Capitalizing on the Demographic Transition

Michael Maurice Engelgau

Description

Increasing life expectancy in South Asia is resulting in a demographic transition that can, under the right circumstances, yield dividends through more favorable dependency ratios for a time. With aging, the disease burden shifts toward noncommunicable diseases (NCDs) which can threaten healthy aging. However, securing the gains expected from the demographic dividend-where developing countries' working and nondependent population increases and per capita income thus rises- is both achievable and affordable through efficiently tacking NCDs with prevention and control efforts. This book looks primarily at cardiovascular disease (CVD) and tobacco use since they account for a disproportionate amount of the NCD burden-the focus is strategic, rather than comprehensive. The goal of this book is to encourage countries to develop, adopt, and implement effective and timely country and, where appropriate, regional responses that reduce both population-level risk factors and the NCD burden.
The work develops (i) an NCD burden and risk factor profile for all countries and the region as a whole; (ii) a rationale for public policy and action for NCDs; (iii) a framework to guide the formulation of public policies and strategies for NCDs; (iv) a country profile, including capacity and ongoing NCD activities, as well as policy options and actions for NCDs that will help stimulate policy dialogue within and among countries; and (v) a regional strategy for NCD prevention and control where regional collaboration offers added value.
The achievements of this book are (i) developing a framework for policy options to identify key areas for strategic country- and regional-level policy and actions; (ii) bringing together demographic and aging trends, disease and risk factor burden data, alongside analyses of capacities and accomplishments to tackle NCDs; and (iii) using these inputs to develop policy options for country and regional strategies.

Sujets

• Tobacco
• Epidemiological transition
• Non-communicable disease
• Disease burden
• Health policy
• Demographic transition
• Population ageing
• Cardiovascular disease
• Health

Informations

• Publié par: world-bank-publications
• Publié le: 02 juin 2011
• Nombre de lectures: 33
• EAN13: 9780821387252
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

DIRECTIONS IN DEVELOPMENT
Human Development
Capitalizing on the
Demographic Transition
Tackling Noncommunicable Diseases
in South Asia
Michael Maurice Engelgau, Sameh El-Saharty, Preeti Kudesia,
Vikram Rajan, Sandra Rosenhouse, and Kyoko OkamotoC apitalizing on the Demographic Transition C apitalizing on the
D emogr aphic T r ansition
T ack ling Nonc ommunic able Diseases
in South Asia
M ichael Maurice Engelgau, Sameh El-Saharty, Preeti Kudesia, Vikram Rajan,
Sandra Rosenhouse, and Kyoko Okamoto
© 2011 The International Bank for Reconstruction and Development / The World Bank
1818 H Street NW
W ashington DC 20433
Telephone: [phone]
Internet: www.worldbank.org
All rights reserved
1 2 3 4 14 13 12 11
This volume is a product of the staff of the International Bank for Reconstruction and
Development / The World Bank. The findings, interpretations, and conclusions expressed in
this volume do not necessarily reflect the views of the Executive Directors of The World
Bank or the governments they represent.
The World Bank does not guarantee the accuracy of the data included in this work. The
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do not imply any judgement on the part of The World Bank concerning the legal status of
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All other queries on rights and licenses , including subsidiary rights, should be addressed to
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ISBN: 978-0-8213-8724-5
eISBN: 978-0-8213-8725-2
DOI: 10.1596/978-0-8213-8724-5
Library of Congress Cataloging-in-Publication Data
Capitalizing on the demogr aphic transition: tackling noncommunicable diseases in South
Asia / Michael Maurice Engelgau ... [et al.].
p. cm.
Includes bibliogr aphical references and index.
ISBN 978-0-8213-8724-5 — ISBN 978-0-8213-8725-2 (electronic)
1. Demographic transition—South Asia. 2. Public health—Economic aspects—South
Asia. 3. Medical economics—South Asia. I. Engelgau, Michael Maurice. II. World Bank.
HB3636.5.A3C37 2011
362.1969'800954—dc22
2011009181
Cover design: Quantum Think Contents
Preface xi
Acknowledgments xv
Abbreviations xvii
Overview 1
Introduction 1
What Is Happening and Its Implications 2
Why the Need to Act Now 5
How to Respond 8
Conclusion 11
Notes
PART I What Is Happening and Its Implications 13
Chapter 1 Regional Aging and Disease Burden 15
Regional Demographic and Epidemiologic
Transitions 15
NCDs in South Asia 24
Economic Burden 31
Notes 36
References 37
v vi Contents
Chapter 2 Country-Level Aging and Disease Burden 41
Afghanistan 42
Bangladesh 43
Bhutan 44
India 46
Maldives 47
Nepal 49
Pakistan 50
Sri Lanka 51
Implications for South Asia 53
Notes 54
References 55
PART II Why the Need to Act Now 57
Chapter 3 Rationale for Action 59
Social and Political Perspective 59
Economic and Development Perspective 60
Health Sector Perspective 62
References 63
Chapter 4 Opportunities for Prevention and Control 65
Global and National Policy Context for NCDs 65
What Can Governments Do? 66
Prevention of NCDs 68
Defining the Focus of NCD Interventions:
Prevention versus Treatment 68
Cost-Effectiveness Evidence on
Prevention, Control, and Treatment of NCDs 71
Notes 76
References 77
PART III How to Respond 81
Chapter 5 Developing a Policy Options Framework for
Prevention and Control of NCDs 83
Introducing the Pramework 83
Common Challenges for Tackling NCDs 90
Reference 93Contents vii
Chapter 6 Country Capacity and Accomplishments and
Application of the Policy Options Framework 95
Afghanistan 97
Bangladesh 98
Bhutan 99
India 100
Maldives 101
Nepal 103
Pakistan 103
Sri Lanka 105
Notes 106
References 106
Chapter 7 Regional Strategies for NCD Prevention
and Control 109
Guiding Principles for Regional
Collaboration 110
Strategies for NCD Risk Factors 112
Strategies to Improve Health Systems 117
Regional Institutional Capacity and
Past Collabor123
Conclusions 124
Notes 125
References 125
Appendix A Country Capacity Assessments and
Accomplishments 129
Reference 131
Appendix B Economic Rationale for Public P olicy
to Address NCDs 133
Standard Efficiency-Based Rationales 134
Nonstandard Economic Rationales:
Behavioral Economics 136
Conclusion 137
Notes 137
References 138viii Contents
Appendix C Disease Control Priorities in Developing
Countries: Population-Based and
Individualized Interventions for NCD
Prevention and Control 141
References 148
Appendix D Aligning Policy Options with Burden
and Capacity 149158
Appendix E Capacity , Key Accomplishments,
and Situational Analysis for NCDs 159
Afghanistan 159
Bangladesh 161
Bhutan 163
India 165
Maldives 167
Nepal 169
Pakistan 171
Sri Lanka 173
Note 175
References 175
Index 177
Boxes
1.1 Demographic and Epidemiologic Transitions 17
1.2 Methods to Describe the Health Situation in South Asia 25
2.1 The Social and Economic Impact of NCDs in
the Russian Federation 54
4.1 Framework Convention on Tobacco Control 66
4.2 Construct for NCDs 69
5.1 The Private Sector and NCDs 92
A.1 Country Capacity 130
D.1 Mapping the Relationship Between Burden and Capacity 150
Figures
1.1 Age Structure in South Asia 16
1.2 Dependency Ratios in Developed and
Developing Countries 18