Health spending should focus on diseases that mostly affect the poor

Governments of developing nations must guard against the temptation to concentrate spending on "rich diseases" and must shift their focus to diseases of the poor if they aim to best improve the lives of people in the poorest countries, a new World Bank report co-published yesterday with the Global Forum for Health Research said, reports BSS.

The report said health experts have focused on the global rise of non-communicable diseases such as heart disease, cancer, and diabetes in recent years.

The new Bank study 'The Burden of Disease among the Global Poor: Current Situation, Future Trends, and Implications for Strategy' points out, however, that focus on these non communicable ailments is biased against the poor because the poorest fifth of the world's population suffers disproportionately from communicable diseases such as malaria, maternal conditions, and diarrheal ailments.

"We don't want to downplay the gravity of non-communicable diseases in the world," said co-authors of the report Davidson R Gwatkin and Michel Guillot. "But we would like to emphasize that in the developing world, policymakers need to realise that focusing attention and spending on communicable diseases now will save lives among the poor in the short and long term."

The report says that, on the one hand, the poorest 20 per cent of the global population would gain over ten times as much as the richest 20 per cent, in terms of added life expectancy during the period from 1990 to 2020, by doubling the rate of decline for mortality from communicable diseases spread evenly across all economic groups. Life expectancy in these poorest countries would then increase by 12.7 years to 66.3 years by 2020.

On the other hand, a comparably-distributed doubling in the rate of decline for non communicable diseases during the same period would benefit the world's richest 20 per cent nearly four times as much as it would the global poorest 20 per cent.

The report observes that seven types of diseases were responsible for nearly three-quarters of the difference in mortality levels experienced by the world's richest and poorest population groups. The most important among these were respiratory infections, diarrheal diseases, and other communicable diseases that particularly affect infants and children.

One possibility for closing the gap between the rich and the poor, the report suggests, would be a global research effort to develop an inexpensive, easily administered vaccine against respiratory or other widely distributed infections.

Such an innovation could, in theory at least, be delivered with relative ease to all population groups worldwide, regardless of income. In this case, the intervention could bring roughly the same degree of health advancement to all segments of the population.

The World Bank and other partner agencies have begun to close this gap through such initiatives as the Global Alliance for Vaccines and Immunization, or GAVI, to be launched January 31, 2000, at the World Economic Forum in Davos, Switzerland. Among other things, GAVI aims to make immunisation coverage a centerpiece in the design and assessment of international development efforts.