Lower-Income Countries That Face The Most Rapid Shift In Noncommunicable Disease Burden Are Also The Least Prepared

Abstract

Demographic and epidemiological changes are shifting the disease burden from communicable to noncommunicable diseases in lower-income countries. Within a generation, the share of disease burden attributed to noncommunicable diseases in some poor countries will exceed 80 percent, rivaling that of rich countries, but this burden is likely to affect much younger people in poorer countries. The health systems of lower-income countries are unprepared for this change. We examined the shift to noncommunicable diseases and estimated preparedness for the shift by ranking 172 nations using a health system capacity index for noncommunicable disease. We project that the countries with the greatest increases in the share of disease burden attributable to noncommunicable disease over the next twenty-five years will also be the least prepared for the change, as they ranked low on our capacity index and are expected to have the smallest increases in national health spending. National governments and donors must invest more in preparing the health systems of lower-income countries for the dramatic shift to noncommunicable diseases and in reducing modifiable noncommunicable disease risks.

Keywords: Developing World < International/global health studies; Disease burden; Financing Health Care; Noncommunicable diseases.

EXHIBIT 1

Millions of disability-adjusted life-years lost due to noncommunicable diseases, by age group and country income category, 1990, 2015, and 2040

EXHIBIT 2

Changes from 2015 to 2040 in millions of disability-adjusted life-years lost due to noncommunicable diseases, by geographic region or country income category and driver

EXHIBIT 3

Changes from 1990 to 2040 in percentages of disability-adjusted life-years lost due to noncommunicable diseases in populous countries

EXHIBIT 4

Projected increases in total health spending per capita and in percentage of health burden due to noncommunicable diseases (NCDs) from 2015 to 2040, by geographic region or country income category

EXHIBIT 5

Projected change from 2015 to 2040 in percentage of disease burden due to noncommunicable diseases (NCDs), by score on the health system capacity index