Cancer, Retroviral Diseases and Global Economy

Abstract

The Human Development Index (HDI), a concept of global socioeconomic subdivision developed by the United Nations based on three characteristics – life expectancy at birth, education and means of decent living – yields four socioeconomic categories: very high, high, medium and low HDI countries. The Gini coefficient, another index used by economists, reflects the distribution of wealth within national boundaries. HDI and Gini indices elucidate the role of poverty in the epidemiology of HIV/AIDS and cancer and other non-communicable diseases, including the consequences of adoption of affluent lifestyles in low- and middle-income countries. High incidence especially of the cancers of the colon, breast, prostate and stomach characterize cancer epidemiology of the high/very high HDI countries, constituting the so-called “cancers of industrialization.” The concept of “double burden” relates to the persistence of high prevalence of communicable diseases in low and middle HDI countries in addition to acquisition of diseases of affluence characteristic of the high/very HDI countries, including obesity and the related diseases like diabetes and cardiovascular disorders and “cancers of industrialization”. Transition in global cancer epidemiology is illustrated by the inverse relationship between the incidence of breast cancer and that of cervical cancer in high/very high and medium HDI countries. In Uganda, a low HDI country, however, the incidences of both cancers are increasing. External funding of health care is discordant with disease burden in recipient countries of medium and low HDI, indicating the need for reappraisal by both local and external sources in the management of health priorities.