Countdown to 2030: The Burden of Non-Communicable Diseases in Southeast Asia

Abstract

Background: Non-communicable diseases (NCDs) are the world's biggest killers, accounting for three-quarters of global deaths. However, few studies have assessed the incidence and mortality trends of NCD in ASEAN (Association of Southeast Asian Nations). This study delivers a comprehensive assessment of NCDs’ prevalence and mortality burden across the ASEAN countries from 1990 to 2019.

Methods: Data for this study were obtained from the Global Burden of Disease Study 2019. We selected the five NCDs with the highest mortality in each ASEAN country in 2019, and 11 diseases were identified. The age-standardised mortality rate (ASMR), age-standardised incidence rate (ASIR) and age-standardised disability-adjusted life-years (DALYs) of the 11 NCDs were extracted. The estimated annual percentage change (EAPC) was used to examine the trends in NCD burdens. Nonlinear regression was used to analyze the relationship between Socio-Demographic Index (SDI), ASMR, and ASIR.

Results: From 1990 to 2019, the ASMR of NCDs increased in Indonesia, Philippines, and Timor-Leste, with Timor-Leste experiencing the most significant increase, reaching 7·75%. The ASIR of NCDs increased globally and in most ASEAN countries, except Indonesia and Singapore. Three of the eleven identified diseases were cancers, and the increases in ASMR and ASIR for colon and rectal cancer tended to be in younger age groups. The increase in ASMR of cancers and ASIR of diabetes mellitus and chronic kidney disease alarms all countries. The NCD ASMR generally increase with the increase of SDI, except in Timor-Leste, Indonesia and Philippines; the NCD ASIR generally decreases with the increase of SDI, except for Indonesia and Singapore. The "positive cycle of economic and health development" is not universally applicable in ASEAN.

Interpretation: It is essential to devise a comprehensive, costed plan that engages multi-stakeholders. The imperative for ASEAN to take decisive action in combating the burgeoning burden of NCDs cannot be overstated.

Funding: This study was supported by the National Science and Technology Project on Development Assistance for Technology: Developing China-ASEAN Public Health Research and Development Collaborating Center (No. KY202101004), and the Bill & Melinda Gates Foundation (Grant number: INV-045085).

Declaration of Interest: The authors declare no conflict of interest.

Keywords: ASEAN, Noncommunicable disease, Burden of disease, Southeast Asia