Communicable and Non-Communicable Diseases
Communicable and non-communicable diseases are undoubtedly the leading cause of morbidity and mortality in India, thus, a major concern in public health sector. Demographic factors and lifestyle changes due to the radical shift to urbanization has been the main reason as to why non-communicable diseases are a burden in India (Kinra et al. 2010). There are little if any quality and assured methods of collecting data in India on non-communicable diseases and this makes it difficult to cover a broad line and offer quality services. Lack of qualified health providers and other trained stakeholders such as community health workers with applicable skilled labor has made it impossible to combat the burden of non-communicable diseases in India. For this reasons, communicable diseases in India accounted for more than 38% and 35 % in inpatient and outpatient care deaths respectively, placing India first with the highest number of people dying at a productive age in the world (Kinra et al. 2010, p.4974; Boutayeb 2006, p.198). Cardiovascular diseases, cancer, chronic obstructive pulmonary disease, and diabetes mellitus are the main four non-communicable diseases that are incessantly destabilizing the health system of India. Due to drastic changes brought up by intense industrialization, these diseases are still seen to be a burden in the near future, causing high mortality as well as disability among her population. There is an estimation of more than 17.9 billion productivity loss by 2030, an alarm that needs immediate address through various interventions (Kinra et al. 2010, p.4974; WHO 2015). On the either hand, the burden of communicable diseases in India is significantly high. The causes of communicable diseases are poor sanitation, poor access to clean and safe drinking water, and generally poor hygiene. Diseases, such as malaria, typhoid, hepatitis, and jaundice diarrhea, have been reported to be endemic in India in the recent past, with the prevalence of people infected being more than 30 % (Kinra et al. 2010).
There is a growing link between communicable and non-communicable diseases especially in low and middle-income countries. In developing countries, the elderly are most susceptible to communicable diseases such HIV/AIDS and tuberculosis, which in turn threatens the invasion of non-communicable diseases such as cardiovascular disease, chronic obstruction pulmonary disorder, and diabetes mellitus (Boutayeb 2006). Evidently, there is a strong association between HIV/AIDS and Tuberculosis in that if an individual is immune suppressed he/she is more predisposed to tuberculosis (as an opportunistic disease) increasing the mortality rate of HIV/AIDS patients. Another instance is experienced in a case where individuals living with HIV/AIDS are at risk of developing cardiovascular disease due to associated early lifestyle factors such as smoking, alcohol intake, and drug abuse. Another scientifically proven example is the link between TB and diabetes mellitus. Diabetes increases chances of contracting TB in that DM interferes with tuberculosis treatment by delaying the sputum results hence increasing death rates. On the other hand, TB hinders diabetic treatment by interfering the control of glucose level in the blood complicating its management (Boutayeb 2006, p.195).
Diabetes
There is a momentous difference in people living with diabetes in high-income countries and people living with diabetes in low-income countries. The variation in economic development leads to a difference in social-economic factors such as education, industrialization, and immigration and how trade is conducted (Boutayeb 2006). This, in turn, leads to unlike type of lifestyle, especially the intake of energy dense versus nutrient dense diets. For example, people residing in urban areas in developing countries are more prone to diabetes as compared to people from rural areas whereas in developed countries elderly are more diabetic because of insufficient knowledge (Boutayeb 2006, P.196;World Health Organization 2002).
Malaria
According to World Health Organization (2015), most malaria infection, transmission, and deaths occur in sub-Saharan Africa countries pregnant mothers, people living with HIV/AIDS, under five children, and infants are at high risk of developing severe malaria. More than 20% of the susceptible group fell sick all over the world and majorly in sub-Saharan countries because there is a high burden of these diseases in these countries (WHO 2015). In Malaria endemic areas, children below five years suffer a lot from transmission of malaria thus causing premature deaths globally because in every two minutes a child life is lost. Studies show that in the year 2010 and 2015 sub-Saharan countries was the inhabitant of up to 90 % malaria incidences and more than 92% people died (WHO. 2015). Malaria pandemic still remains the sole cause of high mortality rate in sub-Saharan countries (WHO 2015).
WHO suggests that the only way to avert this killer disease is by application of broad vector prevention mechanisms, especially to areas highly that are prone and also to some other parts of the community (2015). For this reason, insecticide-treated nets, indoor residual spraying, and intermittent treatment of pregnant mothers, are considered the most effective vector mechanisms to address malaria especially to all people at risk (WHO 2015). Providing people with free and enabling easy access of long lasting insect treated nets, without forgetting the appropriate channeling of sleeping under the net benefits will go a long way to prevent all those at risk. Continuous indoor residual spraying after every 3-6 months serves this situation well, thus, reducing malaria incidents. Issuing anti-malaria drugs especially to travelers will suppress the plasmodium virus thus curbing the staging of malaria. It is recommended that pregnant mothers should be treated with sulfadoxine-pyrimethamine at every visit to the antenatal clinic after the first trimester (WHO, 2015). Also, children living in malaria-prone areas in sub-Saharan Africa should be given the sulfadoxine-pyrimethamine subsequently when other vaccination doses are administered. Through this coverage, between the years 2010 and 2015, people falling sick of malaria have significantly decreased by more than 20 % and decreased death rates accounting for 29% (World Health Organization 2015).
The major challenge in malaria diagnosis and treatment include insecticide resistance due to lack of long lasting insect treated nets (WHO 2015). Another recurring problem is that there are concurrent cases of anti-malaria drugs. The resistance of drugs such as P. falciparum, sulfadoxine-pyrimethamine (SP) and chloroquine has been a major setback in the effort of malaria control in sub-Saharan Africa. WHO encourages routine monitoring of anti-malarial drug resistance, and gives substantial support to countries aiming at intensifying their effort in preventing and eradicating malaria (WHO, 2015)
Mental Health
Studies that have been conducted shows that the global burden of mental disorder have considerably contributed to the larger picture of global diseases burden accounting for the greatest portion of disability adjusted life years with a significant percent of more than 50% (Üstün et al 2004). It is, therefore, suggested that quantification of true causes of mental illness will be significant because of the long term effect to both the person and to the society. However, some researchers argue that the burden of mental disorder is underestimated therefore causing more harm and unexpected deaths that account for not less than 35 % of people suffering from this disorder and the complications involved, such as cardiovascular diseases (Üstün et al 2004). The objectionable lethargy of governments and health funders of health worldwide must be trounced in order to alleviate all costs and other side effects of mental illness (Üstün et al 2004, p.388, WHO 2002).
There exist a strong vicious circle between mental health disorders and poverty. Studies have shown that commonly occurring mental illness are as double frequently among the poor people as compared to the rich. For instance, it is evidenced that low-income earners get depressed twice as compared to high-income earners (Üstün et al 2004). The poor are also likely to be subjected to more debts not to mention hunger which can cause mental disorders. Subjective poverty such as living in unsuitable and overcrowded houses, low level of education, and lack of productive jobs lends a hand in the development of mental disorders (WHO 2002). Schizophrenia disorder has been proved to be associated with people of low social economic status having more than 8 times chances of getting this disorder (WHO 2002). Studies have also indicated that people with schizophrenia in one way or another, graduated from high schools, fewer chances of employment or either, they are divorced. Additionally, several types of research show that there is a symbiotic relationship between poverty and mental disorders. Poverty leads to mental illness and the vice versa is true (World Health Organization 2002; Üstün et al. 2004, p.388).
The condition of mental health has been austere in the global health. The success of millennium development goals in curbing the health gap, especially in rich and poor countries, and its admirable achievement in reducing the rate of infectious diseases, did not take into account the state of mental illness, despite its global impact. There is still observably high treatment gap in low and middle-income countries, which reflect that mentally disadvantaged people do not receive medications at all and worse they suffer from face isolation, discrimination and generally their human rights, are violated. However, in 2015, mental health was included in United Nations Sustainable Development Goals (WHO 2017). The United Nations warmly addresses mental health disease burden and suggests that it will be of benefit to the health sector, in the next 20 years, if mental health will be taken into consideration and appropriate interventions to curb this challenge put across. In response to this, many organization and concerned stakeholders such as Fundamental SDG have joined hands in the effort of including mental health in SDGs. The Fundamental SDG has also gone an extra mile to convince UN to include mental health in the new development goals, coverage and health markers.
Bibliography
Boutayeb, A., 2006. The double burden of communicable and non-communicable diseases in developing countries. Transactions of the Royal society of Tropical Medicine and Hygiene, 100(3), pp.191-199.
Kinra, S., Bowen, L.J., Lyngdoh, T., Prabhakaran, D., Reddy, K.S., Ramakrishnan, L., Gupta, R., Bharathi, A.V., Vaz, M., Kurpad, A.V. and Smith, G.D., 2010. Sociodemographic patterning of non-communicable disease risk factors in rural India: a cross sectional study. Bmj, 341, p.c4974.
Üstün, T.B., Ayuso-Mateos, J.L., Chatterji, S., Mathers, C. and Murray, C.J., 2004. Global burden of depressive disorders in the year 2000. The British journal of psychiatry, 184(5), pp.386-392.
World Health Organization, 2002. The world health report 2002: reducing risks, promoting healthy life. World Health Organization.
World Health Organization, 2015. Global technical strategy for malaria 2016-2030. World Health Organization.
World Health Organization. 2017. Mental health included in the UN Sustainable Development Goals. [online]. Available at http://www.who.int/mental_health/SDGs/en/ (Accessed 17 May 2017)
