Indirect cost of non-communicable diseases deaths in the World Health Organization African Region

  • Joses Muthuri Kirigia
  • Germano M Mwabu
  • James Machoki M'Imunya
  • Rosenabi Deborah Karimi Muthuri
  • Lenity Honesty Kainyu Nkanata
  • Eric Bundi Gitonga

Abstract

Background: In 2012, a total of 9 398 809 deaths from all causes occurred in the WHO African Region; out of which 2 788 381 (29.67%) were due to non-communicable diseases (NCD). The objective of this study was to estimate future gross domestic product (GDP) losses associated with NCD deaths in the African Region for use to advocate for increased investments into prevention and management of NCDs.
Methods: Human capital approach is used to estimate non-health GDP losses associated with NCD deaths. Future non-health GDP losses were discounted at 3%. The analysis was done for three income groups of countries and six age groups. One-way sensitivity analysis at 5% and 10% discount rates was undertaken to assess the impact on expected non-health GDP loss estimates.
Results: The 2 788 381 NCD deaths that occurred in the African Region in 2012 are estimated to have resulted in a total discounted GDP loss of Int$ 61 302 450 005. Out of that total loss, 20.36% was borne by those aged 0-4 years; 12.76% by 5-14 years; 16.64% by 15-29 years; 44.93% by 30-59 years; 2.99% by 60-69 years; and 2.33% by those aged 70 years and above. Thus, those aged between 15 and 59 years bore 61.57% of the GDP losses.
Approximately 47.4%, 33.1% and 19.5% of the total loss was borne by high and upper middle-, lower middle- and low-income countries respectively. The average total non-health GDP loss was Int$ 21 985 per NCD death. The average non-health GDP lost per NCD death was Int$ 54 534 for Group 1, Int$ 21 492 for Group 2 and Int$ 9 096 for Group 3.
Conclusion: Premature NCD deaths are associated with substantive GDP losses in countries of the African Region. Therefore, unless African countries and their development partners bolster their investments to assure universal population coverage of cost-effective promotive, preventive and management interventions for NCDs, prospects of achieving the United Nations General Assembly Sustainable Development Goals (SDG) might be greatly undermined in Africa.
Key words: Non-communicable diseases, non-health GDP loss, NCD prevention and management, human capital approach

References

1. World Health Organization (WHO). Global Health Estimates 2014 summary tables: deaths by cause, age and sex, 2000-2012. Geneva: WHO; 2012.
2. WHO. World Health Statistics 2015. Geneva: WHO; 2015.
3. Galbraith-Emami S. Public Health Law and Non-communicable Diseases. London: UK Health Forum; 2013.
4. Sambo LG, Kirigia JM. Investing in health systems for universal health coverage in Africa. BMC International Health and Human Rights. 2014; 14:28. DOI: 10.1186/s12914-014-0028-5. URL: http://www.biomedcentral.com/1472-698X/14/28.
5. WHO. The World Health Report 2006: Working together for health. Geneva: WHO; 2006.
6. Kidder A, Kwan G, Cancedda C, Bukhman C. The PIH guide to chronic care integration for endemic non-communicable diseases. Boston: Partners In Health; 2011.
7. WHO. Global strategy for the prevention and control of non-communicable diseases. Fifty-Third World Health Assembly Document A53/14. Geneva: WHO; 2000.
8. Kankeu HT, Saksena P, Xu K, Evans DB. The financial burden from non-communicable diseases in low- and middle-income countries: a literature review. Health Research Policy and Systems. 2013; 11:31. URL: http://www.health-policy-systems.com/content/11/1/31.
9. Unwin N, Setel P, Rashid S, Mugusi F, Mbanya JC, Kitange H, Hayes L, Edwards R, Aspray T, Albert KGMM. Noncommunicable diseases in sub-Saharan Africa: where do they feature in the health research agenda? Bulletin of the World Health Organization. 2001; 79: 947–953.
10. World Bank. The Growing Danger of Non-Communicable Diseases: Acting Now to Reverse Course. Washington, DC: World Bank.; 2011.
11. PwC network. Quantifying and tackling the burden of chronic diseases in the GCC. Beirut: PwC network; 2013.
12. Suhrcke M, Rocco L, McKee M, Mazzuco S, Urban D, Steinherr A. Economic consequences of noncommunicable diseases and injuries in the Russian Federation. Copenhagen: WHO Regional Office for Europe; 2007.
13. Bloom DE, Cafiero ET, McGovern ME, Prettner K, Stanciole A, Weiss J, Bakkila S, Rosenberg L. The Economic Impact of Non-Communicable Disease in China and India: Estimates, Projections, and Comparisons. Working Paper 19335. Cambridge: National Bureau of Economic Research; 2013.
14. Australian Institute of Health and Welfare (AIHW). Australia’s Health 2014, Cat. No. AUS 178, Canberra: AIHW; 2014.
15. Zheng H, Ehrlich F, Amin J. Productivity loss resulting from coronary heart disease in Australia. Applied Health Economics and Health Policy. 2010; 8(3): 179-189.
16. Bloom DE, Cafiero ET, Jané-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, Feigl AB, Gaziano T, Mowafi M, Pandya A, Prettner K, Rosenberg L, Seligman B, Stein AZ, Weinstein C. The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum; 2011.
17. Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. The Lancet. 2007; 370(9603): 1929-1938.
18. Becker GS. Human capital: a theoretical and empirical analysis with special reference to education. Chicago: The University of Chicago Press; 1993.
19. Fourie FCN. How to think and reason in macroeconomics. Cape Town: Juta & Co.; 1999.
20. The World Bank. The economic impact of the 2014 Ebola Epidemic: short and medium term estimates for West Africa. Washington, D.C.: The World Bank; 2014.
21. WHO. WHO guide to identifying the economic consequences of disease and injury. Geneva: WHO; 2009.
22. Chisholm D, Stanciole AE, Edejer TTT, Evans DB. Economic impact of disease and injury: counting what matters. BMJ. 2010; 340(c924): 583-586. doi: 10.1136/bmj.c924.
23. Kirigia JM, Masiye F, Kirigia DG, Akweongo. Indirect costs associated with deaths from the Ebola virus disease in West Africa. Infectious Diseases of Poverty. 2015; 4:45. doi:10.1186/s40249-015-0079-4.
24. Kirigia JM, Muthuri RDK. Productivity losses associated with tuberculosis deaths i n the World Health Organization African Region. Infectious Diseases of Poverty. 2016; 5:43. DOI 10.1186/s40249-016-0138-5.
25. Kirigia JM, Mwabu GM, Orem JN, Muthuri RDK. Indirect cost of maternal deaths in the WHO African Region, 2013. International Journal of Social Economics. 2016; 43(5): 532 - 548.
26. Kirigia JM. Economic Evaluation of Public Health Problems in sub-Saharan Africa. Nairobi: University of Nairobi Press; 2009.
27. Drummond MF, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press; 1988.
28. Curry S, Weiss J Project analysis in developing countries. London: The MacMillan Press LTD; 1993.
29. Kirigia JM, Sambo LG, Yokouide A, Soumbey-Alley E, Muthuri LK, Kirigia DG. Economic burden of cholera in the WHO African region. BMC International Health and Human Rights. 2009; 9:8. URL: http://www.biomedcentral.com/1472-698X/9/8.
30. Kirigia JM, Muthuri RDK, Nabyonga-Orem J, Kirigia DW. Counting the cost of child mortality in the World Health Organization African region. BMC Public Health. 2015; 15:1103. Doi: 10.1186/s12889-015-2465-z. URL: http://www.biomedcentral.com/content/pdf/s12889-015-2465-z.pdf
31. WHO. Mortality and burden of disease estimates for WHO member states in 2008. Geneva: WHO; 2011.
32. Murray CJL. Rethinking DALYs. In: Murray CJL, Lopez AD, editors. The global burden of disease - a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge: Harvard University Press; 1996, pp. 1–98.
33. WHO. World Health Report 2000: health systems: improving performance. Geneva: WHO; 2000.
34. Murray CJL, David B. Health systems performance assessment: debates, methods and empiricism. Geneva: WHO; 2003.
35. International Labour Organization (ILO). C138 - Minimum Age Convention, 1973 (No. 138). Geneva: ILO; 1973.
36. WHO. Global Health Observatory - Disease and injury country mortality estimates, 2000–2012. Geneva: WHO; 2016. Accessed at 20h40 on 30 March 2016. URL: http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html.
37. WHO. Global Health Observatory data repository. African Region Projections of number of deaths for 2015-2030. Geneva: WHO; 2016. Accessed at 20h40 on 30 March 2016. URL: http://apps.who.int/gho/data/node.main.GHEPROJMORT?lang=en.
38. WHO. WHO methods and data sources for global causes of death 2000-2012. Global Health Estimates Technical Paper WHO/HIS/HSI/GHE/2014.7. Geneva: WHO; 2014.
39. International Monetary Fund (IMF). World Economic Outlook Database. Washington, D.C.: IMF; 2015. October 2015. URL: http://www.imf.org/external/pubs/ft/weo/2015/02/weodata/weorept.aspx? Accessed on 20 January 2016 at 11 h30.
40. United Nations (UN). Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases. UN General Assembly Resolution A/RES/66/2. New York: UN; 2011.
41. United Nations. Transforming our world: the 2030 Agenda for Sustainable Development. UN General Assembly Resolution A/RES/70/1. New York: UN; 2015.
42. WHO. Follow-up to the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-Communicable Diseases. Sixty-Sixth World Health Assembly resolution WHA66.10. Geneva: WHO; 2013.
43. WHO. Global action plan for the prevention and control of non-communicable diseases 2013–2020. Sixty-Sixth World Health Assembly Doc. A66/9. Geneva: WHO; 2013.
44. WHO. Draft comprehensive global monitoring framework and targets for the prevention and control of non-communicable diseases. Sixty-Sixth World Health Assembly document A66/8. Geneva: WHO; 2013.
45. WHO. Global strategy for the prevention and control of non-communicable diseases. Geneva: WHO; 2000.
46. WHO. Prevention and control of non-communicable diseases. Fifty-third World Health Assembly Resolution WHA 53.17. Geneva: WHO; 2000.
47. WHO. Comprehensive mental health action plan 2013–2020. World Health Assembly Resolution WHA66.8. Geneva: WHO; 2013.
48. WHO. Health and the environment: addressing the health impact of air pollution. World Health Assembly Resolution WHA68.8. Geneva: WHO; 2015.
49. WHO. WHO Framework Convention on Tobacco Control. Fifty-Sixth World Health Assembly resolution WHA56.1. Geneva: WHO; 2003.
50. WHO. Global Strategy on Diet, Physical Activity and Health. Resolution WHA57.17. Geneva: WHO; 2004.
51. WHO. Global strategy to reduce the harmful use of alcohol. Resolution WHA63.13. Geneva: WHO; 2010.
52. WHO. Marketing of food and non-alcoholic beverages to children. World Health Assembly Resolution WHA63.14. Geneva: WHO; 2010.
53. WHO. Strengthening non-communicable disease policies to promote active ageing. World Health Assembly resolution WHA65.3. Geneva: WHO; 2012.
54. African Union (AU) and WHO. Commitment on non-communicable diseases in Africa - policies and strategies to address risk factors. Commitment number AUC-WHO/COM.3/2014. First meeting of African Ministers of Health jointly convened by the AUC and WHO, Luanda, Angola, 16–17 April, 2014. Addis Ababa: AU; 2014.
55. AU. Decision on the special session of the African Union conference of Ministers of Health DOC. EX.CL/435(XIII). Addis Ababa: AU; 2008.
56. World Health Organization Regional Office for Africa (WHO/AFRO). Healthy ageing in the African Region: situation analysis and way forward. Sixty-third Regional Committee for Africa resolution AFR/RC63/R1. Brazzaville: WHO/AFRO; 2013.
57. WHO/AFRO. Consideration and endorsement of the Brazzaville declaration on non-communicable diseases. Sixty-seven Regional Committee for Africa resolution AFR/RC62/R7. Brazzaville: WHO/AFRO; 2012.
58. WHO/AFRO. Reduction of the harmful use of alcohol: a strategy for the WHO African Region. Sixtieth Regional Committee for Africa resolution AFR/RC60/R2. Brazzaville: WHO/AFRO; 2010.
59. WHO/AFRO. A strategy for addressing key determinants of health in the African Region. Sixtieth Regional Committee for Africa resolution AFR/RC60/R1. Brazzaville: WHO/AFRO; 2010.
60. WHO/AFRO. Diabetes prevention and control: a strategy for the WHO African region. Fifty-seventh Regional Committee for Africa resolution AFR/RC57/R4. Brazzaville: WHO/AFRO; 2007.
61. WHO/AFRO. Food safety and health: a strategy for the WHO African region. Fifty-seventh Regional Committee for Africa resolution AFR/RC57/R2. Brazzaville: WHO/AFRO; 2007.
62. WHO/AFRO. Cardiovascular diseases in the African Region: Current situation and perspectives. Fifty-fifth Regional Committee for Africa resolution AFR/RC55/R4. Brazzaville: WHO/AFRO; 2005.
63. WHO/AFRO. Health and environment: a strategy for the African region. Fifty-second Regional Committee for Africa resolution AFR/RC52/R3. Brazzaville: WHO/AFRO; 2002.
64. WHO/AFRO. Health Promotion: a strategy for the African Region. Fifty-first Regional Committee for Africa resolution AFR/RC51/R4. Brazzaville: WHO/AFRO; 2001.
65. WHO/AFRO. Health Promotion: strategy for the African Region. Sixty-second Regional Committee for Africa resolution AFR/RC62/R4. Brazzaville: WHO/AFRO; 2012.
66. WHO/AFRO. Noncommunicable diseases: a strategy for the African region. Fiftieth Regional Committee for Africa resolution AFR/RC50/R4. Brazzaville: WHO/AFRO; 2000.
67. African Union and WHO. Commitment on accountability mechanism to assess the implementation of commitments. AU-WHO Ministers of Health Commitment number AUC-WHO/COM.6/2014. First meeting of African Ministers of Health jointly convened by the AUC and WHO, Luanda, Angola, 16–17 April, 2014. Addis Ababa: AU; 2014.
68. WHO. Global status report on noncommunicable diseases 2014. Geneva: WHO; 2014.
69. Kirigia JM, Nabyonga-Orem J, Dovlo DYT. Space and place for WHO health development dialogues in the African Region. BMC Health Services Research. 2016; 16(Suppl 4):221; 287-304. DOI 10.1186/s12913-016-1452-0. URL: http://www.biomedcentral.com/content/pdf/s12913-016-1452-0.pdf
70. WHO. Scaling up action against noncommunicable diseases: How much will it cost? Geneva: WHO; 2011.
71. Ebrahim S, Pearce N, Smeeth L, Casas JP, Jaffar S, Piot P. Tackling Non-Communicable Diseases In Low- and Middle-Income Countries: Is the Evidence from High-Income Countries All We Need? PLoS Med. 2013; 10(1): e1001377. doi:10.1371/journal.pmed.1001377.
72. WHO/AFRO. Integrated disease surveillance in the African Region: A regional strategy for communicable diseases (1999-2003). Regional Committee for Africa document AFR/RC/48/8. Brazzaville: WHO/AFRO; 2001.
73. Danaei G, Finucane MM, Lin JK, Singh GM, Paciorek CJ, Cowan MJ, Farzadfar F, Stevens GA, Lim SS, Riley LM, Ezzati M. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5·4 million participants. Lancet. 2011; 377(9765):568-577.
74. Mooney G. The Valuation of Human Life. London: Macmillan Education UK; 1977.
75. Linnerooth J. The Value of Human Life: A Review of the Models. Economic Inquiry. 1979; 17(1): 52-74.
76. Mishan EJ. Cost Benefit Analysis: An Informal Introduction. London: George Allen & Unwin Ltd; 1975.
77. Mishan EJ. The Value of Trying to Value Life. Journal of Public Economics. 1981; 15: 133-137.
78. Card WI, GH Mooney. What is the monetary value of a human life? British Medical Journal. 1977; 2:1627-1629.
79. Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, Baugh V, Bekedam H, Billo N, Casswell S, Cecchini M, Colagiuri R, Colagiuri S, Collins T, Ebrahim S, Engelgau M, Galea G, Gaziano T, Geneau R, Haines A, Hospedales J, Jha P, Keeling A, Leeder S, Lincoln P, McKee M, Mackay J, Magnusson R, Moodie R, Mwatsama M, Nishtar S, Norrving B, Patterson D, Piot P, Ralston J, Rani M, Reddy KS, Sassi F, Sheron N, Stuckler D, Suh I, Torode J, Varghese C, Watt J. Priority actions for the non-communicable disease crisis. 2011. Lancet. 377(9775): 1438–1447.
Published
2017-03-13
How to Cite
MUTHURI KIRIGIA, Joses et al. Indirect cost of non-communicable diseases deaths in the World Health Organization African Region. International Archives of Medicine, [S.l.], v. 10, mar. 2017. ISSN 1755-7682. Available at: <http://imedicalsociety.org/ojs/index.php/iam/article/view/2400>. Date accessed: 20 nov. 2017. doi: https://doi.org/10.3823/2304.
Section
Global Health & Health Policy