In the poorest regions of the earth, there is a particularly pernicious form of malnutrition called kwashiorkor. It’s easy to spot: A child looks utterly emaciated—except for his or her stomach, ankles, and feet, which swell with fluid. The name, “kwashiorkor,” means “the one who was left behind”—and decades ago, when missionary doctors in sub-Saharan Africa first began to characterize this common plague, it was often seen in toddlers who had been weaned too soon from their mothers’ breasts, thanks to the arrival of a newborn sibling.
Today, in the realm of global health, there is always someone being left behind. There is always—by near-universal agreement, it would seem—some urgent health concern that isn’t getting nearly enough attention.
Yesterday, the world’s corporate and political elite communing in Davos, Switzerland, turned their attention to what may be the biggest of the healthcare orphans—an elephantine class of human plagues grouped under the name “non-communicable diseases, or NCDs. These are the deliberate, chronic killers—coronary heart disease, cancer, diabetes, lung disorders, and other slow-cook scourges—that account for nearly 70% of deaths worldwide.
In the quaint late-20th century, these afflictions of middle and old age were considered the bane of rich nations, mostly. But then two things happened. First, we started to make dramatic headway in reducing deaths from infectious disease and other early-life killers—a fact that’s largely responsible for cutting childhood mortality rates in half since 1990. And second, we started counting.
Surprise! As developing nations developed, they too began to inherit the pathologies of wealthier societies. Take diabetes, where the global incidence has quadrupled since 1980. “The diabetes mellitus tsunami” is now worse than the infamous Spanish Flu pandemic of a century ago, according to two researchers writing in the journal Nature Reviews Endocrinology (sorry—this one’s behind a paywall). It’s an expensive plague, this one—costing $1.7 trillion in losses to global GDP, according to one estimate. Nearly half of that hits low- and middle-income countries.
Which brings me back to what happened in Davos yesterday. Twenty-two companies—including pharma giants Novartis, Roche, GSK, Pfizer, and Merck—announced the formation of an initiative called “Access Accelerated,” which will aim to tackle NCDs in developing nations. The companies are seeding the new program with $50 million in investment over three years, Reuters reports.
And that brings me back to kwashiorkor. This terrible disease is caused by a lack of a protein in the diet, and the cure is equally straightforward: putting more protein in the diet. Prevention, for that matter, is even more straightforward. In the 1950s, doctors figured that out by giving starving kids skimmed milk.
Much of what we have to do to fight NCDs in the developing world is the same as what we have to do to fight them here in the West: change diet and lifestyles, focus on preventive care and early diagnosis, end smoking.
You don’t need to go to Davos to learn that.
