NCDs: A 47 Trillion Dollar Problem We Cant Ignore

Posted on: March 18th, 2013 by Nalini

This was originally published in the Indiaspora blog on March 18, 2013. You can follow Indiaspora on Twitter @IndiasporaForum.

As Indian Americans, we have a lot to be proud of in our communities and in the changes underway in India. Today, to protect our families and this remarkable progress, we must address one of the greatest health and development challenges of the century, the rise of non-communicable diseases (NCDs). NCDs, including diabetes, heart disease, cancer, and chronic lung diseases, have thus far escaped our attention and collective action.

The Rising Threat of NCDs

NCDs kill 2 out of 3 people today – six times as many as from HIV, TB and Malaria combined, making them the greatest threat to health and development that you’ve never heard of. It’s a mistake to consider these diseases of affluence – 80% of the deaths are in developing countries, and NCDs hit the poorest of the poor the hardest. It’s true that India and other developing countries have raised standards of living and made great strides against many infectious diseases, but there is little time to celebrate: the recent Global Burden of Disease report from the World Health Organization established that while infectious disease is decreasing, the prevalence of NCDs is increasing rapidly around the world.

It is to address this epidemic that I started a non-profit, Arogya World, a couple of years ago. We take a proactive approach to preventing NCDs and engage with individuals and health policy leaders alike on the issue. Our name is aligned with our mission – the word Arogya in Sanskrit means to live a life without disease.

NCDs Matter to all Indian Americans

In India, the country of our origin, 20% of the population has at least 1 chronic disease, and 10% suffer from 2 or more.

  • Some 60 million Indians live with diabetes and 1 million die from it each year.
  • Indians get diabetes at least 10 years earlier than Americans, often in their 30s and 40s rather than in their 50s or 60s. We likely have a greater pre-disposition to diabetes than other Americans.
  • In the US, where we live, the diabetes figures are no less alarming. Some 26 million Americans have diabetes – nearly 1 in 10. More than one-third of Americans are obese and by 2030 half of us will be.

The combination of our genetic profile and Western lifestyle means that the risk for diabetes is alarmingly high for Indian Americans – it is for us a double whammy.

Why are Indians more prone to diabetes?

  • Combine the presumed genetic predisposition with today’s sedentary lifestyles and love of fast food and you have big risk factors.
  • New research also suggests that low birth weight can lead to diabetes later in life. Malnourished mothers in India often have low birth weight babies, which in turn may increase the risk of diabetes and heart disease when the child grows up.
  • And indeed even something as seemingly innocuous as mealtimes can have an influence. A recent study showed that eating dinner late in the evening can increase the risk of diabetes. And we know that among Indians serving dinner at 10 pm is not considered late!

There is Hope in Prevention

Diabetes is preventable. We don’t need to wait for a new technology or vaccine. There is compelling proof from landmark clinical studies that moderate exercise and a healthy diet can prevent diabetes and keep it at bay for at least 10 years. According to the World Health Organization 80% diabetes, 80% heart disease and 40% cancers can be prevented by avoiding tobacco, increasing physical activity and eating healthy foods.

Unfortunately, diabetes is so commonplace we are lulled into inaction. The hard truth is that diabetes is the leading cause of preventable blindness, and leads to heart disease, kidney disease, nerve damage and even amputations. The healthcare costs are staggering. The World Economic Forum (WEF) ranked NCDs as one of the greatest risks to global well-being – similar in magnitude to the fiscal crises we read so much about. WEF projects a cumulative loss of $47 trillion to global GDP by the year 2030 from NCDs. Staggering, to say the least. Poor families in India, for example, may spend 25% of their total income on diabetes care for one adult.

Prevention through lifestyle changes is at the core of Arogya World’s work. In India, we are educating and empowering housewives and farmers, working adults and school children to take small steps towards preventing diabetes by leading healthier lives. Our flagship program, called mDiabetes, is a Clinton Global Initiative commitment. In partnership with Nokia, we have reached over 1 million people in India with diabetes prevention text messages. See, follow us on Twitter and join us on Facebook. This is a big year for us, and we invite you to watch how our small but “mighty” organization is reaching more people and having a greater impact than ever before.