PHA-Exchange> The neglected epidemic of chronic diseases (2)

[Claudio]

From: "Debabar Banerji" <nhpp at touchtelindia.net>
>
> Othmar Arnold seems to ignore some fundamental issues.
>
>  1. India, for instance, has one of the highest maternal mortality rates
in
> the world. The reason is that it does not have basic infrastructure for
> providing most elementary maternal care services to the needy persons. It
> also has very high infant mortality rates, which again, is due to the poor
> infrastucture of health services ( due to preoccupation with the
> internationally promoted vertical programmes, including the infamous Polio
> Eradication Programme, which has failed repeatedly to attain its
`target').
> Now we want to further divert attention by raising the outcry about the
> non-communicable diseases.What is the cost per unit reduction of the
> morbidity/mortality in these diseases of the poor and
the`non-communicable' diseases of the poor?
>
>  2. The data used by him are hopelessly unreliable. That takes away the
very  foundation of Dr Arnol's aregument. How can he have reliable data when
we do not have relable data on births and deaths? China's data have been
repeatedly proven highly doctored (SARS is a good example). Should we talk
of the health information systems of sub-Sharan Africa, or even of
> Latin america and Central and West Asia?
>
>  3. MMR and IMR are related to infants, children and young mothers. How
many of the preventable chronic diseases are in these age groups?
>
>  4. It is often forgotten that we also die `in the long run' and we
> die frequently of chronic diseases.
>
>  5. I presume that Dr Arnold is well meaning. However, his inadequate
> understading of the disease load in poor countries has led him to manifest
> elements of  the `Marie Antointee Syndrome'!

> D Banerji.
> Professor Emeritus, Jawaharlal Nehru University.
> New Delhi