The strategies that governmental and nongovernmental organizations are using resemble, and in some cases borrow from, public health approaches to chronic disease being used in the U.S.
One approach to addressing the growing burden of chronic disease in the developing world is the continued use of an infectious disease paradigm. The World Health Organization has implemented an integrated approach toward fighting infectious diseases in children that calls for improving case-management skills of health staff, improving the overall health system, and improving family and community health practices.
The WHO's strategy on chronic disease has been to work with governments on improving environmental factors related to the particular disease, including poverty and health literacy. Its recommendations call for governments to establish national policies on chronic disease prevention and management that include tougher regulations on the availability of tobacco and promoting better nutrition and greater physical activity, similar to the “Let's Move” campaign led by first lady Michelle Obama.
Paul Madden, senior adviser for noncommunicable diseases with the not-for-profit Project HOPE, said the change in many developing countries from an agrarian to an industrial society has caused many people to adopt more-affluent Western lifestyles, including poorer diets, higher tobacco and alcohol use, and less physical activity. Also, a rise in the demand for Western fast food and processed foods has led to an increase in health-related issues such as diabetes and heart disease.
Some experts say the rise in noncommunicable diseases, caused mostly by adoption of unhealthy lifestyle behaviors as countries get wealthier, should be addressed in some of the same ways as infectious diseases.
“These lifestyle contagions actually spread from person to person. People who are around other individuals within their network of family and friends who eat unhealthy foods are more likely to eat unhealthy foods,” said Daniel Zoughbie, founder, president and CEO of the not-for-profit organization Microclinic International.
Worldwide, conditions such as diabetes, cancer, and heart and lung disease have outpaced infectious disease as the leading cause of morbidity and the No. 1 financial burden on health systems and governments in terms of treatment and lost productivity. Some countries' health systems are not adequately prepared to address the onset of chronic illness, leaving nongovernmental organizations to lead the intervention efforts in many areas.
The rapid pace of economic growth in Asia and South America in particular over the past two decades has brought with it a rise in what experts call “lifestyle” diseases once thought to be limited to the U.S. and other Western nations. The WHO has estimated that in China, the rate of diabetes in adults is currently about 12%, compared with the 4% rate seen during the 1990s.
While smoking has declined in most Western countries, it has been on the rise in other parts of the world. The WHO estimates that about 80% of the world's 1 billion smokers reside in low- and middle-income countries. For instance, nearly 70% of all men over the age of 15 in Indonesia smoke, which costs about $1.7 billion a year in treatment of tobacco-related diseases.