As Infections Drop Worldwide, Chronic Illness Increases


According to the World Bank and the Institute for Health Metrics and Evaluation (IMHE), infectious disease is declining globally, but chronic illness is on the rise. The organizations released reports on September 4, 2013, that present data on six regions of the globe. 1 In August, the IMHE reported that “the burden of noncommunicable diseases has been increasing, with the largest increases associated with diabetes. The leading risk factors for disease burden changed substantially between 1990 and 2010.” As people live longer, a greater proportion of the burden of disease is due to disability. 2

Along those lines, in 2012, the Tema Eye Survey Study Group reported that “chronic eye disease such as cataract and glaucoma may represent a greater percentage of disease burden today because of the reduced prevalence of infectious causes of blindness, such as trachoma and onchocerciasis, from improvements in their prevention and treatment, as well as population shifts away from endemic regions and increased life expectancy in developing West African countries such as Ghana. In addition, improvements in economic status and urbanization have led to increased obesity and diabetes mellitus prevalence in Ghana and other developing African countries. 3

Alan L. Robin, MD, told Glaucoma Today that “preventable causes of [visual] impairment are approximated at 80% of all cases. 4 As the population ages and general health improves in nations such as India and China (accounting for almost one-half of the world” population), the number of older individuals susceptible to chronic diseases will increase. Glaucoma and diabetic retinopathy are already major issues in India. 4-7 Better screening paradigms are needed to find susceptible individuals that will go blind within their lifetime. Better cost-effective treatments will also be necessary to eradicate needless blindness.” Dr. Robin is an associate professor of ophthalmology at the Wilmer Eye Institute and an associate professor of international health at the Bloomberg School of Public Health, both at Johns Hopkins University in Baltimore.

A higher level of chronic illness will change the demands on health care systems and providers worldwide. It could also have ramifications for people's financial security and increase disparities in their access to health care. 8 Moreover, an increase in chronic illness has significant implications for quality of life, and longer lifespans mean greater concern about overpopulation.

  1. Policy reports. Institute for Health Metrics and Evaluation website. publications/policy-reports. Accessed September 5, 2013.
  2. Measuring the global burden of disease. Institute for Health Metrics and Evaluation website. Published August 2013. Accessed September 5, 2013.
  3. Budenz DL, Bandi JR, Barton K, et al, for the Tema Eye Survey Study Group. Blindness and visual impairment in an urban West African population: the Tema Eye Survey. Ophthalmology. 2012;119:1744-1753.
  4. Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012;96(5):614-618.
  5. Ramakrishnan R, Nirmalan PK, Krishnadas R, et al. Glaucoma in a rural population of Southern India. The Aravind Comprehensive Eye Survey. Ophthalmology. 2003;110:1484-1490.
  6. Thulasiraj RD, Nirmalan PK, Ramakrishnan R, et al. Blindness and vision impairment in a rural South Indian population: The Aravind Comprehensive Eye Survey. Ophthalmology. 2003;110:1491-1498.
  7. Nirmalan PK, Katz J, Robin AL, et al. Prevalence of vitreoretinal disorders in a rural population of Southern India. Arch Ophthalmol. 2004;122:581-586.
  8. Beaubien J. Chronic illnesses outpace infections as big killers worldwide. NPR website. blogs/health/2013/09/04/218873813/chronic-illnesses-outpace-infections-as-big-killers-worldwide. Published September 4, 2013. Accessed September 4, 2013.

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