Ischaemic heart disease, stroke, congenital defects, cirrhosis and chronic kidney disease among the 10 leading causes of deaths in 2019
The COVID-19 pandemic and the June 2022 floods have compounded Pakistan’s health indicators, a recent study by medical journal The Lancet has found. However, infectious and non-communicable diseases (NCD) were already increasing in the country, as were region-wise disparities.
The healthcare emergency in Pakistan was analysed by researchers from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine in collaboration with Aga Khan University in Karachi, Pakistan and Pakistan’s Ministry of National Health Services Regulations and Coordination. It was based on the Global Burden of Disease 2019 study.
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Iron deficiency has remained the leading cause of years lived with disability for both men and women since 1990. However, the situation has improved considerably compared to 1990.
Low birthweight, alongside short gestation and particulate matter pollution, has remained the leading contributor to the overall disease burden since 1990.
Pakistan’s life expectancy has improved from 61.1 years in 1990 to 65.9 years in 2019, with women recording an increase of 8.2 per cent, as compared to 7.6 per cent for men. Balochistan and Khyber Pakhtunkhwa provinces recorded the least improvement in life expectancy.
Premature mortality in 2019 was primarily caused by neonatal disorders, followed by ischaemic heart disease, stroke, diarrhoeal diseases and lower respiratory infections, the paper found.
NCDs like ischaemic heart disease, stroke, congenital disabilities, cirrhosis and chronic kidney disease were among the 10 leading causes of years of life lost in 2019.
The findings tell us that Pakistan’s health baseline was already at some of the lowest levels around the globe even before being hit by extreme flooding, said Ali Mokdad, professor of health metrics sciences at IHME, in a press brief.
The evidence couldn’t be any clearer. Pakistan is in critical need of a more equitable investment in its health system and policy interventions to save lives and improve people’s health.
Pakistan has ranked poorly on several indices — 154th of the 195 countries in the Healthcare Access and Quality Index 2016, 164th of 188 countries on chances of achieving health components of the United Nations-mandated sustainable development goals (SDGs) by 2030, 116th out of 195 countries on the Human Capital Index, which assessed education, health status and years lived after 20.
The findings of this paper could offer ways to improve its positions, the authors argued. “Our analysis could be used to address these problems and help build capacities, design disease-prevention activities and set health priorities at both national and subnational levels in Pakistan,” they said.
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The share of NCDs to Disability Adjusted Life Years (DALY) has increased from 25.3 per cent of total DALYs in 1990 to 43.7 per cent in 2019. Such a pattern has been recorded in India as well. It is estimated that by 2040, cardiovascular disease, cancers and diabetes will become the leading causes of death in the country.
“The rise of NCDs in Pakistan, where the population is young, deserves special attention. Although the country still faces infectious diseases challenges, equal attention to NCD prevention is needed to reduce the current and future burden,” the authors noted.
“Our fragile health and economic systems are ill-equipped to handle the current and future NCD burden,” said Zainab Samad, professor and chair of the department of medicine at Aga Khan University. “We have seen national action plans on NCDs, but implementation is largely lacking and much needed in this area.”
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