September 16, 1996 in Nation/World

Tobacco Will Be Top Killer Will Overtake Germs As World’s Leading Cause Of Death By 2020

Associated Press

Heart disease, depression and car crashes will overtake infectious diseases to become the world’s leading causes of death and disability by 2020, the World Health Organization said in a major new health study released Sunday.

It will mark the first time non-infectious diseases kill more people than germs, a sudden rise propelled in part by tobacco.

By 2020, tobacco-related diseases, including those affecting the heart and lungs, will become the world’s greatest killer, causing one in every 10 deaths, says the study.

Those diseases claimed 3 million lives in 1990 - they are expected to claim 8.4 million lives in 2020.

“Non-communicable diseases will be the coming epidemic,” said Dr. Christopher Murray of Harvard University, a co-author of the study.

Already, 30 countries notified of the findings by WHO are considering how to revise public health programs, now focused almost solely on infections, in hopes of having “some way out of this mess,” Murray said.

Infectious diseases like pneumonia and diarrhea are the world’s leading causes of death and disability today and will remain potent threats in 2020. AIDS alone could kill 1 million to 1.7 million people a year by then, Murray reported.

But just as heart disease became the top killer of rich nations decades ago, it is rapidly stalking developing countries. By 2020, Murray concluded, it will have become the world’s No. 1 health threat.

Depression’s rise from the No. 4 world health threat in 1990 to second in 2020 will be due mostly to an aging population, Murray said: The pro portion of the population over 45 will rise 200 percent.

Mental illnesses are among the hardest to prevent - and to cure.

“We’re learning that many mental illnesses are chronic recurring conditions and their treatment requires long treatment and maintenance,” said Barry Lebowitz, the government’s top scientist studying the mental illnesses of the elderly.

And the number of deaths due to car crashes will increase as poor nations speed road development and the percentage within the population of young adults, the age group most often killed on the highways, grows larger, he said..

In all, non-infectious disease will account for seven of every 10 deaths in poor countries by 2020, up from fewer than half today.

Only in sub-Saharan Africa will germs still kill more than non-infectious disease.

WHO commissioned the study as a road map for governments better to spend scarce health resources, said co-author Dean Jamison, a health economist at the University of California, Los Angeles.

He came up with lists of “best buys” for science in low- and middle-income countries that house four-fifths of the world’s population but simply can’t afford the technology that richer countries already use against non-infectious disease.

For example, money now being spent of find a leprosy vaccine might be better directed to a malaria vaccine, since leprosy is rare while malaria causes almost 10 percent of death and disease in sub-Saharan Africa.

Switzerland will host a world meeting next year see how well countries are prioritizing medical research funds.

The report has good news: Life expectancy for girls born in every region of the world will rise by 2020 - up eight years to age 88 in rich nations.

In fact, the only group who won’t live longer are men in Eastern Europe, whose 1990 life expectancy of 65 already has plummeted 10 years and is expected to creep back up very slowly, Murray said.

One health threat the WHO report uncovered - injuries from accidents, murder or suicide that kill 5 million people a year - has no easy medical answer.

Take Colombia, where a third of the health burden is from injuries, most caused by violence.

In China, injuries constitute 17 percent of the health burden, including a staggering 180,000 women a year who kill themselves in what scientists call Asia’s “suicide belt.”

© Copyright 1996 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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