The impact of Western diseases on Latin America
Luke Sewell highlights the burden of Western diseases such as cancer, diabetes and obesity on Latin America in pharmaphorum’s emerging markets themed month.
How Western diseases are impacting Latin America
The disease burden in Latin America has made a recent shift from infectious diseases to chronic conditions such as cancer and diabetes. Most of the governments in the region generally focus on addressing the health issues related to infectious disease and reducing infant mortality rates. As many governments of Latin America have paid little or no attention to the growth of chronic diseases within the region, the health threat looks like it could seriously damage or even bankrupt many of Latin America’s health systems if they do not act promptly. As the economy of Latin America continues to grow and develop, as seen by the growing middle-class of Brazil, the standard of living improves and the wealthier population begins to adopt the habits both good and bad from the developed world. The demand for fast food chains on the streets of Latin American cities increases along with the consumption of alcohol and smoking of cigarettes. Early detection programs that are currently in place in countries across Latin America have been either ineffective or never implemented causing diseases such as cancer and diabetes to be diagnosed at a later stage when the chances of survival or recovery are significantly lowered. When later-stage diagnosis and treatment do come into play, they are usually carried out in public hospitals which have limited resources due to the demand for their services as a result of the generally poor infrastructure. Rather than concentrating on providing a quality service similar to those provided in the US and Europe, the main focus is on providing the minimum health services possible and therefore sacrificing the quality of treatment provided. The lack of treatments, up to date clinical guidelines and provision of care has also led to a growing problem of availability of treatment to the masses due to geographical gaps. Latin American governments do have some form of chronic disease management strategy in place however; the personnel providing the care have to deal with the limited resources whilst trying to give a high level of service and care.
How cancer is impacting Latin America
Although the number of cancer cases are fewer than those in the US and Europe, the proportion of patients who die from the disease in Latin America is far higher. The main reasons Lancet Oncology see in their April 2013 study for this disproportionate rate of death to the number of those with the disease is due to late diagnosis and poor access to treatment. As seen in a number of medical centres based in the US and Europe, these two issues, which are causing the higher mortality rates in Latin America, could be resolved with investment by the developed world and their own emerging market governments. The Lancet Oncology report also states that in Latin America, 163 people in every 100,000 has cancer. This is in stark contrast to 300 cases per 100,000 in the US and 264 cases per 100,000 in Europe. Even though these numbers are not comparable, the mortality rate in Latin America brings the issue and struggle facing the continent to light. It was recorded that 13 out of every 22 cases of cancer in Latin America result in death in comparison to 13 deaths for every 37 cases in the US and about 13 deaths for every 30 in Europe. At the head of the Lancet Oncology research was Harvard Medical School Professor of Medicine, Paul Goss, who stated that due to the adoption of developed country lifestyles in Latin America, the number of cancer patients is likely to increase. In total, the study estimates that by 2030, there will be 1.7million cancer cases in Latin America, a cost burden which the emerging countries of Latin America are by no means ready for or capable of controlling.
How diabetes & obesity is impacting Mexico
If wealth was measured by the width of a person’s waistline, Mexico would be one of the richest countries in the world. With the world and national Mexican press often concentrating on the amount of gang violence and organised crime related deaths, there is a bigger killer on the streets of Mexico. The type-2 variety of diabetes is believed to affect an astonishing 11 million Mexicans, and unfortunately kills more than 73,000 of them a year which amounts to 7 times the amount of deaths caused by organised crime. When thinking of a nation that consumes the most fatty foods and fizzy drinks, one might think that the US population would be at the top of the list. However, Mexicans consume 40% more on average than their neighbours north of the border and along with a lack of exercise; the result is that nearly 1 in 6 Mexican adults suffer from diabetes and of these; only 10% reside in the US. The risk of diabetes in Latin America is not only found to be as a result of the heavy and unhealthy consumption styles that have recently emerged throughout this region. A recent study in the journal Nature found that Latin Americans inherited a gene from Neanderthals that is believed to increase the chance of suffering from type-2 diabetes. Researchers and scientists from the Cambridge genomic research centre, the Broad Institute, compared more than 9 million spots in the genomes of 8,000 Latin Americans. The study found a genetic risk factor for type-2 diabetes that was inherited from Neanderthals which is believed to be traced back to when they interbred with humans more than 50,000 years ago. With recent figures released by the National Statistics Institute stating that only 43.6% of Mexicans exercise or practice sports regularly, the obesity endemic facing Mexico could spiral further out of control with Mexico spending more than USD$4 billion back in 2012 in managing diabetes-related problems. The UN Food & Agriculture Organisation further stress the issue facing Mexico with just under one-third of adults in Mexico being classed as obese and making Mexico one of the fattest countries in the world!
Battling cancer & obesity in Latin America
However, it isn’t all doom and gloom in Latin America, as governments are trying to treat the problem earlier rather than later. At the end of 2013, Mexico introduced a tax on sugary drinks whilst in Chile and Peru, Happy Meal toys were banned. The rest of the world is watching as governments put into action public policies which aim to steer consumers away from the world of processed food. Whereas many of the proposed taxes and actions put into action in the US have failed due to public or corporation uproar, the leftist governments and sentiment in Latin America may just be their saving grace. Due to their slightly leftist alignment, the governments and population do not have the same affiliation or relationship with the large fast food corporations as is the case in the US, resulting in the implementation of taxes and other policies restricting their availability or ease of functionality.
The Latin American governments and newly-formed NGOs are also waking up to the shocking cancer mortality rates that have hit the region. In Mexico and Brazil the NGO community has begun to develop a network of cancer survivors who are able to provide additional and practical support to those undergoing treatment for the disease. Assisting in helping cancer sufferers with the social, emotional and physical implications of being a cancer sufferer has been the main focus of the work carried out. From within this movement has growing positive advocacy in putting further pressure on the government to promote changes within the public health system and to provide better access and standard of treatment and care. Help has also started coming from developed countries seeking to not only help manage this issue but also to learn more about the disease and develop the treatments available further. The American Cancer Society has collaborated with a number of NGOs across Latin America by providing training, technical assistance, funding and building an institutional body able to promote advocacy and patient empowerment.
About the author:
Luke Sewell has been working in the clinical sector in Latin America for a number of years. He now works for Latin Link providing scientific translation services and translation to Latin America and Europe.
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