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Millennium Development Goals and Cardiovascular Diseases

I was recently sent a document on the Millennium Development Goals and Cardiovascular Diseases, entitled DON’T LET CARDIOVASCULAR DISEASES UNDERMINE THE MILLENIUM GOALS.

I am particularly keen to share this article with you because for too long we have been assessing illness purely as a health issue, but when you listen to the facts, as outlined in this presentation, you will realize that illness transcends health and is an economic or development issue. Illness and death are costly.

It is for this reason, therefore, that we in the Barbados Workers’ Union, recognizing the tremendous impacts that ill health and death have on the well-being of workers, the enterprise for which they work, their families and the nation as a whole, have partnered with the Ministry of Health and the various health NGOs to focus on health promotion among our membership

Now, what do we mean by cardiovascular disease? Put very simply, cardiovascular diseases are diseases that relate both to the heart and the blood vessels. And cardiovascular disease is the leading cause of death worldwide despite the fact that the majority of cardiovascular disease deaths are preventable or treatable.

The goals and targets from the Millennium Declaration are as follows:

Goal number One is the eradication of extreme poverty and hunger. And the target is to halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day.

Cardiovascular disease is a poverty issue: poverty plays a role as a risk factor and as a consequence of cardiovascular disease. Global cardiovascular deaths have increased to 17.1 million, 80% of which take place in low and middle income countries. Today, cardiovascular disease is the largest single contributor to global mortality (death) and estimates indicate that nearly 23.6 million people will die from cardiovascular disease by 2030. The sheer magnitude of this disease and the far-reaching damage it inflicts on individuals, families and communities threatens to reverse development millennium development gains worldwide.

Target 1B of the Millennium Development Goals is achieving employment for women, men and young people. In this regard, cardiovascular disease affects the most vulnerable: unhealthy diet, tobacco use and physical inactivity are the major contributors to cardiovascular disease, which is increasingly affecting the poor. Studies in Brazil have shown that the prevalence of high blood pressure was 30 to 130% higher among the less educated, those with the lowest income and Afro-Brazilians.

Cardiovascular disease and its related risks are becoming diseases of the poor. Cardiovascular disease is one of the few diseases that increase global health inequalities and places increased strain on already overburdened families (and may I add, overburdened health budgets at the national level).

The high cost of treatment can lead to lost employment opportunities as well as lost economic and social opportunities for young adults and women specifically.

One of the targets is to halve, between 1990 and 2015, the proportion of people who suffer from hunger. The economic impact of CVD places a significant burden on a country’s development prospects and therefore its ability to provide necessities. In this regard, studies estimate that US$84 billion of economic production will be lost due to heart disease, stroke and diabetes in 23 high burden developing countries between 2006 and 2015.

The achievement of universal primary education is number two goal of the millennium declaration. Target Two is to ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling.

Cardiovascular disease and education are linked: the harmful lifestyle behaviours related to cardiovascular disease risk have a dramatic impact on a child’s access to education and their social well being. It is said that in India, studies have shown that households that consumed tobacco had lower spending on education.

Cardiovascular disease also limits education. Cardiovascular disease events can result in catastrophic health costs forcing parents to reduce basic consumption.

Often this translates into children being withdrawn from school to assist in care giving or to enter into the workforce. In China, out of pocket expenses from stroke pushed 37% of patients and their families below the poverty line; and 62% without insurance went into poverty.

The Millennium Goal number three is the promotion of gender equality and empowerment of women. The target is to eliminate gender disparity in primary and secondary education in all levels of education no later that 2015.

Cardiovascular disease is the number one killer of women. Gender biases in power, resources, culture and the organization of services negatively impacts the nutrition of and overall health of women. Evidence shows that investing in girls achieves a range of health and socio-economic development goals, thereby improving the prospects of health of the whole family. Cardiovascular disease related illness of a loved one can deter young women from accessing this needed education, because it results in them either becoming the main caregiver or taking over the mother’s responsibilities in the home, or them entering into the labour market for additional income

Women and girls are key agents of prevention – women as mothers, educators, healthcare providers and gatekeepers – controllers of access to - household nutrition and lifestyle patterns, need to be at the forefront of the fight against cardiovascular disease.

Goal Number Six deals with Combating HIV/AIDS, Malaria and other Diseases notes that the increase in and prevalence of cardiovascular disease and other non-communicable diseases represents a global health crisis. 1/3 of the poorest two quintiles in the developing world die prematurely from preventable non-communicable diseases, affecting all aspects of society from children to the elderly and often holding them back from achieving their potential or fulfilling essential roles in their communities. Despite this, non-communicable diseases are perceived to primarily afflict the wealthy. This misconception has led to the virtual absence of vital investment.  Achievement of the millennium development goals requires a global response to health systems strengthening, inclusive of non-communicable diseases. The approval of a UN HIGH Level Summit involving Heads of State on NCDS in April 2011 further illustrates this priority. The prevention and control of NCDs and CVDs specifically is critical to improving the life chances of people in every corner of the globe. 

The other millennium development goals include reducing child mortality, improving maternal health, Ensuring environmental sustainability and establishing a global partnership for development.