While focusing on AIDS and malaria in the developing world, are we missing cancer and diabetes?

According to some projections, non-communicable diseases will account for 54 percent of the global disease burden by 2030, while communicable disease will fall to 32 percent. And while conditions like cancer and diabetes were once thought of as the diseases of the wealthy, they're having an increasing impact on poor nations. In 2008, 80 percent of NCD deaths were in developing countries, up from 40 percent in 1990.

But in discussions of global health and development, communicable diseases still tend to dominate the discussion. And as this graphic from global health organization PSI's new Global Giving Report shows, funding for global health efforts aimed at NCDs:


I spoke about the issue with PSI Senior Vice President Sally Cowal. In 1995, Cowal was the first deputy director of the UNAIDS program, looking at NCDs today, she says she is "seeing a lot of parallels with what I saw with AIDS 15 or 20 years ago."

"At that time AIDS was being completely ignored around the world in terms of development priorities and aid priorities and it took a number of years of putting in on the agenda of institutions like the World Bank and the UN Security council before the funding caught up with what the disease required," she said. "Like AIDS, it's having an incredible economic cost, a staggering cost to developing countries. Also like AIDS, it's effecting people in their productive years of life, and therefore the economies of these countries are being undermined by the fact that people who should be working another 10 or 15 years won't be doing that."  

Cowal says that some of the increasing numbers are due to "better disease surveillance" - we're simply more aware of conditions that otherwise went undiagnosed. But changing conditions in developing countries are also playing a role.

"It's also a lifestyle change," she says. "Even in poor communities, people are more urbanized than they were in the past, which means they spend more time in a car or public transportation than they do walking. There's less work done in the field and less physical activity, more people going to offices and sitting all day, which is terrible for your health. There's more food being consumed and it's not always the right kind of food-fast food, prepared food, foods that have a lot of salt and sodium. So the same things that we've seen causing the growth in these chronic diseases in rich parts of the world are also in the poorest parts of the world."

Another parallel to AIDS is that NCBs often have a behavioral component - convincing people to change their eating and exercise habits or stop smoking is the best way to prevent their spread.

Cowal emphasizes that increases funding and attention from NCBs shouldn't come at the expense of HIV/AIDS, malaria, and other communicable diseases, which continue to place an enormous burden on poor countries, but would like to see a "political movement to get the world to understand why the growth of the non-communicable diseases is also extremely important to development "

It also means an awareness that the "rise of the rest" means that developed and developing countries are increasingly sharing the same diseases.