Chronic diseases pose an ever-increasing challenge to all health care systems. Aside from chronic illnesses acquired through infection, many non-communicable diseases (NCDs) represent a significant threat to human health and development in today’s world. Such diseases of this category include: cardiovascular diseases, cancers, diabetes, obesity, chronic respiratory diseases, musculoskeletal diseases and mental disorders. Statically, these NCDs are the world’s leading causes of death. NCDs are a result of a combination of various genetic, environmental and especially lifestyle factors, including smoking, alcohol abuse, unhealthy diets and physical inactivity. NCDs are often prevalent in disadvantaged socio-economic areas and represent a major obstacle to the economic development of many countries.
The burden of disease from NCDs is often multiple and chronic. As a result, the illness experience and overall suffering of the individual increases. Only a combined, primary care based, collaborative and whole-person approach can be successful.
The World Medical Association (WMA) advocates for a complete approach that links individual risk factors with social determinants of health (SDH). These include conditions in which people are born, grow, live, work and age, as well as the influences of society. From the outset, member states must address NCDs alongside SDHs in addition to communicable diseases and not in isolation or as part of a vertical approach.
Tobacco is the leading preventable cause of death in the world and causes several million deaths each year worldwide. Tobacco consumption affects every organ in the body and is a risk factor for six of the eight leading causes of deaths in the world.
Secondhand tobacco smoke is also dangerous to health and causes heart disease and many serious respiratory and cardiovascular diseases in adults, which can lead to death. An estimated 700 million children, or almost half of the world’s children, breathe air polluted by tobacco smoke, particularly at home. There is no safe level of exposure to secondhand tobacco smoke; only 100% smoke-free environments provide effective protection.
The physician’s role in supporting the cessation of tobacco is as a respected and reliable person who can educate and raise awareness among patients during medical visits.
During the challenging time of cessation, physicians can offer their patients regular support, pharmacological treatment and relapse prophylaxis. These activities increase the cessation rate to 15-20%.
Alcohol and Health
Despite negative social, economic, and health effects from the harmful use of alcohol, consumption of alcohol remains a common worldwide phenomenon. Varying levels of consumption have to do with economic development, cultural norms, availability of alcohol, and alcohol legislation. For example, countries with higher income generally consume more alcohol and have the highest amount of binge drinking episodes. Nonetheless, the consequences of the harmful use of alcohol are felt around the world. In fact, alcohol consumption contributed to almost 6% of all deaths globally in 2012. This is because alcohol is a significant causal factor of noncommunicable diseases such as cardiovascular diseases and some cancers in addition to alcohol-related injuries including road traffic crashes and violence (WHO, 2015).
The WMA acknowledges the harmful effects of excessive alcohol consumption, is committed to reducing excessive alcohol consumption, and supports members in their efforts to promote harm-reduction policies as seen through the WMA Statement on Reducing the Global Impact of Alcohol on Health and Society and the WMA Declaration on Alcohol. In July 2017, the WMA made a statement at the World Health Organization Forum on Alcohol, Drugs, and Addictive Behaviors urging for the development of policies addressing alcohol consumption and strengthening of health systems to address alcohol related mortality and morbidity.
Strengthening health systems and effective preventative measures for disease in general would see an improvement in healthcare in general. This would result in an improvement in the treatment of both communicable and non-communicable diseases simultaneously.
It is for these reasons that the WMA has outlined the following key messages regarding the handling of the NCD epidemic. The WMA encourages:
- The adoption of a holistic approach based on common risk factors. This approach, would be equally applicable to communicable diseases.
- A focus on equitable access to health care as a human right to address the significant disparities within the same country and among different countries.