HIV and noncommunicable diseases hinder the progress of poor countries' Millennium Development Goals

A study published in PLoS Medicine this week examines why poor countries are falling behind with the UN Millennium Development Goals for health, finding that noncommunicable diseases and HIV prevalence are strongly associated with the difficulty countries have meeting these targets.

The Millennium Development Goals (MDGs), which underpin the global development agenda, include the reduction of child mortality, improvements in maternal health, and decreasing the burden of HIV/AIDS, malaria and other major diseases, but few of these targets are going to be met by 2015.

David Stuckler of the University of Oxford, Sanjay Basu at the University of California, San Francisco, and Martin McKee at the London School of Hygiene & Tropical Medicine re-examined the progress that countries have made towards these targets to understand why some countries are falling behind. They found that the traditional explanations, such as economic under-development, low priority of health, inadequate spending by governments, and weak health infrastructure accounted for only a fifth of the inequality in progress. In contrast more than half of the inequality in progress in poor countries could be explained by the prevalence of HIV and the burden of non-communicable diseases - non-infectious diseases such as heart disease, stroke and diabetes that are often associated with environmental and lifestyle factors such as smoking.

Until now, both donors and recipients of development assistance have paid little attention to non-communicable diseases, instead targeting their activities to infections. This new analysis shows how the co-existence of these epidemics represent an important and previously unappreciated source of poor progress towards the existing international health targets. The researchers stress the biological and economic interrelationships of illness affecting those living in poor households, concluding that the achievement of feasible reductions in non-communicable diseases could greatly enhance progress towards health MDGS.