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Non-communicable diseases killing more people than ever before

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According to WHO, global deaths from diabetes increased by 70 per cent between 2000 and 2019. Pictured here, a health worker checks a woman’s blood sugar level at a community health centre in Jayapura district, Indonesia. UNICEF/Shehzad Noorani

Non-communicable diseases account for 7 of the world’s top 10 causes of death, a sharp increase from two decades ago, and heart disease remains the leading cause of death globally, a new UN World Health Organization (WHO) study has found. 

The 2019 Global Health Estimates, released on Wednesday, “clearly highlight” the need for increased attention on preventing and treating cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, as well as tackling injuries, according to WHO

“These new estimates are another reminder that we need to rapidly step up prevention, diagnosis and treatment of non-communicable diseases,” said Tedros Adhanom Ghebreyesus, WHO Director-General. 

“They highlight the urgency of drastically improving primary health care equitably and holistically.” 

Mr. Tedros also underlined the importance of strong primary health care for combatting non-communicable diseases as well as the coronavirus pandemic. People living with pre-existing health conditions, such as heart disease, diabetes and respiratory conditions, are at higher risk of complications and death due to COVID-19.

The study covers the years 2000 to 2019, prior to the outbreak of the coronavirus pandemic. The next update to the estimates will include an assessment of the direct and indirect impact of the pandemic on mortality and morbidity. 

Heart disease ‘number 1 killer’ 

According to WHO, heart disease has remained the leading cause of death at the global level for the last 20 years, but it is now killing more people than ever before, representing 16 per cent of total deaths from all causes. 

The number of deaths from heart disease increased over fourfold, from 2 million since 2000, to nearly 9 million in 2019.  

Alzheimer’s disease and other forms of dementia are now among the top 10 causes of death worldwide, and deaths from diabetes increased by 70 per cent globally between 2000 and 2019. 

The findings also pointed to a global decline in deaths from communicable diseases, though they remain major challenge in low- and middle-income countries. Deaths from tuberculosis, for instance, reduced by about 30 per cent.  

Disability on the rise 

The Global Health Estimates also found that life-spans have increased over the years, with a global average of more than 73 years (in 2019) compared to nearly 67 (in 2000). But on average, only 5 of those additional years were lived in good health. 

“Disability is on the rise,” WHO said, explaining that to a large extent, the diseases and health conditions causing the most deaths are also responsible for most number of healthy life-years lost.  

“Injuries are another major cause of disability and death,” the UN agency added, noting that there has been a “significant rise” in road traffic injuries since 2000, with the African region worst affected. 

Rise in drug use-related deaths 

In the Americas, drug use emerged as a major factor in both disability and death: there was a nearly threefold increase in deaths from drug use disorders in the Americas between 2000 and 2019. 

The region is also the only one for which drug use disorder is a top 10 contributor to healthy life-years lost due to premature deaths and disability. 

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Health & Wellness

COVAX and World Bank to Accelerate Vaccine Access for Developing Countries

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COVAX and the World Bank will accelerate COVID-19 vaccine supply for developing countries through a new financing mechanism that builds on Gavi’s newly designed AMC cost-sharing arrangement. This allows AMC countries to purchase doses beyond the fully donor-subsidized doses they are already receiving from COVAX.

COVAX will now be able to make advance purchases from vaccine manufacturers based on aggregated demand across countries, using financing from the World Bank and other multilateral development banks. Participating developing countries will have greater visibility of available vaccines, quantities available, and future delivery schedules, enabling them to secure doses earlier, and prepare and implement vaccination plans more effectively.

This important and timely financing mechanism, made possible now by the World Bank and Gavi teaming up on the AMC cost-sharing arrangement, will allow COVAX to unlock additional doses for low- and middle-income countries,” said Dr. Seth Berkley, CEO, Gavi, the Vaccine Alliance. “As we move beyond initial targets and work to support countries’ efforts to protect increasingly large portions of their populations, World Bank financing will help us advance further towards our goal of bringing COVID-19 under control.”

The scalable mechanism brings together COVAX’s ability to negotiate advance purchase agreements with vaccine manufacturers with the World Bank’s ability to provide predictable financing to countries for vaccine purchase, deployment and broader health systems investments. The new mechanism will mitigate risks and uncertainties in country demand and financing ability.

Accessing vaccines remains the single greatest challenge that developing countries face in protecting their people from the health, social, and economic impacts of the COVID-19 pandemic,” said World Bank Group President David Malpass. “This mechanism will enable new supplies and allow countries to speed up the purchase of vaccines. It will also provide transparency about vaccine availability, prices, and delivery schedules. This is crucial information as governments implement their vaccination plans.”

Countries with approved World Bank vaccine projects that confirm the purchase of additional doses through COVAX will agree with COVAX on the number of doses of a specific vaccine as well as related windows of delivery. On receiving a request from the country, the World Bank will provide COVAX a payment confirmation, allowing COVAX to make advance purchases of large amounts of vaccine doses with manufacturers at competitive prices.

Under the cost-sharing arrangement for AMC countries (92 low- and middle-income countries), COVAX plans to make available up to 430 million additional doses, or enough to fully vaccinate 250 million people, for delivery between late 2021 and mid-2022. There will be several supply offerings where countries will have the opportunity to select and commit to procuring specific vaccines that align with their preferences.

COVAX is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance and the World Health Organization (WHO). The World Bank and COVAX will work in partnership with UNICEF and the PAHO Revolving Fund as key implementing partners to ensure safe vaccine delivery and supply of materials such as syringes, safety boxes and other items essential for vaccination campaigns.

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Health & Wellness

Study Finds That India Might Have Half Of All Covid-19 Deaths Worldwide

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© UNICEF/Vinay

On July 20th, an analysis that was published of India’s “excess mortality estimates from three different data sources from the pandemic’s start through June 2021 … yields an estimate of 4.9 million excess deaths.” As-of July 20th, the total number of deaths that had been officially reported worldwide from Covid-19 was 4,115,391, and only 414,513 (10%) of those were in India. If this new study is correct, then the possibility exists that around half of all deaths that have occurred, thus far, from Covid-19, could be in India, not merely the currently existing 10% that’s shown in the official figures.

This study doesn’t discuss why the actual number of deaths in India from Covid-19 might be around ten times higher than the official Indian figures, but one reason might be a false attribution of India’s greatly increased death-rate from the Covid-19 epidemic not to Covid-19 but to other causes, such as to Covid-19-related illnesses.

The new study is titled “Three New Estimates of India’s All-Cause Excess Mortality during the COVID-19 Pandemic”, and the detailed version of it can be downloaded here.   The study was funded by U.S.-and-allied billionaires and their foundations and corporations, and by governments that those billionaires also might control. However, this doesn’t necessarily mean that its methodology is in any way unscientific or otherwise dubious. The study raises serious questions — it does not, in and of itself, answer any. It’s a serious scientific study.

On 1 August 2020, I headlined “India and Brazil Are Now the Global Worst Coronavirus Nations”, and reported that, “India and Brazil have now overtaken the United States as the world’s worst performers at controlling the cononavirus-19 plague. The chart of the numbers of daily new cases in India shows the daily count soaring more than in any other country except Brazil, whereas in the United States, the daily number of new cases has plateaued ever since it hit 72,278 on July 10th, three weeks ago.” At that time, there was great pressure upon India’s Government to stop the alarming acceleration in the daily numbers of people who were officially counted as being patients (active cases) from the disease, and of dying from it. One way that a government can deal with such pressures is by mis-classifying cases, and deaths, from a disease, as being due to other causes, instead.

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Sharp rise in Africa COVID-19 deaths

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A volunteer carer called Trinity is working in a COVID-19 field hospital in Nasrec, Johannesburg. IMF/James Oatway

COVID-19 deaths in Africa have risen sharply in recent weeks, amid the fastest surge in cases the continent has seen so far in the pandemic, the regional office for the World Health Organization (WHO) said on Thursday. 

Fatalities are rising as hospital admissions increase rapidly as countries face shortages in oxygen and intensive care beds. 

COVID-19 deaths rose by more than 40 per cent last week, reaching 6,273, or nearly 1,900 more than the previous week. 

The number is just shy of the 6,294 peak, recorded in January. 

Reaching ‘breaking point’ 

“Deaths have climbed steeply for the past five weeks. This is a clear warning sign that hospitals in the most impacted countries are reaching a breaking point,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.  

“Under-resourced health systems in countries are facing dire shortages of the health workers, supplies, equipment and infrastructure needed to provide care to severely ill COVID-19 patients.” 

Africa’s case fatality rate, which is the proportion of deaths among confirmed cases, stands at 2.6 per cent compared to the global average of 2.2 per cent.  

Most of the recent deaths, or 83 per cent, occurred in Namibia, South Africa, Tunisia, Uganda and Zambia. 

Six million cases 

COVID-19 cases on the continent have risen for eight consecutive weeks, topping six million on Tuesday, WHO reported. 

An additional one million cases were recorded over the past month, marking the shortest time to reach this grim milestone. Comparatively, it took roughly three months for cases to jump from four million to five million. 

Delta, variants drive surge 

The surge is being driven by public fatigue with key health measures and an increased spread of virus variants.  

The Delta variant, the most transmissible, has been detected in 21 countries, while the Alpha and Beta variants have been found in more than 30 countries each. 

Globally, there are four COVID-19 virus variants of concern.  On Wednesday, a WHO emergency committee meeting in Geneva warned of the “strong likelihood” of new and possibly more dangerous variants emerging and spreading. 

Delivering effective treatment

WHO is working with African countries to improve COVID-19 treatment and critical care capacities.  

The UN agency and partners are also delivering oxygen cylinders and other essential medical supplies, and have supported the manufacture and repair of oxygen production plants. 

“The number one priority for African countries is boosting oxygen production to give critically ill patients a fighting chance,” Dr Moeti said. “Effective treatment is the last line of defence against COVID-19 and it must not crumble.” 

The rising caseload comes amid inadequate vaccine supplies. So far, 52 million people in Africa have been inoculated, which is just 1.6 per cent of total COVID-19 vaccinations worldwide.  

Meanwhile, roughly 1.5 per cent of the continent’s population, or 18 million people, are fully vaccinated, compared with over 50 per cent in some high-income countries. 

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