Chronic illnesses have become the leading medical scourge of developed countries in recent decades and have now emerged in developing countries as well. What has been called the “demographic transition” has seen a global decline in recent years in deaths from infectious diseases and an increase in deaths from chronic diseases. By 2030, the percentage of those dying from chronic illnesses in low-income countries is projected to be about 59 percent of all deaths.1 To make matters worse, there is now a double burden on poor countries: a high and rising rate of infectious disease as well as a rapid increase in chronic disease, most notably diabetes, cardiovascular disease, cancer, and chronic respiratory disease.
It is also common to find obesity—a major contributor to chronic disease—and malnutrition in the same families. Unlike in developed countries, chronic illness now typically begins about a decade earlier in low-income countries. Its causes are changing diets, particularly an increase in meat and processed food consumption, alcohol consumption, smoking, and less physical activity. At the same time, aging populations in developing countries guarantee that a rising proportion of the elderly as well as the young will die from chronic illness. One might then speak of a triple burden.