Cardiovascular disease is ravaging India and China. Unfortunately, though, the people of such low- and middle-income countries (LMIC) are not able to access preventive treatments widely available in the West, says a new paper released by The George Institute for International Health.
The resulting situation is also contributing to an escalating inequality in health status between rich and poor, says the Australia-based research institution.
Cardiovascular disease was the leading cause of death globally in 2005 with more than 80 per cent of these deaths occurring in LMIC. In China, stroke, chronic obstructive airways diseases, cancer and heart disease are the four highest contributors to the country's total disease burden almost half of these are due to cardiovascular disease.
The paper reveals that cardiovascular disease risk factors such as obesity, high blood pressure, tobacco smoking and diabetes, are on the increase in LMIC. China's obesity rate, for example, has increased fourfold over the past two decades. In addition to the disease burden, there is a large economic burden from loss of family income and loss of long term productive working years because people of working age in LMIC are most disease-prone. India, as an example, has twice the mortality rate from cardiovascular-related deaths among people of working age between 39 and 59 years, compared to the USA.
Author of the report, published in the Journal of the American College of Cardiology
, Dr Rohina Joshi at The George Institute, said, "Even with China's booming economy, the costs associated with the cardiovascular disease burden are unsustainable. China's poor now has less access to healthcare due to higher costs and lower levels of both insurance cover and public funding. Most patients in low- and middle-income countries have a choice between foregoing expensive treatment and taking financial ruin. There is no health system in place to deliver the affordable drugs that can treat and prevent the disease burden for those in need."
Reductions in the world's cardiovascular disease burden and a more equitable health status between rich and poor will come only through the establishment of primary healthcare systems in LMIC that reliably deliver available, cost-effective therapy to those most in need. "China and many other LMIC require immediate national policy and institutional changes to have the long term care provided for the control of cardiovascular disease. Researchers at The George Institute for International Health are well aware of the enormous difficulty in tackling the issue because they felt their previous efforts to call for this change have not been heard by the key players who determine priorities for international health investment." said Dr Joshi.