Access to essential medicines and standard treatment for chronic diseases

Abstract

Chronic diseases have emerged as a major killer globally. Nearly 60% of all deaths in the world are caused by chronic ailments such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes. The World Health Organization (WHO) reports that of the 35 million (60%) people who died from chronic diseases in 2005, half were under 70, and half were women. Of these, 72% deaths were estimated to have occurred in developing countries, indicating an epidemiologic transition in these countries. In India, chronic diseases contribute to an estimated 53% of the deaths and 44% of disability-adjusted life-years lost.[1] A study conducted in 45 villages in East and West Godavari in Andhra Pradesh shows that noncommunicable diseases are a leading cause of death in rural India.[2] The implications of these findings are far-reaching. Chronic diseases are a serious public health issue, particularly because they require long-term therapy. Management of chronic diseases has a complex and adverse impact on health systems in countries like India, which are already burdened with the unfinished agenda of communicable diseases as well as maternal and child health problems. Ensuring access to medicines for treating chronic diseases, however, remains neglected in most developing countries. Generally, the focus is on improving access to medicines for treating infectious diseases. For chronic diseases, prevention is the priority. However, it is well established that in addition to prevention, treatment of chronic diseases should form an essential component of any comprehensive public health programme. Chronic diseases have a multidimensional impact on the community as well as on the individual, and require a lot of healthcare resources for their management. At the individual level, one faces financial problems, which is one of the most important reasons of non-compliance, resulting in complications. At the national level, chronic diseases have a huge economic impact. The WHO reports that India could forgo US $236 billion in national income over the next 10 years as a result of heart disease, stroke, cancer and diabetes.[3] Hence, this largely invisible epidemic of chronic diseases must be addressed through necessary actions by policy makers, regulators, doctors and researchers.