Do you remember those Lipitor commercials from a few years ago? A cocky man struts his stuff around the pool, flexing his overly tanned muscles and prepares to dive in. Instead of impressing the ladies with his double pike, he lands flat on his stomach, suffering from a premature heart attack caused by a cholesterol problem he was completely unaware of.
How is this at all relevant to global health or larger world politics? I’m sure you can think of a few countries now strutting their stuff on the world stage. Empowered by high economic growth and a debilitated West, Brazil, Russia, India, China, and the newest member of their club, South Africa, are increasingly optimistic (and perhaps even cocky) about their position in the world and their potential for economic dominance in the future.
But these BRICS are walking around carrying their own heart stopping baggage. They all face enormous challenges in what many predict will be growth crushing epidemics of noncommunicable chronic diseases (NCDs) like heart disease, diabetes and cancer.
In China, 80% of deaths are caused by NCDs, and the country’s rapidly aging population in addition to its declining population growth ensure that the burden of these diseases will only grow, in both absolute numbers and economic cost.
Nearly three out of every four deaths in Brazil is caused by NCDs.
Indians have their first heart attack six years earlier than the rest of the world—killing or disabling a startling number of people during their most productive years of life.
And the economic costs of NCDs are staggering. A recent study estimated that $35 trillion dollars in global economic output will be lost from 2005-2030 because of NCDs. With 80% of chronic disease related deaths occurring in the developing world, we can be sure that the BRICS and other emerging markets will suffer economically if this issue is not dealt with soon.
Despite such scary statistics, the BRICS have a unique opportunity to lead the international community in preventing a public health and economic catastrophe.
In September, the United Nations General Assembly will host a special two-day High Level Meeting on Non-communicable Diseases. Many hope that it will be a turning point in the fight against NCDs. Thus far, it looks like the event will be a bust.
The UN has not been able to get a single head of state/government from a major power to commit to attend the Summit. The Americans and Europeans are tied up with their own economic issues and are largely fatigued by their already extensive commitments in global health. The Caribbean countries, which courageously led the effort to put NCDs on the agenda, don’t have the clout or the resources to influence nations outside of their region.
It is exactly this lack of leadership that opens a door for the BRICS. They have the chance to set the agenda for an issue with incredible global implications without the interference or resistance of the United States or European Union (they could only dream of such circumstances on other global governance issues like the Doha trade talks or climate change negotiations).
The BRICS need to grab this opportunity by the horns. A great start could include the simultaneous launching of national strategies to combat NCDs. This would be followed by a joint proposal for the UN Summit on how the international community can move forward together to combat noncommunicable diseases. While specifics would obviously need to be worked out, a joint proposal from the BRICS, presented ideally by their heads of state/government, would bring much needed attention to the battle against NCDs.
The BRICS, as an unofficial alliance, would gain prestige for finally demonstrating real leadership, rather than acting only as a talking shop. They would also produce momentum for moving their domestic NCDs agendas forward.
Developing countries would benefit by finally having a global health strategy developed by countries facing similar resource limitations (in comparison to being dictated to from on high by Western donors).
Likewise, rich countries will feel less anxiety that the summit’s only real agenda is to get them to pony up more funds for yet another global health initiative.
There is clearly still a great deal of work to be done before a comprehensive solution to the challenge of NCDs can be developed. However, with no one at the helm, it is unilkely that the international community will be up to the task. The BRICS have domestic and foreign policy incentives for taking up this issue and presenting a united front. Their leadership is not only desirable, but increasingly, necessary.
Without urgent action, we’re headed for a (figurative) belly flop caused by a very real cardiac arrest (or more precisely, several million of them).