IXL Social Enterprise Case Studies Chronic Diseases October, 2013 | Page 11

Improving Chronic Disease Care in Slums by 2019

The social and economic cost of chronic
diseases is significant for individuals,
families and society

“If we fail to act, the World Health
Organization estimates that NCDs will
cost these countries more than US$7
trillion by 2025.”
- President Clinton

My family pays the price
Roberto Severino Campos was from a
shanty town in Brazil. He worked as a
public transport agent and never paid
attention to his high blood pressure or
smoking and drinking habits. Now,
he lives with his seven children and 16
grandchildren, who must take care of
him, because after three strokes, he is
paralyzed and has lost his ability to speak.
“Fortunately his medication and checkups are free, but sometimes we just don’t
have enough money for the bus to take us
to the local medical centre,” explains his
31-year-old daughter Noemia. Roberto
depends entirely on his family, and much
of the family’s income is used to cover his
healthcare needs. “We all wish we could
get him a wheelchair to make his life a
little easier,” she says, but unfortunately,
the family cannot afford it.
Source: http://www.who.int/features/
galleries/chronic_diseases/roberto/01_
en.html

Figure 8. Global costs for chronic
diseases will increase

Individuals suffering from a chronic disease pay with more than their health
The majority of slum dwellers are daily wage earners who make, on average, less than 5 USD per
day.47 The direct costs associated with chronic disease, even if diagnosed early, are overwhelming.
For example, one chemotherapy session in India costs nearly 1,500 USD. Six months of cancer
treatment in India can range from 4,000 USD to 32,000 USD.48 Without insurance and financing,
slum dwellers bear almost all medical costs out-of-pocket. In addition to the direct cost, chronic
disease impacts an individual’s ability to work – lowering income and affecting productivity.
Aside from the economic costs, individuals also suffer tremendous emotional and psychological
effects from pain, anxiety, inconvenience and bereavement.49 Individuals are often treated poorly
and ostracized by other community members.
Families who care for members with chronic disease face financial and emotional stress
Those with chronic diseases are not the only people who feel pain. Entire families often bear the
burden when one member suffers from a chronic disease. Management of chronic disease is
complicated, and can require special therapy and training. Families who must help with this care
lose income and productive time from work and school. Lost income and direct costs for care push
many families deeper in to poverty. This vicious cycle is often called the “medical poverty trap”.50
According to the World Health Organization (WHO), 44 million households (100 million individuals)
fall in to poverty each year because of catastrophic health costs.51 It is estimated that 90 percent of
these people live in low income countries.52 Because of the expense and duration, catastrophic risk
is associated mainly with chronic disease. In Burkina Faso, the possibility of catastrophic economic
consequences increases from 3.3 to 7.8 times in households stricken by chronic disease.53 Living
with sick family members is also a psychological burden, stressing relationships, creating anger and
frustration, and spawning feelings of hopelessness that often only end with the loss of a loved one.54
Chronic diseases are costly for society
In addition to threatening human health, chronic diseases have huge impact on economic growth
and societal development. Global costs for chronic disease are enormous – ranging from 290 billion
USD for cancer to 2.5 trillion USD for mental illness each year.55 Cumulative losses for the five most
threatening chronic diseases (Figure 8) are estimated at 47 trillion USD over the next two decades.
This sum could eliminate 2 USD per day poverty for 2.5 billion people for more than fifty years.56
These costs will be felt not just today but for several generations to come.

Generic pharmaceuticals, better
medicine and digital technology may
offer solutions, but more are needed to
counter the increasing slum population
Generic pharmaceutica