Infectious And Non-communicable Diseases In Asia-Pacific 28102021 V1
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Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare3Contents4About this report6Executive summary9Chapter 1. Epidemiology: The status of infectious diseases in Asia22Chapter 2. Covid-19 as a wake-up call27Chapter 3. Infectious disease and NCDs33Chapter 4. Country recommendations for the future of care39Conclusion40References The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare4About this reportInfectious and non-communicable diseases inAsia-Pacific: The need for integrated healthcareis an Economist Impact report that is sponsoredby Roche. The paper analyses the current stateof policy and practice regarding infectious andnon-communicable diseases in the Asia-Pacificregion and advocates ways to better ensure thatinfectious and non-communicable diseases aretackled synergistically, given their linkages. Thereport brings together findings from a literaturereview, expert panel meetings, and interviewswith health system officials, scientific leadersand policymakers. We would like to thank thefollowing individuals who have generouslycontributed their views and insights (listedalphabetically): Adeeba Kamarulzaman, professor of medicineand infectious diseases, University of Malaya,Malaysia Anthony Harries, senior advisor, InternationalUnion Against Tuberculosis and Lung Disease(The Union) Ben Cowie, director of the World HealthOrganisation Collaborating Centre for ViralHepatitis, Doherty Institute, Australia Bin Cao, Department of Respiratory andCritical Care Medicine, China-Japan FriendshipHospital, Beijing, China David Boettiger, research fellow, The KirbyInstitute, University of New South Wales,Australia Donghyok Kwon, director of public healthemergency response research, Korea DiseaseControl and Prevention Agency Hoang-Thy Nhac-Vu, School of Pharmacy,University of Medicine and Pharmacy of Ho ChiMinh City, Vietnam Kimberly Green, director of primary healthcareat PATH, US/Vietnam Mitsunori Odagiri, WASH specialist, Indonesia Nina Renshaw, director of policy and advocacy,NCD Alliance, Switzerland Nittaya Phanuphak, executive director,Institute of HIV Research and Innovation,Bangkok, Thailand Po Lin Chan, medical officer for viral hepatitis,World Health Organization Office for theWestern Pacific Richard Coker, emeritus professor of publichealth, London School of Hygiene and TropicalMedicine, Thailand Rosmawati Mohamed, consultant hepatologist,University Malaya Medical Centre, Malaysia The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare5 Shitong Huan, senior programme officer, Billand Melinda Gates Foundation China OfficeThe views of interviewees are their own, and notnecessarily those of their affiliated institutions. Soewarta Kosen, independent health systemsexpert, IndonesiaEconomist Impact bears sole responsibility forthe content of this report. The findings and viewsexpressed in the report do not necessarily reflectthe views of the sponsor. The report was writtenby Adam Green and edited by Rohini Omkarand Paul Tucker. The Economist Impact researchteam consisted of Gerard Dunleavy, JocelynHo, Jordan Lee, Keven Sew, Radha Raghupathyand Rohini Omkar. While every effort hasbeen taken to verify the accuracy of thisinformation, Economist Impact cannot acceptany responsibility or liability for reliance by anyperson on this report or any of the information,opinions or conclusions set out in this report. Taweesap Siraprapasiri, senior advisor on HIV,Department of Disease Control, Ministry ofPublic Health, Thailand Tham Chi Dung, infectious disease expert;vice-director of UNICEF-MOH Program,Vietnam Tran Thi Ngoc-Van, researcher at the Schoolof Pharmacy, University of Medicine andPharmacy University of Ho Chi Minh City,Vietnam Vu Ngoc Bao, deputy program director, HIV/TB, PATH, Vietnam Yodi Mahendradhata, vice-dean for researchand development, Faculty of Medicine, PublicHealth and Nursing, Universitas Gadjah Mada,Indonesia The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare6Executive summaryThe Asia region, home to more than half of theworld’s population, bears much of the globalinfectious disease (ID) burden, especially inpoorer countries.1, 2 Alongside the continuingthreat of prevalent infections like tuberculosis(TB), HIV, malaria, hepatitis and diarrhoealdiseases, the region is also witnessing a rise innon-communicable diseases (NCDs) as a resultof ageing populations and lifestyle changes.3, 4Changes to socioeconomic status in the AsiaPacific region—all five of the countries coveredin this report have become wealthier over theprevious 30 years—increasing air pollution,population expansion and ageing have alteredthe distribution of the disease burden, withNCDs rising in prevalence alongside a still-highID burden.5, 6Infectious and non-communicable diseasesrepresent distinct categories, but in reality,they are not separate. IDs can lead tochronic diseases, while NCDs can increasesusceptibility to infections; for example, abi-directional relationship exists betweenTB and diabetes, individuals with chronickidney disease are more likely to die fromrespiratory tract infections, and infectiousdiseases such as HIV (and its treatment)can predispose individuals to cardiovasculardisease, diabetes and various cancers.7-9 Yethealth systems, policies and funding streamsare often siloed, and the impact of NCDs hasbeen underestimated in the global discourseon health in developing countries.A growing appreciation for theinterconnectedness of IDs and NCDs is drivingattempts to integrate health services, investin innovative approaches and dismantlethe existing silos between them.7 Changingpopulation and disease dynamics across theregion, coupled with the increasing awarenessof the importance of integrated care models,presents a potential paradigm shift in diseasemanagement. This report endeavours toidentify the key challenges and success storiesin the breaking down of divisions betweenthese two sets of diseases, and presentsrecommendations for a more cohesive healthsystem.This report covers five study countries inthe Asia-Pacific region (China, Indonesia,South Korea, Thailand and Vietnam). Thecountry selection is designed to generate arepresentative sample of the region acrossparameters such as income level, populationsize, disease prevalence and so on. Theselected countries span the World Health The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcareOrganization (WHO) South East and WesternPacific regions. Drawing from a wide-ranginginterview programme, the report outlinesthe state of IDs in each country, the degreeto which IDs and NCDs are linked, and theopportunities for more integrated planning.It analyses key data on the epidemiology andimpact of, in particular, diarrhoeal diseases,lower respiratory tract infections, TB, HIV,hepatitis B virus and NCDs.Key findings include: Infectious and non-communicable diseasesare dynamically linked, and both posemajor challenges across Asia, yet they areoften not managed in an integrated way.Southeast Asia accounted for 43% and theWestern Pacific for 18% of the global burdenof TB in 2020.10 The Western Pacific regionhas the largest burden of chronic hepatitisB globally, accounting for about 39% of allcases in 2019.11 Simultaneously, NCD deathsare rising, and the highest number of deathsglobally due to NCDs occur in the WesternPacific (followed by Southeast Asia).4Factors constraining better integrationinclude bifurcated funding streams andorganisational silos, and lack of awarenessamong both the public and healthcareworkers about the linkages between IDs andNCDs. Covid-19 could provide a turning point inpublic health strategy as the interactionsbetween infectious and non-communicablediseases become more apparent tocitizens and healthcare communities. Thepandemic has accelerated innovation thatcould aid more integrated planning, notablytelemedicine consultation and digital healthtools, and led to a more health-informedpublic that is aware of the risks of commonconditions like such as obesity and high7blood pressure. The crisis has shown thepowerful role of community organisationsas allies in the fight for public health.Examples include collaborations betweenhealth authorities, hospitals, communityworkers and volunteers in Thailand that haveenabled NCD care to continue throughoutthe pandemic.12 These could play a largersocial role in the future in promoting publicawareness of linkages between IDs andNCDs, tackling stigma that may preventpeople seeking access to health services andproviding information to empower citizens. Screening programmes are a high-returnintervention to detect IDs with NCDimplications. Relevant programmesinclude those screening women with HIVfor cervical cancer, bi-directional TB anddiabetes screening, and surveillance for livercancer in patients with chronic hepatitis andcirrhosis.13-15 Experts that we interviewedhighlighted distinct areas for increasing theimplementation of effective multi-diseasescreening approaches. This has becomemore important as health systems bracefor a potential rise in NCD diagnoses orprogression among people who may nothave sought medical support during theworst phases of the covid-19 pandemic.16 Health stakeholders can improve theintegration of ID and NCD managementthrough investments in data, capacitybuilding, technology and public education.Data is a powerful tool with which to revealthe costs of NCDs resulting from curableIDs and provide the evidence base forinvestment in preventive measures suchas screening. Improving public awarenessabout the linkages between IDs and NCDscould ensure that patients take actionsooner. Building primary care capacity tobetter identify related conditions (such as The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare8TB and diabetes, HIV and cervical cancer,and lung infections and long-term chroniclung conditions) would ensure integrateddiagnosis and treatment services in the longterm. International donors could also exploreways to reduce the financial and technicalsilos that still exist between IDs and NCDs.Innovative financial instruments—suchas social-impact bonds—could also bedeveloped and refined, while greaterinvestment in human capital relative tohealth infrastructure could greatly improvethe quality of health services by empoweringmore staff with the necessary medicalexpertise to support citizens impacted byNCDs linked to IDs.17As Asian countries look to a post-covid future,the lessons of the pandemic—from positivesignals about the speed at which policies,technologies and medicines can be deployedto challenges such as social determinants ofhealth risks—must be applied. In doing so,stakeholders in the healthcare sector canachieve synergies, tackle multiple conditionsmore efficiently, and help the region toovercome its historical ID burden and avoidor forestall the new and serious chronicconditions that risk replacing them. The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare9Chapter 1.Epidemiology: The status ofinfectious diseases in Asia1.1 Burden of diseases: Episodic andlong termAsia, home to 60% of the world’s population,bears much of the global ID burden.2, 18Although there has been significant globalprogress towards the elimination of IDs—covid-19 notwithstanding—the diseasesanalysed in this report continue to impactpopulations and healthcare systems on thecontinent.Episodic diseaseInfective diarrhoea can be triggered by a rangeof viral, bacterial and parasitic organisms.19 In2017, the death rates from diarrhoeal diseasesin the countries in this report ranged from 0.54per 100,000 in China to 46.02 per 100,000 inIndonesia.20 Lower respiratory tract infections,defined as pneumonia or bronchiolitis, aremostly caused by bacteria but viruses such asinfluenza also play an important role.21 As of2019, lower respiratory tract infections werethe fourth-highest cause of death globally.22 In2017, death rates due to influenza were about0.8 per 100,000 individuals in China and 3 per100,000 in Thailand.23Longer-term infectious diseasesTuberculosisForty-three percent of all global casesof TB occur in Southeast Asia, and 18%in the Western Pacific.32 TB is unevenlydistributed in the region, with South Koreaand China showing lower incidence rates—59per 100,000 people and 58 per 100,000respectively—in comparison to Indonesia’srate of 312 per 100,000.32 China shouldersapproximately 10% of the global burden ofmultidrug-resistant TB.33 As well as mortality,TB contributes to severe levels of morbidity—in 2019, disability-adjusted life-years (DALYs)lost to TB ranged from 37 per 100,000population in South Korea to 4,985 per100,000 in Indonesia.34HIV/AIDSHIV impairs immune system function andcan progress to AIDS. In 2020, 3.7m peoplein Southeast Asia were living with HIV and2.2m were receiving treatment for the virus.Approximately 100,000 new infectionsoccurred, with 82,000 deaths. New infectionrates were stable but mortality had declinedcompared to 2019.35 The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcareHepatitis BHepatitis B virus infects the liver and leads toboth acute and chronic liver diseases. Globally,296m people are estimated to have chronichepatitis B infection, of which 116m live in theWestern Pacific and 18m in Southeast Asia.About 820,000 deaths were linked to chronichepatitis B in 2019, most of which wereattributable to the development of cirrhosis orliver cancer.11Influenza – a growing challengeInfluenza (flu), a respiratory virus belonging to theOrthomyxoviridae family of viruses, is transmitted swiftly throughdroplets, typically causes seasonal epidemics and has the greatestimpact on the elderly, immunocompromised or pregnant people,as well as those with chronic diseases.24 Complications that canarise as a result of severe cases of flu include superimposedbacterial pneumonias and worsening of underlying chronic lungand heart conditions.25 The World Health Organization (WHO)estimates that the virus infects 1bn people globally and causesbetween 290,000 and 650,000 deaths every year.26 Southeast Asiahas the second-highest influenza-related mortality rate globally, at3.5-9.2 per 100,000 individuals.27There have been significant achievements in flu prevention,control and preparedness. The Pandemic Influenza Preparedness(PIP) Framework for the sharing of influenza viruses and access tovaccines and other benefits provides key global guidance to WHOmember states. The PIP Framework strengthens global pandemicinfluenza surveillance and response through private-sector industrycontributions, benefiting low- and middle-income countries(LMICs) by increasing access to technologies and strengtheningcountries’ capacities.28 Other major initiatives include improvedepidemiological surveillance through the Global InfluenzaSurveillance and Response System, the development of the GlobalAction Plan for Influenza Vaccines to help to reduce shortagesand inequitable access of vaccines, and the establishment of theWHO Health Emergencies Programme to coordinate internationalresponses to contain disease outbreaks.29-31 Yet, there are ongoingchallenges, such as lack of capacity to detect and test for novelviruses in some countries; lack of robust epidemiological data(especially in LMICs); and inconsistent use of non-pharmaceuticalinterventions (such as hand washing or facemask use), antiviraldrugs and other treatments.10, 26101.2 Infectious diseases andnon-communicable diseases ascomorbiditiesIDs are not just important in and ofthemselves. They are also dynamically linkedto NCDs. Bi-directional relationships meanthat people with pre-existing conditions aremore vulnerable to some IDs, and IDs canincrease the risk of individuals developingNCDs. This intersection of infectious andnon-communicable diseases is oftenunderestimated and requires integratedhealthcare planning and policy.Pneumonia, for instance, increases the riskof lung cancer by an estimated 43%.36 Comorbidities, such as cancers, in turn, increasethe risk of mortality due to pneumonia.37 Inthose with existing chronic kidney disease, therisk of death from a respiratory tract infectionis almost doubled.8 Diarrhoeal infections area major cause of malnutrition and stuntingin children, and poor nutrition is a risk factorfor NCDs such as cardiovascular disease,metabolic disease and diabetes later in life.38Among longer-term infections, similarinteractions are evident. Hepatitis B virus isthe leading cause of liver cirrhosis and cancerin the Asia-Pacific region.39 Of patients witha history of TB, 50-70% develop chroniclung disease and the risk of lung cancer isincreased sixfold.7 In addition, treatments forlung cancer can reactivate TB.40 The acute andchronic inflammation triggered by TB is alsobelieved to contribute to the development ofcardiovascular disease.41 A previous EconomistImpact analysis, the Index of CancerPreparedness, highlighted that 23% of cancersthat occur in less-developed geographicalregions do so as a result of IDs, includingparasitic infections.42 The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare11Both HIV infection itself and its treatmentincrease the risk of NCDs such ascardiovascular disease, certain cancers,diabetes and depression. Such risk is furthercompounded by lifestyle factors.43 Expertsinterviewed for this report point to thechallenge posed by these relationships for aregion that is simultaneously struggling withIDs and a rising NCD burden. “NCDs andHIV are often seen as two different worlds,whereas at a clinical level we are starting tosee increasing NCDs in people living withHIV,” says Adeeba Kamarulzaman, dean of theFaculty of Medicine and professor of medicineand infectious diseases at the University ofMalaya in Kuala Lumpur. “Programmatically,because of the numbers, NCDs in manycountries in Asia are now seen as requiring afar greater priority than HIV/AIDS.” The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare121.3 Country snapshotsChinaInfectious diseases in China – an overviewCountry profile4,699Number of lower respiratory tractinfections in 2017.45 A high prevalenceof COPD and bronchiectasis canincrease the risk of acute infections,leading to negative outcomes.46Number of deaths from diarrhoeal diseasesin 2017 in children aged 0-4 years old.44Despite water and sanitation interventionsconsistently being a strategic part of eachof China’s five-year development plans, theburden remains high.500,34163 per100,000China’s TB incidence rate putsthe country among the top 20worldwide for TB burden.470.1% adult HIV prevalence48The HIV/AIDS epidemic in China has shiftedfrom primarily affecting injecting drug usersand female sex workers to men who have sexwith men.49 Testing and treatment are free,but stigma continues to hinder testing.49, 5095%Percentage of deaths that NCDsaccount for.52 Over 40% are dueto cardiovascular disease and23% are caused by cancer.52Coverage of China’s child hepatitis Bvaccination programme.51 Nonetheless,China has the world’s largest burden ofhepatitis B infections, with around70m cases.5189% The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcareOverview of China’s health system Health has been an important focus ofthe Chinese government in recent years,with large-scale reforms such as universalhealth care (UHC).53 Public health andprevention, in particular, have receivedrenewed attention following the 2003 SARSepidemic.54 China has a strong information systeminfrastructure, which plays an importantrole in guiding policy decisions. After SARS,the country established the world’s largestinternet-based reporting system of IDepidemics for the country’s 37 notifiablediseases.3,4 China extended coverage of basic medicalinsurance from 29.7% in 2003 to 95.7%in 2011, with a view to achieving 100%coverage by 2020.53 Despite attempts at decentralisation ofadministration, the central governmentremains the leading force in policymaking.53This has allowed China to deliver publichealth programmes at scale, with a focus onareas and population groups most at need.In particular, the government has played animportant role in coordinating programmefunding from donors targeting the samedisease area.50, 5513 China’s healthcare system is heavily relianton hospital-based care and lacks an effectiveprimary healthcare system.56 Owing to the sheer size of China’s geographyand population, there are large variations ininfection rates, health services, treatmentand outcomes across regions. The dividehas been found to be even greater betweenurban and rural populations.53 China’s economic development hasgenerated an important internal migrantpopulation. Migration has negativelyaffected access to services and thecontinuum of care.57-59 Despite the expansion of UHC in China,out-of-pocket payments still represented34% of total health expenditure in 2012.53The hospital fee-for-service model is alsocreating negative incentives for unnecessaryprocedures. 53, 60, 61 The government is also engaged in variousefforts to reform the medical insurancesystem and has introduced diagnosisrelated, group-based payments in variouscities around the country.62 The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare14Infectious diseases in Indonesia – an overviewCountry profile7,750Mortality from pneumonia inunder-5-year-olds in 2017.45 Lowerrespiratory tract infections affected444,000 people in 2017.45Number of deaths fromdiarrhoeal diseases in 2017 inchildren aged 0-4 years old.444%319 per100,000TB incidence rate puts Indonesiaamong the top 20 countriesworldwide.47 Many private clinics thatare not linked to the national TBcontrol programme are notprescribing within this guideline.6219mPeople currently live with hepatitis Bvirus in Indonesia.65 Childhoodvaccination commenced in 2013, butthere is a large variation in coverage.6548,000 cases per year63Indonesia is experiencing the fastest growing HIVepidemic in Southeast Asia.63 Low public awarenessand condom use, stigma and opposition fromreligious organisations, and counselling and testingfor pregnant women that requires husbands’approval has hindered national programmes.64Percentage of deaths accounted for byNCDs, a third of which are due tocardiovascular disease.52 Seventy-sixpercent of men smoke and over 10mpeople have type 2 diabetes, puttingIndonesia into the global top 10 forprevalence.5273% The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcareOverview of Indonesia’s healthsystem Indonesia introduced a novel national healthinsurance scheme in 2014, the JaminanKesehatan Nasional. By 2019 the schemecovered 77% of the population, makingit the largest single-payer scheme in theworld.63 A defining characteristic of the Indonesianhealth system is decentralisation, owing tothe complexity and diversity of the country’spopulation and geography. Decentralisationhas allowed flexibility in local health policiesbut also hindered the implementation ofcohesive national plans.63 Collection andmonitoring of health data are weakenedby decentralisation and multiple separatereporting systems.6615 Indonesia’s health expenditure stands atless than 3% of GDP, which is the lowestamong LMICs in Southeast Asia.63 This hasimpacted the capability to deliver ambitiousprogrammes. Despite the implementationof UHC, the government only covered 39%of total health expenditures in 2015, whileout-of-pocket expenses covered almost 47%of total health expenditure.66 The focus ofgovernment investment has also been oncurative services rather than public healthand prevention.66 The availability of medicines and medicalequipment is a major challenge for remote,underserved areas. Stronger managementand procurement systems are needed.67 The health workforce is currentlyinsufficient. The health worker/populationratio remained static between 2004 and2015, meeting less than 50% of the intendedgoal. Geographical distribution is also notaligned with population needs, with theworkforce concentrated in urban centres.63 The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare16Infectious diseases in South Korea – an overviewCountry profile8Number of deaths from diarrhoealdiseases in 2017 in children aged 0-4years old.44 Diarrhoeal diseaseprevalence is low, reflecting a higherstandard of living conditions comparedwith other countries in Asia Pacific.17,326 LRTI cases in 201745The prevalence of lower respiratory tractinfections is comparatively low.45 However, ithas increased in the past ten years to becomethe fifth leading cause of death, possiblylinked to the smoking rate in men of 40%.68, 6977 TB cases per 100,000 in 201670South Korea is the most TB-affectedOECD country.70 The elderly areparticularly affected, making up 42% ofall cases and 82% of TB-related deaths.70TB treatment is now fully paid for by thenational health insurance system.7014,880 total cases in 201571HIV prevalence has remained relatively low.The government has shifted its early focus onmass mandatory testing and compulsorytreatment to voluntary and anonymous testingand ensuring better access to free treatment.72 1%Percentage of deaths that NCDsaccount for.52 NCD burden is boostedby physical inactivity, high bloodpressure and the fact that 40% of mensmoke. Rising levels of obesity anddiabetes are also of concern.52The 2020 interim goal of childreninfected with hepatitis B under 5 wasmet. Nationwide vaccine coverage since1995 means that South Korea is ontarget to meet the WHO SDG toeliminate hepatitis B by 2030.7384% The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcareOverview of South Korea’s healthsystem South Korea achieved UHC in 1989. NationalHealth Insurance (NHI) covers 97% of thepopulation and the remaining is covered byMedical Aid for the low-income population.68Purchasing decisions on health services to becovered by the NHI are centralised.74 NHI requires co-payments for coveredservices, which are capped. Insured services,which typically involve new technologiesand medicines, require high out-of-pocketpayments and are an increasing concern.6817 Population ageing and the associated risein NCDs have been at the forefront ofKorea’s health policy and funding decisions,with limited attention paid to infectiousdiseases.70, 75 As a result, public interest andunderstanding of ID remain limited.70 Human resources for health have increasedin response to the growing demand forhealthcare due to UHC implementation andpopulation ageing. Nonetheless, the healthworker/population ratio is still below theOECD average and is concentrated in largemetropolitan areas.68 Health expenditure has increased rapidly,from 3.7% of GDP in 1995 to 7.4% of GDP in2011. The share of government expenditureincreased by 36% in this time, while out-ofpocket payments decreased from 52% to35%.68 The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcare18Infectious diseases in Thailand – an overviewCountry profileNumber of lower respiratorytract infections in 2017.45 Lowerrespiratory tract infectionsremain a public health concern.Decrease in AIDS-related deathsince 2010.78 The prevalence ofadults aged 15 and over living withHIV is around 1%.78174Number of deaths from diarrhoealdiseases in 2017 in children aged 0-4years old.44 The prevalence of diarrhoealdiseases remains high despite efforts toimprove water and sanitation.Top 30With an estimated 14.6m infected,Thailand ranks among the 30 countriesglobally with the highest prevalence ofboth TB and HIV-associated TB.76 Only20% of cases of DR-TB and MDR-TB aredetected and treated.77131,79058%3mPercentage of deaths accounted for byNCDs.52 Twenty-three percent ofthese are due to cardiovasculardisease and 18% are caused by cancer.Obesity has become a major issue,with 12% of male and 7% of femaleadolescents obese in 2016.52Estimated number of people withchronic hepatitis B infection. Eliminationgoals have worked well in driving policyinterest in the virus over the past fiveyears and vaccination is free.7974% The Economist Group 2021
Infectious and non-communicable diseases in Asia-Pacific: The need for integrated healthcareOverview of Thailand’s healthsystem The Thai government has made healtha priority, which is reflected i
Infectious and non-communicable diseases in Asia-Paciflc: The need for integrated healthcare 3 Contents 4 About this report 6 Executive summary 9 Chapter 1. Epidemiology: The status of infectious diseases in Asia 22 Chapter 2. Covid-19 as a wake-up call 27 Chapter 3. Infectious disease and NCDs 33 Chapter 4. Country recommendations for the .
The Economics of Non-Communicable Diseases in Indonesia report was written by Bloom, D. E., Chen S., McGovern M., Prettner K., Candeias V., Bernaert A. and Cristin S. 3 4 6 9 11 12. The Economics of Non-Communicable Diseases in Indonesia 3 Overview and purpose Non-communicable diseases (NCDs) have been
61. Diseases Common to Humans & Animals 62. Animal Assisted Therapy 63. Causes of Infectious Diseases 64. Infectious Diseases: Digestive System 65. Infectious Diseases: Respiratory & Reproductive Systems 66. Infectious Diseases: Integumentary System 67. Infectious Diseases: Cardiovas
COMMUNICABLE DISEASES IN CALIFORNIA, 2001-2008 SURVEILLANCE AND STATISTICS SECTION INFECTIOUS DISEASES BRANCH DIVISION OF COMMUNICABLE DISEASE CONTROL CENTER FOR INFECTIOUS DISEASES CALIFORNIA DEPARTMENT OF PUBLIC HEALTH Edmund G. Brown Jr. Governor State of California Diana S. Dooley, Secretary Health and Human Services Agency
3 2018 Australia s health Chapter 3 3.19 Communicable diseases Communicable diseases are caused by infectious agents and can be passed from one person or animal to another. Transmission can occur directly (through contact with bodily discharge), indirectly (for example, by shar
Communicable Disease Management Page 6 of 14 3.2. Communicable diseases of concern Table 1 - Communicable Disease Definitions, Modes of Transmission, and Signs and Symptoms Disease Definition Transmission Signs & Symptoms Tuberculosis (TB) TB is an infectious disease that primarily affects the lungs, but it can attack almost any
National Policy and Action Plan for Non-communicable Diseases Prevention and Control 2013-2017 BURDEN OF CHRONIC DISEASE (BOD) According to the Pan American Health Organization (PAHO) the epidemic of chronic non-communicable diseases (CNCDs) in the Caribbean is the worse in the Region of the
EPIDEMIOLOGY OF NON-COMMUNICABLE DISEASES LEARNING OBJECTIVES 1. List risk factors relevant to selected non-communicable diseases 2. Identify general concepts, risk factors, healthy lifestyle, risk modification, primary and secondary prevention of NCD 3. Explain the importance of periodic examinations 4.
Although there are different types of reports, in general, an academic report is a piece of informative writing, an act of communication and an account of an investigation (Reid, 2012). An academic report aims to sell a product, idea or points of view (Van Emden and Easteal, 1995). It should inform, explain and persuade (Williams, 1995) by using well- organised research. Sometimes it will .
