Global health initiatives and dollars tend to focus heavily on infectious diseases such as malaria, AIDs, polio, and tuberculosis. Major goals of the Gates Foundation, for example, are to focus on childhood health and eradicate malaria and polio. At the same time, common, potentially hereditary diseases that affect millions of people on all continents are often overlooked and underfunded, leaving a gap in care.
Arthritis is an example of a disease that is extremely painful and debilitating and also carries severe economic consequences. The World Health Organization estimates that 350 million people worldwide suffer from arthritis. Thirty percent of those affected are in the prime working ages of 45 to 65.
In higher income countries, arthritis frequently causes reduced workplace productivity. However, for residents of developing countries arthritis creates a vicious cycle that impacts productivity and subsequently worsens poverty. Those with joint diseases and arthritis slowly become crippled and eventually become so disabled they can’t work. In fact, the Years Lost to Disability (a statistical term) attributable to osteoarthritis has increased by 75 percent from 1990 to 2013 in developing countries.
Citizens outside of the western capitalist structure may have less flexibility regarding working conditions or hours and possess few if any options for early retirement with no social security or other “safety net.” Consequently, they become burdens on their families and villages, adding to the poverty level of both. For many who suffer, there’s little prospect for restorative implant or other surgery, options that patients in the United States routinely access.
Millions of people suffer from Non-Communicable Diseases (NCDs) like diabetes, cancer, and heart disease. These are the leading global causes of death and disability with 39.5 million people dying from NCDs every year.
I have seen the ravages of arthritis disease up close and personal as an 11-time volunteer with Operation Walk, a medical humanitarian organization that performs free knee and hip implant surgeries for people in need all over the globe. I have helped with surgeries in Nepal, Vietnam, Panama, Nicaragua, El Salvador, Honduras, Cuba, Guatemala, Mexico, and Tanzania.
Led by surgeons from USC Keck Hospital, Operation Walk brings a team of 60 volunteers—primarily medical professionals but with a few regular citizens like me—to spend three days operating from 7 a.m. to 7 p.m. We spend the first day screening patients and selecting 50 or so for surgery, disappointing hundreds of others. We spend the last 3 days helping patients with recovery. We often meet government officials and have an opportunity to talk with them about conditions in their country with an emphasis on health issues.
The hospitals give us a warm welcome, but they generally are poorly equipped so Operation Walk imports everything from instruments and implants to antibiotics and even Band-Aids. Cargo is the organization’s largest expense, and unused medical supplies, implants, walkers, crutches, and other supplies stay behind at the local hospital post-mission. In-country doctors help with surgeries so they can learn the newest techniques and advances.
Sometimes a patient will be too disabled for local doctors to operate. Just recently in Guatemala we had an older patient who could barely stand because his legs were so bowed. He couldn’t work but was able to live in a room in a farm building for free by opening the gates at 4 a.m. every day and closing them at 9 p.m. A day after surgery on both legs, he was up and walking with crutches. His sister was amazed to see him. They had a tearful but joyous reunion in which he repeatedly said he couldn’t wait to get back to a full-time job.
Most victims of arthritis continue to live in pain and suffer the indignities of being dependent upon others. Millions of others suffer as well from diabetes, cancer, and heart disease, the leading global causes of death and disability with 39.5 million people dying from them every year.
Dr. Lawrence Dorr was responsible for the first mission of Operation Walk in 1996. He had seen conditions in other countries as he was often invited to visit as a guest surgeon so he anticipated the challenges. Orthopedic surgeons from around the United States have joined Dr. Dorr on missions and have returned home to start 14 local chapters.
I have witnessed 500+ people walk again, pain free for the first time in years and excited to be able to go back to work. They will earn money once again, improving the lives of their families, adding to the GDP of their countries and regaining their self-esteem. I always come home completely energized and recommitted to the next mission of freeing 50 more people from the pain and immobility of arthritis.
While the Operation Walk teams help a fortunate few, most victims of arthritis continue to live in pain and suffer the indignities of being dependent upon others. Millions of others suffer as well from Non-Communicable Diseases (NCDs) like diabetes, cancer, and heart disease. These are the leading global causes of death and disability with 39.5 million people dying from NCDs every year. But these diseases receive only a tiny amount of funding when compared with their burden on the economic health of communities and countries. In 2011, $7.7 billion was allocated to HIV/AIDS projects, while malaria, tuberculosis, and maternal, newborn, and child health received $1.8 billion, $1.3 billion, and $6.1 billion respectively. NCDs received only 1.5 percent of all health aid.
A small dollar investment in preventing and treating Non-Communicable Diseases will pay off in dramatic advances in longevity, quality of life, and global GDP.
Why does this disparity exist? A lack of data on cost-effectiveness of NCD interventions is most likely one reason. Management of diabetes, for example, requires long-term monitoring and medication—whereas a vaccine can be administered in one or a few doses, and return on investment is easily and simply calculated.
Further, the exclusion of NCDs from the UN Development Goals has been a major barrier to getting NCDs on the agenda. But a strong voice has now emerged at the global level—the NCD Alliance. This group has brought together 2,000 organizations to advocate for NCD funding and has spearheaded several global conferences to address the funding shortfall, disease protocols, and action frameworks. It already has led the United Nations to recognize the need for NCD action and hopefully NCDs will be part of the next iteration of the Sustainable Development Goals.
Look for the NCD Alliance to play a major role in raising awareness and convincing global funding decision makers of how a small dollar investment in preventing and treating NCDs will pay off in dramatic advances in longevity, quality of life, and global GDP.
Carolyn Miller is a Pacific Council member and president of Miller Ventures, Inc.
The views and opinions expressed here are those of the author and do not necessarily reflect the official policy or position of the Pacific Council.