‘Storm’ of Noncommunicable Diseases May Hit South America

A new report from the Pan American Health Organization (PAHO), titled Major storm on the horizon, warns that between 2020 and 2050, noncommunicable diseases (NCDs) and mental health issues will result in economic losses in South America equivalent to the entire annual GDP of Latin America and the Caribbean. This loss is attributed to healthcare spending and productivity decline.

The report was produced in collaboration with Harvard University’s T.H. Chan School of Public Health in Boston.

This report serves as a wake-up call and a call to action, said Jarbas Barbosa, PAHO’s director and a public health expert, during a press briefing. “The economic impact of NCDs [and mental health problems] is unacceptable because of the harm it causes to families, communities, and society. But we have tools to stop this process, such as health promotion measures and strengthening primary care.”

David Bloom, PhD, the report’s lead author and a professor of economics and demography at Harvard University’s T.H. Chan School of Public Health, stressed that healthy people can work more, be more productive, and maintain their savings. He further stated that the report aims to provide PAHO and South American decision-makers with solid evidence to push for significant and transformative increases in health sector budgets, as well as the rational allocation of these budgets to competing uses.

Analytical Model

Bloom and colleagues developed an analytical model to forecast the macroeconomic effects of NCDs and mental health issues between 2020 and 2050 in 10 South American countries: Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela. They calculated that the total GDP loss from these conditions could reach $7.3 trillion during this period. The report noted that if NCDs and mental health conditions were eliminated, “the annual GDP would be about 4% higher every year for 30 years.”

Brazil, due to its large population, is expected to face the greatest GDP losses during the projected period, with an estimated loss of $3.7 trillion — three times higher than that of Argentina and Colombia. These three countries are also predicted to have the largest losses in disability-adjusted life years. However, when adjusted per 1000 inhabitants, Uruguay, Argentina, and Venezuela top the list. The rise in NCDs and mental health issues in Latin America and the Caribbean is largely attributed to the aging population. “This is an issue that will become increasingly relevant over time, as the region has the fastest demographic transition in the world,” said Barbosa. Additionally, the growing burden reflects greater exposure to preventable risk factors such as tobacco use, unhealthy diets, physical inactivity, alcohol consumption, and air pollution.

In six of the 10 countries studied (Argentina, Bolivia, Chile, Ecuador, Peru, and Uruguay), cancer is expected to be the leading cause of GDP loss between 2020 and 2050. In Brazil, cardiovascular diseases will have the most significant impact, while in Colombia and Venezuela, diabetes and kidney diseases will be the biggest challenges. In Paraguay, mental health disorders are projected to be a major burden.

Investment in Interventions

The report stresses that several interventions can help reduce the risk factors and social determinants of NCDs and mental health issues. These include cost-effective strategies advocated by the World Health Organization, such as taxes on tobacco products, alcohol, and sugary drinks; front-of-package food labeling; vaccination against HPV; cervical cancer screening; public awareness campaigns to reduce physical inactivity; and pharmacological treatments for individuals who have experienced myocardial infarction or stroke.

“For every dollar invested in these interventions, the return on investment is estimated at between two and three dollars,” said Silvana Luciani, a master’s degree holder in community health and head of PAHO’s NCD Unit, during the press briefing.

Other recommended strategies include investing in technology, from portable devices for monitoring blood glucose or blood pressure to artificial intelligence tools that enhance diagnostic accuracy. Additionally, strengthening healthcare systems, with a focus on equity and quality in primary care, is critical for timely diagnosis and treatment.

“The goal is to make better use of available resources to identify individuals with diabetes, hypertension, or cancer at an early stage, where better treatment options and potential cures or maintenance therapies can be offered,” said Barbosa. “With a relatively low investment in primary care, we can prevent people in vulnerable situations from being unaware of their condition until they experience severe health problems, such as heart attacks or strokes.”

Link Between Mental and Physical Health

Another key recommendation from the report is integrating mental health with chronic disease management to reduce the health and economic impact of the growing burden.

“When a person consults for diabetes, we must also assess their emotional state. For depression, it is necessary to monitor blood pressure and blood glucose. This integration saves lives and significantly reduces costs. Every dollar invested in treating depression and anxiety generates at least four dollars in economic benefits. The question is not whether countries can afford to invest in mental health, but whether they can afford not to,” said Matías Irarrázaval, PAHO’s regional mental health and substance use advisor and associate professor of psychopathology and mental health at the University of Chile, Santiago, Chile.

Santiago Levín, professor at the National University Arturo Jauretche in Florencio Varela, Argentina, and president of the Latin American Association of Psychiatrists, agreed. “It’s no longer acceptable to separate mental and physical health as if they were different substances. There is only one health,” he said.

Levín praised the economic analysis presented in the report, which he said was designed to capture the attention of policymakers. He also emphasized that investing in health is not just a cost-saving strategy but also part of promoting the common good. “Public health is the health arm of social equity, and social equity is the ultimate goal of politics,” he concluded.

Levín disclosed having no relevant financial conflicts of interest. 

This story was translated from Medscape’s Spanish edition.