Reducing the Burden of Communication Disorders in the Developing World

Abstract

AT THE MILLENNIUM SUMMIT IN SEPTEMBER 2000 IN New York, leaders of 189 countries, including 147 heads of state and government, adopted the United Nations Millennium Declaration, committing their nations to a global partnership to work toward 8 development goals. This project has since emerged as the global priority for resource allocation to the developing world through 2015. Three of the 8 goals—“to reduce child mortality,” “improve maternal health,” and “combat HIV/AIDS, malaria and other diseases”—are directly related to health, while the others—“to eradicate extreme poverty and hunger,” “achieve universal primary education,” “promote sex equality and empower women,” “ensure environmental sustainability,” and “develop a global partnership for development”—are indirectly linked to health. Eight of the 18 targets and 18 of the 48 indicators are health related. However, given the myriad problems confronting most developing countries, it is not surprising that some conditions received less attention and others were overlooked or forgotten outright. The World Health Organization (WHO) and other groups have drawn attention to the prevention of chronic diseases, which accounted for an estimated 35 million deaths in 2005. Although health status is often measured in terms of mortality trends, there is a growing recognition of the disease burden associated with diverse health conditions besides mortality. For example, cardiovascular diseases, diabetes, and cancer not only account for high mortality rates but also cause physical and functional disabilities. Based on the current WHO definition, disability is viewed more within the context of a health condition or disorder that limits activity and that may restrict participation in daily life situations for the affected individuals. Paradoxically, most disabilities are life-long and therefore constitute chronic diseases. Health care systems in the developing world, where 80% of the more than 600 million individuals with disabilities worldwide reside, rarely make provision for adequate intervention services. The millennium development project now presents a unique opportunity to redress the neglect of disabilities in the developing world.