**1. Introduction**

As with many high-resourced countries, low-resourced countries have not been spared the global challenges caused by non-communicable diseases (NCDs), such as cardiovascular diseases, coronary heart disease, hypertension, diabetes mellitus,

**8**

*Public Health in Developing Countries - Challenges and Opportunities*

[1] Acheson D. Independent Inquiry into Inequalities in Health Report. London,

[2] Binns C, Low W-Y. What is public health. Asia-Pacific Journal of Public

[3] World Health Organization (WHO). Preamble to the Constitution of the World Health Organization. Geneva:

[4] Kaseje D. Health care in Africa: Challenges, opportunities and an emerging model for improvement. In: Paper Presented at the Woodrow Wilson International Centre for Scholars

[5] Chatora R. An Overview of the Traditional Medicine Situation in the African Region. African Health Monitor, World Health Organization Africa Region (WHO-AFRO). 2003;**4**(1):4-7

[6] Anugwom EE. Beyond morality: Assessment of the capacity of faithbased organizations (FBOs) in

responding to the HIV/AIDS challenge in southeastern Nigeria. Iranian Journal of Public Health. 2018;**47**(1):70-76

[7] Dilger H. Doing better? Religion, the virtue ethics of development, and the fragmentation of health policies in Tanzania. AFR Today. 2009;**56**:89110

[9] Cooke J. Public Health in Africa: A report of the CSIS Global Health Policy Centre. Washington, D.C: Center for Strategic and International Studies

[8] Chikwendu E. Faith-based organizations in anti-HIV/AIDS work among African youth and women. Dialectical Anthropology.

2004;**28**:307-327

(CSIS); 2009

UK: Stationery Office; 1998

Health. 2015;**27**(1):5-6

WHO; 1946/48

**References**

(November 2); 2006

and obesity [1, 2]. For countries with minimal health budgets, every effort needs to be made to reduce patients' reliance on costly medical solutions to health problems, including NCDs, for which drugs are often the first line of treatment to reduce the associated morbidity and premature mortality [3]. Prevention efforts within the healthcare system need to take a broader public health approach to motivate people to address their unhealthy lifestyles that result in the development of NCDs. To achieve this, however, Ministries of Health in low-resourced countries needs factual, timely, and reliable NCDs data that can build a comprehensive information system to provide evidence-based decision-making and to develop appropriate prevention strategies for the specific population affected by NCDs [4, 5].

All healthcare organisations, including governmental and non-governmental institutions, have their strategies to prevent and control diseases and to maintain the health of their community effectively and efficiently. Likewise, healthcare organisations have a strategy for disease prevention and control to maintain the health of the community. Most healthcare systems rely on accurate, timely, correct, and factual data to make political and administrative decisions [4–6]. Moreover, healthcare systems should have a balanced approach in preventing both infectious communicable disease and NCDs, which require factual data at the mega, macro, meso, and micro level of healthcare.

This chapter aims to create a better understanding of the growing global burden and perspectives on NCDs. It also aims to reflect on the prevention of NCDs, the global status and availability of NCDs data, and effective strategies to prevent the growing burden of NCDs in low-resourced countries.

#### **1.1 The global burden of non-communicable disease**

Non-communicable diseases (NCDs) are the leading public health challenges globally in the twenty-first century, resulting in ill health, economic loss, life loss, diminished quality of life, and poor social development equally in both high-resourced and low-resourced countries [7, 8]. According to the World Health Organisation Global Status Report (GSR) on non-communicable disease, from 38 million deaths due to NCDs each year, more than 40% were premature and were preventable [9]. Based on the projection of the WHO, by 2025 NCDs will account for over 70% of all deaths globally, with 85% of these occurring in developing countries [10]. Evidences show that if proper prevention approaches are not designed and applied, an estimated 41 million people in low-resourced countries will die from NCDs by 2025, mainly due to cardiovascular diseases (CVDs) (48%), cancers (21%), chronic respiratory diseases (12%), and diabetes (3%) [11].

Globally, more than 9 million deaths occurred due to NCDs in people under the age of 60, with most being preventable. Untimely losses from NCDs range from 22% amongst men and 35% amongst women in low-resourced countries to 8% amongst men and 10% amongst women in high-resourced countries [10]. According to current research, more than 80% of heart diseases, stroke, hypertension and type 2 diabetes, and over a third of cancers can be prevented by eradicating the common risk factors, mainly tobacco use, unhealthy diets, physical inactivity, and the harmful use of alcohol [12]. The effective prevention and management of common NCDs risk factors require the establishment of a strategic framework which can tackle health problems associated with the growing burden of morbidity and mortality of these diseases [13]. According to evidence by the WHO, globally, NCDs deaths will increase by 17% over the next 10 years, with the most considerable increase being in low-resourced countries such as Africa (27%) and the Eastern Mediterranean region (25%) [7, 8]. Current research indicates that cancer, diabetes, high blood pressure, cardiovascular diseases, and kidney diseases are no longer the

**11**

**Figure 1.**

*The Global Burden and Perspectives on Non-Communicable Diseases (NCDs)…*

illness of high-resourced countries, but also, non-communicable disease hampers the people and the economies of the deprived populations even more than communicable diseases, representing a public health emergency in slow motion [14, 15]. As illustrated in **Figure 1**, common NCDs account for most of the avoidable morbidity and preventable mortality, these being cardiovascular disease, coronary heart disease, high blood pressure, diabetes, and obesity. The percentage of mortality associated with the major NCDs across three regions of the world, such as high-resourced countries, low-resourced countries, and Africa varies. In highincome countries, the percentage of mortality related with NCDs such as cardiovascular disease, coronary heart disease, high blood pressure, diabetes, and obesity decreases, whilst in low-resourced countries and Africa, it continues to raise. For instance, the percentage of mortality due to cardiovascular disease is 38% in highresourced countries [16] and 42% in low-resourced countries, from which 20% is

In low-resourced countries, the largest percentage of mortality (70%) is due to coronary heart disease with Africa's share 10% [19]. In high-resourced countries, coronary heart disease accounts for 20% of mortality. The share of high blood pressure is 46% in Africa, exceeding the total percentage of deaths in low-resourced countries (40%) [20]. In high-resourced countries, high blood pressure accounts for

The percentage of mortality as a result of diabetes is 8, 12, and 14% in highresourced, low-resourced countries, and Africa, respectively [22, 23]. The percentage of deaths due to obesity is 29.5% in high-resourced countries and 37.5% in

In 2011, the United Nations High-Level Meeting presented and promised a unique opportunity for international communities to take action against the rising

*Percentage of mortality associated with NCDs in Africa, high-resourced and low-resourced countries.*

low-resourced countries with the share of Africa 33% [24–27].

*DOI: http://dx.doi.org/10.5772/intechopen.89516*

the share of Africa [17–19].

a relatively lower 35% of mortality [21].

**1.2 The global perspective on NCDs**

#### *The Global Burden and Perspectives on Non-Communicable Diseases (NCDs)… DOI: http://dx.doi.org/10.5772/intechopen.89516*

illness of high-resourced countries, but also, non-communicable disease hampers the people and the economies of the deprived populations even more than communicable diseases, representing a public health emergency in slow motion [14, 15].

As illustrated in **Figure 1**, common NCDs account for most of the avoidable morbidity and preventable mortality, these being cardiovascular disease, coronary heart disease, high blood pressure, diabetes, and obesity. The percentage of mortality associated with the major NCDs across three regions of the world, such as high-resourced countries, low-resourced countries, and Africa varies. In highincome countries, the percentage of mortality related with NCDs such as cardiovascular disease, coronary heart disease, high blood pressure, diabetes, and obesity decreases, whilst in low-resourced countries and Africa, it continues to raise. For instance, the percentage of mortality due to cardiovascular disease is 38% in highresourced countries [16] and 42% in low-resourced countries, from which 20% is the share of Africa [17–19].

In low-resourced countries, the largest percentage of mortality (70%) is due to coronary heart disease with Africa's share 10% [19]. In high-resourced countries, coronary heart disease accounts for 20% of mortality. The share of high blood pressure is 46% in Africa, exceeding the total percentage of deaths in low-resourced countries (40%) [20]. In high-resourced countries, high blood pressure accounts for a relatively lower 35% of mortality [21].

The percentage of mortality as a result of diabetes is 8, 12, and 14% in highresourced, low-resourced countries, and Africa, respectively [22, 23]. The percentage of deaths due to obesity is 29.5% in high-resourced countries and 37.5% in low-resourced countries with the share of Africa 33% [24–27].
