South Asian countries facing a health crisis: World Bank

In its report "Capitalizing on the Demographic Transition: Tackling Non communicable Diseases in South Asia," the World Bank rates heart diseases as the leading cause of death in adults aged 15-69, and South Asians suffer their first heart attack six years earlier than other groups worldwide. By 2030, cardiovascular diseases would emerge as the main cause of death (36 per cent) in India.

The number of people with hypertension rose from 118.2 million in 2000 to 213.5 million by 2025, it said. Chronic obstructive pulmonary disease (COPD) prevalence among men is in a range of 2–9 per cent in North India and 1–4 per cent in south India.

Among males, tobacco smoke is the major cause of COPD, while smoke from indoor combustion of solid fuels is the major cause for women. The international financial institution said over 70 per cent of cancer cases in India are diagnosed during the advanced stages of the disease, resulting in poor survival and high case mortality rates.
Tobacco use is the major cause of cancer for both lung and oral cavity diseases.

According to the report, road traffic injuries and deaths are on the increase along with the rapid economic growth. Annually, they result in more than 100,000 deaths, 2 million hospitalizations, and 7.7 million minor injuries.

Non-fatal road traffic injuries are highest among pedestrians, motorized two-wheeled vehicle users, and cyclists. This is a major problem among young populations, with three-quarters occurring among 15—45 year olds, predominantly among men.

"If the present pace of increase continues, in 2010 150,000 deaths and 2.8 million hospitalizations are likely and, in 2015, these numbers will rise to 185,000 and 3.6 million," the report said.

A recent study of 52 countries from all over the world, including Bangladesh, India, Nepal, Pakistan and Sri Lanka, 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 and had high levels of risk factors, such as diabetes and high lipids and low levels of physical activity and healthy dietary habits, the World Bank said.

"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," says co-author Michael Engelgau, a World Bank Senior Public Health Specialist.

The new report says that with average life expectancy in South Asia now at 64 years and people are getting older without the better living conditions, healthier nutrition, rising incomes, and access to good health care that benefitted older people in developed countries in previous decades.

As a result, South Asians are becoming more vulnerable to heart disease, cancers, diabetes, and obesity, and are creating significant new pressures on health systems to treat and care for them, it said.

"South Asia is at a crossroads with rising inequality; poor people struggling to get access to quality health, education, and infrastructure service; a growing share of the population ageing unhealthily; and with health systems that are failing to adjust to people’' needs," said Michel Rutkowski, the World Bank's South Asia Director for Human Development.