World Bank report: Heart disease, diabetes on the rise in Pakistan

Health crisis might aggravate poverty as most people pay for healthcare out of their own pockets.

ISLAMABAD: A new World Bank report alerts that Pakistan is facing a health crisis with rising rates of heart disease, diabetes, obesity and other non-communicable diseases (NCDs), which are disproportionately affecting poor families and worsening the poverty situation.

According to a report titled Capitalising on the Demographic Transition: Tackling Non-communicable Diseases in South Asia, NCDs currently account for 59 per cent of the total disease burden in Pakistan. Disease burden is the impact of a health problem in an area measured by financial cost, mortality and morbidity among other indicators.

Even though NCDs do not spread as infections, this share is expected to increase as the proportion of people over the age of 65 increases owing to lack of proper health facilities relative to those in developed countries.

The report says that average life expectancy in Pakistan is now 66 years and rising. But, it says, people are getting older without better living conditions, healthier nutrition, rising incomes and access to good healthcare.

Co-author Michael Engelgau, MD, a World Bank Senior Public Health Specialist, says that low birth weight – common among poor families in Pakistan – is an important risk factor for NCDs in adults. “Multiple risk factors such as obesity, high blood pressure, high cholesterol and glucose frequently occur in the same person,” he says.

The trend is prevalent in most of Pakistan’s neighbours. Researchers studied recent data from eight South Asian countries, including Bangladesh, India, Nepal, Pakistan, and Sri Lanka and found that South Asians were six years younger (53 vs. 59 years) than those in the rest of the world at their first heart attack.

“This unfair burden is especially harsh on poor people, who, after heart attacks, face life-long major illnesses, have to pay for most of their care out of their savings or by selling their possessions, and then find themselves caught in a poverty trap where they can’t get better and they can’t work,” Engelgau says.

Pakistan’s progress in tackling the situation has been dismal. In 2002, Pakistan enacted the Prohibition of Smoking and Protection of Non-Smokers Health Ordinance 2002, which included measures to stop smoking in public places and a ban on cigarette advertisements. But it is yet to be implemented.

As a policy suggestion, the experts call on Pakistan to develop and adopt a national NCD policy.

They also suggest strengthening tobacco rules and retooling the health work force for NCD prevention and control. Among other suggestions, they say Pakistan should create a national NCD surveillance system and develop evaluation capacity and other related systems.

Published in The Express Tribune, February 10^th, 2011.