A Call for Urgent Action on Cardiovascular Disease in the Asia-Pacific
29 September 2024 by Dr. Krishna Reddy, Chief Executive Officer, Access Health International
World Heart Day gives us a moment to reflect on the progress, challenges, and gaps in addressing cardiovascular disease (CVD) in the Asia-Pacific (APAC) region. CVD, along with related conditions like diabetes, obesity, and chronic kidney disease, continue to claim millions of lives yearly. Despite being largely preventable, CVD remains a leading cause of death and disability in the region, accounting for up to half of all fatalities across APAC countries.
The rapid rise of CVD demands urgent action. The APAC region, home to 60% of the world’s population, is incredibly diverse—ethnically, culturally, and economically. This diversity is reflected in its healthcare systems, which range from advanced infrastructures to those still lacking basic services. This inconsistency results in uneven responses to the CVD burden, leading to missed opportunities for prevention and care.
While countries are at different stages of healthcare development, many are not maximizing their capacities to combat CVD. Addressing CVD requires a comprehensive approach, from improving public health policies to strengthening healthcare access. Failure to act could result in severe health and economic consequences for the region. As laid out in the recent report, A Call for Cohesive Action: Redefining Cardiovascular Care in the Asia-Pacific, there are few critical actions, policies and recommendations governments must consider to address the growing burden of CVD.
Prioritizing Prevention and Early Detection
Prevention is the most effective strategy for reducing CVD burden. Risk factors like hypertension, diabetes, smoking, obesity, and high cholesterol are well known and largely preventable. Despite the availability of cost-effective screening tools, many APAC countries have not fully implemented prevention programs.
Early detection, such as through coronary calcium scores, enables healthcare providers to intervene before CVD becomes life-threatening. Scaling up screening and preventive care will be crucial to reducing future CVD cases.
Strengthening NCD Surveillance
Most APAC countries focus heavily on infectious disease monitoring, neglecting the growing threat of non-communicable diseases (NCDs) like CVD. However, effective NCD surveillance is essential for public health planning. The digital transformation underway in many APAC healthcare systems presents an opportunity to develop comprehensive surveillance systems to monitor CVD and its risk factors.
Without robust data on CVD, it becomes difficult to design targeted interventions. Establishing such systems can help policymakers track disease trends, allocate resources, and implement evidence-based solutions. Perhaps there are lessons to be learned and applied from surveillance systems developed for communicable diseases?
Adapting Guidelines to Local Contexts
One major challenge in CVD care is the reliance on Western-derived clinical guidelines, which often do not account for the unique factors affecting health outcomes in the region. APAC countries must adapt and tailor these guidelines to reflect local realities, such as air pollution, dietary habits, and healthcare capacity.
By customizing risk assessments and treatment protocols, APAC countries can better serve their populations and reduce the impact of CVD.
Addressing the Shortage of Health Workers
The region faces a significant shortage of specialized health workers, particularly in CVD care. The migration of healthcare professionals to more developed countries exacerbate this issue, leaving many APAC nations with a limited workforce to manage CVD.
Innovative solutions are needed. Training non-specialists, such as primary care physicians, nurses, and community health volunteers, to manage chronic diseases can help fill this gap. These multi-disciplinary teams, supported by digital tools, have already shown success in managing conditions like diabetes and heart failure.
Improving Emergency Care for CVD
CVD often presents as medical emergencies, such as heart attacks and strokes, where rapid intervention is crucial. While diagnostic tools for heart attacks and heart failure are increasingly available, stroke care remains inadequate, particularly in rural areas.
Scaling up emergency care pathways and integrating mobile stroke units into primary healthcare systems is vital to ensuring timely treatment for patients. Rapid response can save lives and reduce long-term disability from CVD.
Universal Health Coverage: A Critical Need
Achieving universal health coverage (UHC) is key to controlling CVD. UHC ensures that all people can access necessary healthcare services without financial hardship. Yet, for many APAC countries, UHC remains an unfulfilled goal, especially in CVD care. Many people are unable to access timely treatment, particularly in rural areas, where resources are scarce.
Addressing healthcare disparities is crucial to making progress. Ensuring that all citizens, regardless of geography, have access to quality care is essential for reducing the burden of CVD and toll on communities.
Cross-Sector Collaboration for CVD Control
A “health in all policies” approach is critical for addressing the social determinants of CVD. Factors like air pollution, dietary habits, and physical inactivity are shaped by policies outside of healthcare. Governments must collaborate across sectors, including education, urban planning, and environmental regulation, to create environments that promote health.
Public health campaigns promoting healthier lifestyles and policies such as taxation on unhealthy foods, tobacco, and sugary drinks can also significantly reduce CVD risk factors. Cross-sector collaboration will be essential in addressing the root causes of CVD and promoting long-term health.
Conclusion: The Time for Action Is Now
The Asia-Pacific region faces a critical moment in the fight against heart health. Without immediate and coordinated action, the crisis will continue to deepen, straining healthcare systems and economies alike. By prioritizing universal health coverage, strengthening NCD surveillance, adapting clinical guidelines, and fostering collaboration across sectors, APAC countries can make meaningful progress in managing CVD.
Governments, healthcare providers, and civil society must work together to prevent more lives from being lost and prioritize heart health. Only through cohesive and sustained efforts can the region reduce the burden of CVD and unlock its full health and economic potential. The time for action is now.
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