Coinciding with the UN high level meeting on NCDs, in which Mrs. Miri Ziv, ICA Director General, participated as World Cancer Ambassador, representing the American Cancer Society (ACS) and as a member of the Israeli delegation to this historic meeting, the World Bank also held a meeting in a small forum, to which Mrs. Ziv was also invited to take part.
This meeting discussed the World Bank's report on NCDs which revealed the following statistics: NCDs account for 63% of total deaths worldwide– cancer, heart diseases, chronic lung diseases and diabetes. NCDs - non-communicable diseases have been established as a clear threat not only to human health but also to development and economic growth. Half of those who die as a result of NCDs are in the prime of their productive years, and thus, the disability imposed and the lives lost are also endangering industry competitiveness.With respect to tobacco use, unless stronger action is taken, the 3.4 million tobacco-related deaths today will become 6.8 million in 2030.The macroeconomic simulations suggest a cumulative output loss of US$ 47 trillion over the next two decades, a loss that represents 75% of the global GDP (gross domestic product) in 2010 (US$ 63 trillion). Consequently, millions of people in the world will be driven below the poverty line. A recent WHO report reveals that the population-based measures for reducing tobacco and harmful alcohol use, as well as unhealthy diet and physical inactivity, are estimated to cost US$ 2 billion per year for all low- and middle-income countries, which in fact translates to less than US$ 0.40 per person. The rise in the prevalence and significance of NCDs is the result of complex interaction between health, economic growth and development and is strongly associated with universal trends such as ageing of the global population, rapid unplanned urbanization and globalization of unhealthy lifestyles. In addition to the tremendous demands that these diseases place on social welfare and health systems, they also cause decreased productivity in the workplace, prolonged disability and diminished resources within families.The good news is that there appear to be numerous options available to prevent and control NCDs. The WHO has identified a set of NCD interventions they call "best buy". There is also considerable scope for the design and implementation of programs aimed at promoting behavioral change among youth and adolescents, and more cost-effective models of care – models that reduce the care-taking burden that falls on family members. Furthermore, as mentioned, intervention - that can potentially save a significant portion of the US$ 47 trillion incurred by NCDs - is estimated to cost US$ 2 billion. The statistics speak for themselves:About 12 million people worldwide are diagnosed with cancer every year, and that figure is expected to reach 27 million by 2030. Experts assert that most developing countries allocate 4% to 7% of their healthcare budgets to dealing with cancer diseases.The issue that concerns economists and policymakers is not just the amount of money spent on healthcare, but also the rate of increase in healthcare spending, or what has become known as the cost curve. The estimated cost of treating cancer patients is US$ 290 billion dollars for those who have been diagnosed in 2010 and it is anticipated to rise to US$ 458 billion for those who will be diagnosed in 2030.In the UK for example, the total cost of treating breast cancer has increased by about 10% in each of the past 4 years. The increases in the cost of healthcare in the UK are driven by innovation – more effective but exceedingly expensive drugs and technologies.The number of cancer drugs available has risen from 35 in the 1970s to nearly 100 today!The trend towards personalized medicine leads to more effective treatment that is tailored to the patient and his/her distinct qualities.
In Japan, for instance, testing for the KRAS gene in colorectal cancer patients before deciding whether to use a cancer drug has saved about 50 million dollars. Erbitux is a drug now covered in the Israeli health care package as well, solely for patients who were tested for KRAS - and is thus administered only to those to whom the drug is suited, whereby resources are not wasted by needlessly prescribing a costly drug to unsuitable candidates.
In other words, we are in the era of introduction and effective use of new, but expensive, drugs, and it is imperative that they be included in the health package. However, we must keep in mind that at the same time, it is very important to firstly invest in disease prevention, and as mentioned, according to the WHO, the World Bank, and the Union for International Cancer Control, with the tools that are currently available, cancer morbidity in particular, and NCD morbidity in general may be reduced by about 50%! This is a matter of saving lives and realizing tremendous savings in cost and resources.