by Tracy J. Sims, '91
 More than
$1 trillion.
That's what
the World
Economic
Forum's Global Risks
2010 Report estimates as
the potential
economic
impact of chronic disease worldwide. And
this is in addition to the massive economic
impact of infectious diseases. Growing and
highly interconnected global economies
simply cannot withstand the combined
social, political, and economic impact of
escalating global health realities.
Today, 60 percent of all deaths globally
are associated with chronic diseases, and
80 percent of those deaths occur in lessdeveloped
countries. Reports and statistics
tell one side of the story but fail to convey
the human side of global health issues. In
order to make any improvement in this
dire situation, one must understand global
health issues at the personal level and
must take effective action there.
Of the many stories I could relay to
describe the personal-health issue, none
is more immediate than that from a small
hut two hours east of Kigali, Rwanda.
There, a young man, his wife, and their
newborn daughter live in a hut with
thumb-sized wasps clinging to its ceiling.
The man suffers from diabetes and
struggles daily to maintain his health at a
level that allows him to grow enough corn
and cassava from his one-half acre plot to
feed his family and to generate money for
basic needs. This young man says, "I am
too weak to farm. If I can't grow, I can't
earn. I won't be able to feed my family,
and my daughter will not go to school."
This is where the $1 trillion impact begins
– but the personal pain can never be
measured.
I have seen personal-health realities
in many locations. Recently, in New
Delhi, I saw first-hand the scale of chronic
disease's impact on a population; it is
mind-numbing. India is home to more
than 1 billion people (700 million live on
less than $2/day), and it is experiencing
a dramatic growth in chronic disease. No
country has more people with diabetes –
50 million-plus. The deputy minister of
health there shared with me the urgent
need to find ways to halt the increase of
such diseases and to treat those currently
afflicted. The cost is much greater than
India can cover.
What is the bridge, then, that connects
personal health issues with sustainable
improved outcomes? The bridge may be
three words wide: research, report, and
advocate (RRA). This bridge is built on
a foundation of aggressive prevention
measures. Many chronic diseases are
preventable, but preventive measures must
be put in place and incentivized. When
prevention fails, efficient, data-supported
treatment must be available.
The RRA framework provides a
system through which such approaches
can be developed and refined. Once
weaknesses are identified, an improvement
hypothesis can be applied. Examples
include improving diagnostics, refining
treatments, evaluating access to medicines
and programs, and using wireless
treatment-support tools. Once applied,
the improvement hypothesis is studied
through a formal research effort that
produces data that confirm or deny
the strength of the hypothesis. If the
data are useful and show a probability
of being replicable, they are reported.
Reporting allows for a broader audience
to refine and apply the measures and
to develop additional information and
broad-scale applications. These, in turn,
allow organizations to advocate for policy
change at the global and national level
and to partner with government and other
funders to determine the best uses of finite
resources.
RRA is just one tool. Other ideas, such
as evolved partnerships and the social
leverage of global business capability,
can energize new approaches. Action is
needed, and my company is pleased to
be a member of the alliance to improve
outcomes for people – especially the
underserved – around the world.
In September, the U.N. will host a
high-level meeting on chronic diseases.
Global leaders recognize the threat of
chronic disease coupled with already
challenging infectious disease issues; at
the meeting, they will seek agreement on
a collaborative and sustainable path to
prevent and treat chronic disease – in a
hut in Rwanda, in the bustling New Delhi
cityscape, or in one of countless other
places of great need in a hurting world.
Tracy J. Sims is senior advisor for Global
Health Programs and vice president of The
Lilly Foundation, Eli Lilly and Company.
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