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  • Dr. Ratna Devi & Rajat Jain — India

The lesser-known non-communicable diseases that immobilise lives

Known as non-fatal diseases, conditions ranging from Alzheimer’s to chronic pain and eczema extract an enormous personal and economic toll. Yet they rarely grab the attention of medical forums, researchers or policymakers.

Non-communicable diseases (NCDs) kill over 41 million people each year, with heart disease, stroke, cancer, diabetes and chronic lung disease collectively causing 74% of all deaths worldwide.


More than 15 million people aged 30-69 die each year from an NCD, with low- and middle-income countries accounting for 85% of these "premature" deaths. Besides the above five NCDs, there are others that are a significant cause of disability and loss of quality of life. Conditions such as Alzheimer’s and dementia, chronic pain, chronic kidney disease, skin conditions and eczemas, bone conditions and arthritis cause significant loss of productivity and healthcare expenses. Termed as non-fatal chronic diseases, this group rarely gets mentioned at high-level meetings or other forums, nor during policymaking and funding decisions.


Low-back and neck pain have consistently been leading causes of disability internationally, with other chronic pain conditions featuring prominently in the top 10 causes of disability.

According to a Lancet report dated May 2021, chronic pain exerts an enormous personal and economic burden, affecting more than 30% of people worldwide. The World Health Organization has estimated that osteoarthritis affects nearly 10% of men and 18% of women aged 60-plus; rheumatoid arthritis affects 0.3–1% of the general population; and low-back pain affects 4–33% of the population at any given point.

The Global Burden of Disease Study 2016 reaffirmed that the high prevalence of pain and pain-related diseases is a leading cause of disability and disease burden globally. Worldwide, the burden caused by chronic pain is escalating: 1.9 billion people were found to be affected by recurrent tension-type headache, which is the most common symptomatic chronic condition. Low-back and neck pain have consistently been leading causes of disability internationally, with other chronic pain conditions featuring prominently in the top 10 causes of disability.


However, the problem is not confined to adults, since an estimated 25% of children and adolescents experience chronic pain, with a third reporting severe pain. Additionally, the impact of chronic pain is expected to increase as the effects of population ageing become apparent, and increased levels of obesity and lack of physical activity will increase the incidence of conditions associated with chronic pain.


Eczema, sometimes called atopic dermatitis, is the most commonly prevalent skin condition across race and ethnicity. It affects 11% of white people, 10% of black people, 13% of Asian or Pacific Islander people, and 13% of Native American people. Global Burden of Disease data confirms the substantial worldwide burden of eczema, but there is significant geographical variation. Combined with other conditions like urticaria and psoriasis, as much as 1.8% of the global population is affected. The long-term morbidity that goes with them, such as excruciating itching in eczema and urticaria, or disfigurement in leprosy, are part of the burden of skin diseases. Psoriasis, a chronic inflammatory skin condition, causes illness, disability, disfigurement and arthritis.

Embarrassment caused by visible symptoms and itching in front of others has been linked to societal rejection, anxiety, depression, and suicidal behaviour.

A study, conducted by DakshamA Health in 2021, of people living with eczema in India found that it severely affected their quality of life, disrupted their daily routine, and caused pain due to continuous itching. Embarrassment caused by visible symptoms and itching in front of others has been linked to societal rejection, anxiety, depression, and suicidal behaviour. Loss of jobs, rejection in personal relationships, and the progressive nature of the condition, combined with several myths and misconceptions, led to self-blaming and isolation.


NCDs are complex, diversified, and affect the overall health in a range of ways. A strategic, all-encompassing, and balanced approach to NCD research, treatment, and prevention is necessary to lessen their impact. This approach will also place great value on diseases that are major contributors to health loss but previously overlooked as global health priorities. The only way to guarantee that people living with non-fatal NCDs are heard on a global level is through a concentrated effort to promote international advocacy, research, and education initiatives. Studying the impact of these illnesses and formulating policy initiatives to provide high-quality care are crucial to tackle them.

A holistic and humane view that keeps the patient at the centre of focus would perhaps help break the compartments of fatal and non-fatal NCDs, as many of them co-exist or are intertwined in people with multiple conditions.

Medical science has advanced rapidly to bring a focused and siloed approach to treating diseases. A holistic and humane view that keeps the patient at the centre of focus would perhaps help break the compartments of fatal and non-fatal NCDs, as many of them co-exist or are intertwined in people with multiple conditions. A wellness-oriented healthcare that views the person as a whole being and eliminates or prevents the causative factors of chronic conditions would serve to foster a healthier society, reduce healthcare costs and increase productivity. It’s time we recognised the value of a rounded healthcare system that stops focusing on the curative, compartmentalised approach and embraces a balanced preventive and wellbeing approach.

 

The opinions expressed are those of the authors and do not necessarily reflect the position of Re:solve Global Health.


Dr. Ratna Devi is a medical doctor, and public health and management professional with more than 30 years’ experience working to improve health outcomes in India. She is the CEO and co-founder of DakshamA Health and Education, an organisation working for access to health, patient education and advocacy.


Rajat Jain is working with DakshamA Health in the capacity of Manager - Projects. He is responsible for overseeing the execution and implementation of different research projects. He worked in the UK in an independent pharma market research firm before permanently moving to India. He holds a bachelor’s degree in computer engineering from Narsee Monjee Institute of Management Studies and a master's degree in international business from the prestigious University of Sheffield.





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