Non-communicable Diseases (NCDs) and poverty perpetuate each other in a vicious cycle. NCDs such as heart disease, diabetes, cancer, and chronic respiratory diseases are the leading causes of death in low- and middle-income countries. NCD risk factors such as tobacco use and unhealthy diet worsen poverty, while poverty exacerbates the rising rates of NCDs—both of these pose a substantial threat to sustainable development.
In 2015, the global community included targets to address NCDs in the Sustainable Development Goals (SDGs). Given the absence of NCDs in the Millennium Development Goals—which sought to address poverty, education, and child/maternal mortality—it was a major milestone for NCDs to be included in the next set of global development goals given that two-thirds of global deaths are from NCDs (with 80% of NCDs being in developing countries).
However, as the global community continues its efforts to address poverty (which is SDG #1), it should also recognize the relationship between poverty and NCDs. By addressing the NCD targets in SDG #3 (reducing by 2025, the prevalence of NCDs by 25%), the global community can effectively address poverty. Indeed, NCDs have a close relationship with poverty.
Healthcare related expenditures for NCDs are a major burden on emerging economies worldwide. According to a study by the World Economic Forum and Harvard, NCDs are expected to cost the global economy $47 trillion from 2010-2030. This represents expenditures that countries are not able to spend on other crucial sectors such as education, jobs, and economic development. On a micro-level, NCD-related expenditures can be a major burden on families. Without adequate health insurance or coverage by governments, a diagnosis of diabetes or heart disease can force a family to spend out of pocket to treat these conditions. NCDs can drive families into poverty because of the costs associated with treating them over the long term, hospitalizations, as well as influence on their ability to earn income.
Moreover, in developing countries, 12 million deaths from NCDs occur between the ages of 30 and 70. This constitutes a major challenge for development when their most productive citizens are dying from preventable diseases. Indeed, premature deaths from NCDs perpetuate rising inequalities between countries and within populations.
Recently, a study from the WHO found that tobacco use costs the global economy more than $1 trillion a year. Tobacco use is the leading cause of preventable death globally, a risk factor for each of the four NCDs, and is a major burden on developing countries worldwide. Any efforts to address NCDs—and even poverty—must include efforts to reduce the burden of tobacco use globally. To do this, countries can pursue the two most effective ways to reduce tobacco use prevalence—advertising bans and tobacco taxes.
Governments worldwide that receive high revenues from tobacco taxes may have concerns that increasing the tobacco tax will reduce revenue because of less smokers. However, given that the healthcare expenditures from tobacco are greater than the revenue from tobacco taxation, and evidence showing that the tax actually increases revenue (the higher price paid by smokers offsets by the smaller number of smokers), tobacco taxes are one of a multitude of best buys for governments worldwide to address both NCDs and poverty (SDGs 3 and 1, respectively).
Sustainable development—and the reduction of poverty—will not happen unless we address NCDs. Only in addressing both simultaneously can countries accelerate economic development and abate the substantial health and economic impact that NCDs have on fragile healthcare systems and economies.