ramachandran A Diabetes Care 2007

21. In Conclusion: Barrier to Development
• CVDs and other NCDs Will Further Widen the Health
Gap between Rich and Poor Countries
• They Are Killing and Disabling People at Their Peak
Productivity
• They Will Slow Economic Growth Rates in Poor
Countries