A Massive Wave of Chronic Disease in China and India
When most people think of global health they think of infectious diseases and all of the associated images this conjures up (and it is harder to capture provocative images of chronic diseases). However, as we have empahsized before, developing countries are facing a dual burden of both chronic and infectious diseases.
This past Tuesday I was privileged enough to attend the launch of the new Health Affairs issue on global health in China and India. I was joined by an esteemed panel of guests who gave great presentations about various issues facing these two nations. Unfortunately I don’t have time to summarize all of their talks but encourage you to read them in the latest issue. I want to focus on Dr. Somnath Chatterji’s paper because the projections of the aging of China and India are quite stunning and the associated social and economic implications will be profound.
Somnath Chatterji runs the WHO’s Study on Global Ageing and Adult Health (SAGE). Here are some highlights from his paper and quotes I picked up (these are based on my hand written notes, so please forgive any factual mistakes):
The pace of change is stunning – what took 100 years in France (the graying of the population) is going to take place in 30 years in China/India (I can’t remember which one he specified). “Aging has been on the backburner…but China and India are facing dramatic demographic shifts in very short periods of time”.
By 2030, 65.6 percent of the Chinese and 45.4 percent of the Indian health burden are projected to be borne by older adults.
By 2019 in China and 2042 in India, the proportion of people age sixty and older will exceed that of people ages 0–14.
Within the next 20 years there will be 42 million diabetics in China and 80 Million in India.
“In four decades 40% of the worlds elderly population will be in China and India…these countries are getting older before they get richer”.
“Traditionally, people think of chronic diseases as diseases of the of the rich, this is probably not going to be true for China and India…we really need longitudinal data to track this”.
There are dozens of issues that come to mind when hearing these projections, some of which include – access, who will get access to care? how will the delivery system be set up for this? where will the focus be (primary care?)? how will this be financed at both health system level and a household level – how much payment will be borne by the patient? can we use capacity developed for tackling infectious diseases for chronic diseases (a very different ballgame in some ways)? what will be the role of the private sector? if the private sector gets involved heavily to sell their drugs and devices in this new “market” – will that lead to better infrastructure for delivery and distribution of medical supplies? how will this impact the economic growth of these countries? There are many more pressing questions, but I will stop here.
Another one of the articles in this global health issue is on obesity in China. This paper is authored by one of world’s leading experts in nutrition (Barry Popkin). We covered some of this before in a recent issue of Scientific American and here is the link for the new paper. Kudos to Health Affairs for the issue and to Burness Communications for a well run launch.