Poverty and Human Development

Abstract

Cardiovascular disease (CVD) is absent from the global development agenda. This absence is striking, because CVD is a major impediment to human development, imposing large health and economic burdens in low- and middle-income countries. These burdens have a reciprocal relationship in that poverty is a potent cause of CVD, whereas CVD contributes to poverty. The present editorial explores and seeks to explain the global neglect of CVD in pursuit of a strategy for its prevention and control worldwide. Chronic (noncommunicable) disease, principally CVD, cancer, chronic respiratory disease, and diabetes mellitus, caused 35 million deaths (60% of all deaths) in 2005. CVD (mainly heart disease and stroke) is the leading chronic disease, with 17 million deaths. The contribution of diabetes mellitus is underestimated; deaths due to diabetes are usually recorded as being due to heart disease or renal failure. CVD is also responsible for much disability, often for decades of a person’s life. Nearly half of the global burden of disease is caused by chronic diseases, and CVD is the leading contributor among these.1 Although the CVD burden and trends vary from country to country,2,3 from a human development perspective, 4 aspects of the burden of CVD are critical. First, the number of CVD deaths is similar in men and women, although the average age of onset is older in women than in men, so no gender bias exists in the burden of CVD that might remove it from development agendas.4 Second, the poorest countries are often deeply affected. CVD deaths are spread evenly among the developed and developing world; this is not a disease specific to wealthy nations. Of the world’s population, 80% of people live in developing nations, and 80% of all CVD deaths, occur in countries with a per capita income in 2001 of less …