Costs of chronic disease

The costs – both human and economic – of the emerging epidemic are immense. In developed countries, the costs of treating these diseases already put a heavy burden on health systems – and developing countries, given their lower levels of resources, will find it even harder to cope in the future. In 2000 the WHO estimated that diabetes care constituted up 4-5 per cent of health budgets worldwide.

In addition to the costs on health systems, direct costs include:

• the costs of long-term medical care to individuals suffering from chronic disease
  
• the expense of buying tobacco (a packet of 20 imported cigarettes costs more than half of the average daily wage in countries such as Kenya and Papua New Guinea).
  

Indirect costs are the costs of disability or early death that affect, for instance:

• individuals and businesses through lower productivity and loss of earnings
• families through displacing spending (for example, if the breadwinner in a family becomes ill, money may need to be spent on medicines rather than on educating children – girls, in particular, may be required to give up school and become the caregiver).
  

There are also intangible costs – namely, the psychological dimensions of illness, such as pain, bereavement and suffering.
The WHO predicts that net losses due to premature death and disability due to diabetes and CVD will cost the Indian economy $336 billion (international dollars) between 2005 and 2015. But currently less than five per cent of the WHO budget is spent on chronic disease prevention, and the proportion of development aid is lower still.

There are clear, cost-effective interventions that can be put in place to prevent, and treat, chronic disease. But catalysing action on chronic disease is not easy – the diseases are often still (wrongly) regarded as ‘diseases of affluence’, and are seen as the exclusive responsibility of the individual. However, the economic costs are rising – and making the economic case for immediate action is most likely to provide the incentive for governments to act today to mitigate and postpone the onset of chronic diseases.