Chronic diseases could cost $47 trillion over the next 20 years: Report

By Dr. Ananya Mandal, MDSep 19 2011

A latest report by the World Economic Forum (WEF) suggests that the global economic impact of the five leading chronic diseases -- cancer, diabetes, mental illness, heart disease, and respiratory disease - could reach $47 trillion over the next 20 years.

The estimated cumulative output loss caused by the illnesses, which together already kill more than 36 million people a year and are predicted to kill tens of millions more in future, represents around 4 percent of annual global GDP over the coming two decades, the study said.

Eva Jane-Llopis, WEF's head of chronic disease and wellness, said, “This is not a health issue, this is an economic issue -- it touches on all sectors of society.” The research was published on Sunday, the eve of a two-day United Nations meeting on chronic, or non-communicable diseases (NCDs), which aims to draw up global action plans to tackle growing levels of death and illness from these costly diseases often linked to diet, tobacco, alcohol and exercise.

According to the World Health Organization (WHO), the worldwide NCD epidemic is expected to accelerate so that by 2030 the number of deaths from NCDs could reach 52 million a year. Earlier these NCDs were believed to affect only the rich countries but these now disproportionately affect those in poorer nations. More than 80 percent of NCD deaths are among people in low and middle income countries.

The WEF study, which was conducted with Harvard School of Public Health, found the cumulative costs of heart diseases, chronic respiratory diseases, cancer and diabetes in these poorer countries are expected to top $7 trillion in 2011-2025, an average of nearly $500 billion a year. Mental health, which is typically left off lists of leading NCDs, will account for $16 trillion - a third of the overall $47 trillion anticipated costs.

In 2010, the global direct and indirect cost of heart diseases - which currently kill more than 17 million people a year - was around $863 billion and is estimated to rise 22 percent to $1,044 billion by 2030. Overall, the cost for heart diseases could be as high as $20 trillion over the 20 year period, it said.

Increasing costs from the obesity- and lifestyle-linked illnesses in the next two decades represent 75 percent of gross domestic product in 2010.

An ageing population brings a new set of critical health challenges. Alzheimer's disease and other dementias, for example, affect 12% of those over 65 and more than 30% of those over 85. Over the next two decades, the number of people aged 65 and older suffering from diabetes is expected to increase by 134%. And then there's cancer, which, according to one British study, is six times more likely to affect women aged 60 to 64 than women aged 35 to 38.

Olivier Raynaud, the WEF's senior director of health, said the study showed how families, countries and economies are losing people in their most productive years. “Until now, we've been unable to put a figure on what the World Health Organization calls the 'world's biggest killers',” he said in a statement. But these numbers suggest NCDs “have the potential to not only bankrupt health systems but to also put a brake on the global economy,” he added.

The study uses three different methods to calculate the economic burden of non-communicable diseases, enabling the authors to analyze data from both a private and social perspective, they said. “Non-communicable diseases undermine productivity and result in the loss of capital and labor,” said David Bloom, the Clarence James Gamble professor of economics and demography at the Harvard School of Public Health in Boston, and one of the report’s authors. “These costs are unbearable and clearly call for innovative solutions and an all-of-society approach, with strong government partnerships between government, the private sector and society,” Bloom said in a statement.

“The most basic package of prevention and control measures is affordable, even for poor countries,” said Ann Keeling, chief executive officer of the NCD Alliance, a network of more than 2,000 non-government organizations working on non- communicable diseases, in a statement. “But the cost of not tackling these growing killers is inestimably higher than the cost of acting now.”

The U.N. meeting is the only second-ever such high-level meeting to be held on a threat to global health and has been billed as a “once in a generation” opportunity to tackle the predicted wave of these diseases. But health organizations fear big consumer firms selling processed foods, alcohol and cigarettes could hijack the meeting to protect their own interests and persuade governments away from setting targets or making firm commitments.

“Think of what could be achieved if these resources were productively invested in an area like education,” WEF's executive chairman Klaus Schwab said. “The need for immediate action is critical to the future of the global economy.”

WHO’s recommendation targeting populations include taxing tobacco and alcohol, ensuring smoke-free workplaces, wider access to health information and warnings, and improving public awareness about diets and physical activity. For individuals, WHO recommends cancer screening, drug therapy and vaccination against tumor-causing infections such as hepatitis B.