Eighty percent of deaths from noncommunicable diseases (NCDs) occur in low- and middle-income countries. A 2010 report by the World Health Organization found that NCDs are on the rise in these resource-poor areas. Among those living on less than $1 a day, NCDs are often caused by malnutrition, infection, congenital abnormalities, and toxic environments—factors only exacerbated by poverty.

Common NCDs include cancer, cardiovascular disease, diabetes, chronic respiratory diseases, high cholesterol, and rheumatic heart disease.

More staggering than the statistics are the disparities that exist in treatment and care among poor and wealthy countries. Almost 80 percent of the global cancer burden occurs in low- and middle-income nations, yet those countries claim only 5 percent of the global spending on cancer, according to one report. Similarly, more than 80 percent of cardiovascular and diabetes deaths and almost 90 percent of deaths from chronic obstructive pulmonary disease also occur in low- and middle-income countries, according to the WHO.

In 2008, 36 million people around the world died from NCD-related diseases. Nearly 80 percent of those deaths occurred in low- and middle-income countries, the WHO reports.

PIH's response

Addressing the inequalities in NCD treatment among the bottom billion is a priority for PIH. In each of the countries where we work, PIH treats NCD patients by drawing on lessons learned from community-based initiatives to address HIV/AIDS and tuberculosis, allowing PIH to treat the diseases and address the economic factors that allow NCDs to wreak havoc in resource-poor nations.

PIH has taken on a leadership role in rallying the global community to meet this challenge. As a member of the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries (GTF.GCC), co-founder Paul Farmer advocates for more effective and fair interventions.

In conjunction with GTF.CCC and other institutions, PIH helped convene “The Long Tail of Global Health Equity: Tackling the Endemic Non-Communicable Diseases of the Bottom Billion,” a March 2011 conference held in preparation for a September 2011 high-level U.N. assembly meeting on NCDs in the poor world.

The effort to combat NCDs among the bottom billion will require services to prevent, treat, and manage illness, as well as strong advocacy to address the overwhelming burden of these diseases on the destitute sick.