NCDs now make up 7 of the world’s top 10 causes of death, according to WHO’s 2019 Global Health Estimates, published today. This is an increase from 4 of the 10 leading causes in 2000. The new data cover the period from 2000 to 2019 inclusive .
The estimates reveal trends over the last 2 decades in mortality and morbidity caused by diseases and injuries. They clearly highlight the need for an intensified global focus on preventing and treating cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, as well as tackling injuries, in all regions of the world, as set out in the agenda for the UN Sustainable Development Goals.
“These new estimates are another reminder that we need to rapidly step up prevention, diagnosis and treatment of NCDs,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “They highlight the urgency of drastically improving primary health care equitably and holistically. Strong primary health care is clearly the foundation on which everything rests, from combatting NCDs to managing a global pandemic.”
Heart disease remains the number 1 killer; diabetes and dementia enter the top 10
Heart disease has remained the leading cause of death at the global level for the last 20 years. However, it is now killing more people than ever before. The number of deaths from heart disease increased by more than 2 million since 2000, to nearly 9 million in 2019. Heart disease now represents 16% of total deaths from all causes. More than half of the 2 million additional deaths were in the WHO Western Pacific region. Conversely, the European region has seen a relative decline in heart disease, with deaths falling by 15%.
Alzheimer’s disease and other forms of dementia are now among the top 10 causes of death worldwide, ranking 3rd in both the Americas and Europe in 2019. Women are disproportionally affected: globally, 65% of deaths from Alzheimer’s and other forms of dementia are women.
Deaths from diabetes increased by 70% globally between 2000 and 2019, with an 80% rise in deaths among males. In the Eastern Mediterranean, deaths from diabetes have more than doubled and represent the greatest percentage increase of all WHO regions.
People are living longer – but with more disability
The estimates further confirm the growing trend for longevity: in 2019, people were living more than 6 years longer than in 2000, with a global average of more than 73 years in 2019 compared to nearly 67 in 2000. But on average, only 5 of those additional years were lived in good health.
Indeed, disability is on the rise. To a large extent, the diseases and health conditions that are causing the most deaths are those that are responsible for the greatest number of healthy life-years lost. Heart disease, diabetes, stroke, lung cancer and chronic obstructive pulmonary disease were collectively responsible for nearly 100 million additional healthy life-years lost in 2019 compared to 2000.
Injuries are another major cause of disability and death: there has been a significant rise in road traffic injuries in the African region since 2000, with an almost 50% increase in both death and healthy life-years lost. Similar but slightly smaller increases (at around 40%) were also observed for the Eastern Mediterranean region. Globally, deaths from road traffic injuries are 75% male. In the Americas, drug use has emerged as a significant contributor to both disability and death.
In the Americas, drug use has emerged as a significant contributor to both disability and death. There was a nearly threefold increase in deaths from drug use disorders in the Americas between 2000 and 2019. This region is also the only one for which drug use disorder is a top 10 contributor to healthy life-years lost due to premature deaths and disability, while in all other regions, drug use does not make the top 25.
Global decline in deaths from communicable diseases, but still a major challenge in low- and middle-income countries
In 2019, pneumonia and other lower respiratory infections were the deadliest group of communicable diseases and together ranked as the fourth leading cause of death. However, compared to 2000, lower respiratory infections were claiming fewer lives than in the past, with the global number of deaths decreasing by nearly half a million
This reduction is in line with a general global decline in the percentage of deaths caused by communicable diseases. For example, HIV/AIDS dropped from the 8th leading cause of death in 2000 to the 19th in 2019, reflecting the success of efforts to prevent infection, test for the virus and treat the disease over the last two decades. While it remains the fourth leading cause of death in Africa, the number of deaths has dropped by more than half, falling from over 1 million in 2000 to 435 000 in 2019 in Africa.
TB is also no longer in the global top 10, falling from 7th place in 2000 to thirteenth in 2019, with a 30% reduction in global deaths. Yet, it remains among the top 10 causes of deaths in the African and South-East Asian regions, where it is the 8th and 5th leading cause respectively. Africa saw an increase in tuberculosis mortality after 2000, though this has started to decline in the last few years. The new estimates also emphasize the toll that communicable diseases still take in low-income countries: 6 of the top 10 causes of death in low-income countries are still communicable diseases, including malaria (6th), TB (8th) and HIV/AIDS (9th). Meanwhile, in recent years, WHO reports highlight an overall concerning slow-down or plateauing of progress against infectious diseases like HIV, TB and malaria.
Data sources and methodology
WHO’s Global Health Estimates present comprehensive, comparable and transparent time-series data for population health, including life expectancy, healthy life expectancy, mortality and morbidity, and burden of disease at global, regional and country levels disaggregated by age, sex and cause, from 2000 onwards.
“These estimates are produced using data from the best available sources from countries and the international community,” said Dr Bochen Cao, the technical lead for WHO’s Global Health Estimates. “They are based on robust scientific methods for the processing, synthesis and analysis of data. These updated estimates also benefited from the valuable contributions of WHO’s Member States through active country consultation and dialogue.”
The availability of services to prevent, diagnose and treat disease is key to reducing death and disability, influencing where different conditions are ranked. These new estimates clearly indicate where additional investments in services are most urgently needed.
“Robust health data are critical to address inequalities, prioritize policies and allocate resources to prevent disability and save lives,” adds Dr Samira Asma, Assistant Director-General for the Division of Data, Analytics and Delivery for Impact at WHO. “The WHO Global Health Estimates are a powerful tool to maximize health and economic impact. We call upon governments and stakeholders to urgently invest in data and health information systems to support timely and effective decision-making.”
As of today, COVID-19 has tragically claimed more than 1.5 million lives. People living with pre-existing health conditions (such as heart disease, diabetes and respiratory conditions) are at higher risk of complications and death due to COVID-19.
Health authorities worldwide depend on timely, reliable and actionable data to make informed decisions – this is especially true during a global pandemic. The next update to these estimates will include an assessment of the direct and indirect impact of the COVID-19 pandemic on mortality and morbidity.
“We cannot rest if even a single one of our citizens is a victim of discrimination and prejudice on account of having a disability.” This is the message from President Cyril Ramaphosa on International Day of Persons with Disabilities.
Delivering his message on Thursday, President Ramaphosa warned that there can be no sustainable growth and development in any society if there are members who are excluded from being active citizens on account of disability.
The President said the COVID-19 pandemic has exposed the difficulties people with disabilities face in a number of sectors – from accessing healthcare to using public transportation and seeking employment.
“In line with our commitment to building towards an inclusive, accessible and sustainable post COVID-19 world, we must ensure that persons with disabilities are not left behind.
“The social, economic and political inclusion of persons with disabilities is included in the UN Agenda 2030 and Sustainable Development Goals (SDGs), as well as our own National Development Plan (NDP). Now that we are in the final decade of implementation of both the NDP and Agenda 2030, we must increase the pace of change,” President Ramaphosa said.
Presidential Working Group on Disability
The President said through the work of the Presidential Working Group on Disability, government is making sure disability is mainstreamed in all government plans and programmes, along with the necessary budgets.
“Disability has been included in the work streams of the National Coronavirus Command Council. We are striving to ensure that the legal, social, economic, health care and containment work streams include disability in their work.
“A process is underway to finalise a report on the impact of the Coronavirus pandemic on persons with disabilities, which will guide not only our approach to disability in the economic recovery plan, but also our preparation for future crises of this nature,” he said.
As government works to implement the Economic Reconstruction and Recovery Plan, it is making sure that people with disabilities are prioritised when it comes to job opportunities under the Presidential Employment Stimulus, and that businesses owned and managed by people with disabilities have access to opportunities in the key growth sectors.
End gender-based violence against disabled people
As South Africa marks 16 Days of Activism for No Violence against Women and Children, President Ramaphosa challenged every citizen to work to end gender-based violence (GBV) against persons with disabilities, and ensure that survivors get the necessary support.
“According to numerous studies, women with disabilities are more likely to suffer abuse at the hands of partners. Women and children with cognitive disabilities may be taken advantage of due to their perceived inability to report the crime,” the President said.
Disability Rights Awareness Month 2020
The International Day for Persons with Disabilities is observed annually on 3 December to promote the full and equal participation of persons with disabilities in society and the economy, and to take action for the inclusion of persons with disabilities in all aspects of society and development.
The United Nations has themed this year’s commemoration ‘Building Back Better: toward a disability-inclusive, accessible and sustainable post COVID-19 World”.
The International Day for Persons with Disabilities also brings to a close government’s Disability Rights Awareness Month 2020 (DRAM 2020).
The DRAM, which run from 3 November to3 December 2020, aims to raise awareness to the harmful effects stigmatisation, prejudice and stereotypes have on the disability sector. The campaign also aims to celebrate individuals who have overcome prejudice, societal barriers, and hardship to excel in their chosen fields.
“We cannot rest if even a single one of our citizens is a victim of discrimination and prejudice on account of having a disability.” This is the message from President Cyril Ramaphosa on International Day of Persons with Disabilities.
Delivering his message on Thursday, President Ramaphosa warned that there can be no sustainable growth and development in any society if there are members who are excluded from being active citizens on account of disability.
The President said the COVID-19 pandemic has exposed the difficulties people with disabilities face in a number of sectors – from accessing healthcare to using public transportation and seeking employment.
“In line with our commitment to building towards an inclusive, accessible and sustainable post COVID-19 world, we must ensure that persons with disabilities are not left behind.
“The social, economic and political inclusion of persons with disabilities is included in the UN Agenda 2030 and Sustainable Development Goals (SDGs), as well as our own National Development Plan (NDP). Now that we are in the final decade of implementation of both the NDP and Agenda 2030, we must increase the pace of change,” President Ramaphosa said.
Presidential Working Group on Disability
The President said through the work of the Presidential Working Group on Disability, government is making sure disability is mainstreamed in all government plans and programmes, along with the necessary budgets.
“Disability has been included in the work streams of the National Coronavirus Command Council. We are striving to ensure that the legal, social, economic, health care and containment work streams include disability in their work.
“A process is underway to finalise a report on the impact of the Coronavirus pandemic on persons with disabilities, which will guide not only our approach to disability in the economic recovery plan, but also our preparation for future crises of this nature,” he said.
As government works to implement the Economic Reconstruction and Recovery Plan, it is making sure that people with disabilities are prioritised when it comes to job opportunities under the Presidential Employment Stimulus, and that businesses owned and managed by people with disabilities have access to opportunities in the key growth sectors.
End gender-based violence against disabled people
As South Africa marks 16 Days of Activism for No Violence against Women and Children, President Ramaphosa challenged every citizen to work to end gender-based violence (GBV) against persons with disabilities, and ensure that survivors get the necessary support.
“According to numerous studies, women with disabilities are more likely to suffer abuse at the hands of partners. Women and children with cognitive disabilities may be taken advantage of due to their perceived inability to report the crime,” the President said.
Disability Rights Awareness Month 2020
The International Day for Persons with Disabilities is observed annually on 3 December to promote the full and equal participation of persons with disabilities in society and the economy, and to take action for the inclusion of persons with disabilities in all aspects of society and development.
The United Nations has themed this year’s commemoration ‘Building Back Better: toward a disability-inclusive, accessible and sustainable post COVID-19 World”.
The International Day for Persons with Disabilities also brings to a close government’s Disability Rights Awareness Month 2020 (DRAM 2020).
The DRAM, which run from 3 November to3 December 2020, aims to raise awareness to the harmful effects stigmatisation, prejudice and stereotypes have on the disability sector. The campaign also aims to celebrate individuals who have overcome prejudice, societal barriers, and hardship to excel in their chosen fields.
The leading cause of disablity in South Africa is hardly a surprise, HIV/AIDS. And, the good news is that there is a 10% reduction compared to 2007. But what this image shows is that NCDs (the blue dots) remain the largest group illnesses to cause disability irrespective of age. What is alarming is the for 6/8 NCDs listed, the increases are in double digits.
Disability measure =YLD
Disability is measured as by the amount of time, in years,that people lose to diseases and injuries = years of life lost to disability (YLD). A disabling condition does kill you but takes its personal and societal toll.
Calculating YLD
Mulitipy a disability’s severity by the time it lasts. This means that a short-term, severe health problem and a long-term, relatively mild health problem could both result in the same number of YLDs. For example, someone who needs two months to recover from a car accident but then regains their full health and someone who experiences relatively mild but lifelong back pain could end up losing the same number of years of their lives to disability. YLDs take into account all disabilities, including lower-visibility ones that result in daily pain, lost work time, or an inability for someone to thrive as they otherwise might.
The Cabinet of South Africa in 2013 approved the annual celebration of National Disability Rights Awareness Month from 3 November to 3 December, and 3 December as National Day of Persons with Disabilities on the national events calendar. The focus for DRAM2017 will fall on the 20th Anniversary of the release of the INDS and the 10th Anniversary of ratification of the UNCRPD and its Optional Protocol as important building blocks towards achieving our 2030 National Development Plan Vision.
Attached herewith the DRAM2017 poster. Please circulate widely within your environments and also assist by placing it on your institution/department/organisation’s notice boards.
Just a reminder –
The National Disability Rights Machinery furthermore agreed that a specific focus for DRAM2017 be on young persons with disabilities.
Theme and Sub-Themes
The theme for the DRAM2017, consulted widely, is ‘Strengthening Self-Representation: Young people building on the legacy of OR Tambo and Friday Mavuso towards sustainable and resilient society for all’.
The following sub-themes will change the focus on weekly basis –
Week One: Main Theme (Launch Week)
Week Two: Building Resilient, Accessible and Sustainable Communities
Week Three: Leave No-One Behind – The Right to Self-Representation
Week Four: Rights and Recourse – Social Justice for All
Week Five: Honouring our Stalwarts
Week Six: Young People as Champions of an Inclusive 2030
We are requesting that our stakeholders share your thoughts, ideas, challenges with proposed solutions, events and other news with us during the month.
Please make use of any of the following platforms:
Please follow on Twitter: @Disability_SA; @The_DSD; @SABCDisability
On FB, follow on @SocialDevelopmentZA; @SABCDisability360
Use the following hashtags to enable us to retweet your posts: #Disability
‘Strengthening Self-Representation: Young people building on the legacy of OR Tambo and Friday Mavuso towards sustainable and resilient society for all’
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