“No great loss.” This phrase is a line from Stephen King’s novel The Stand. I read the novel over 12 years ago. Although the details are now fuzzy, the plot featured a pandemic—an influenza-like contagion that ravaged the world, killing people swiftly and indiscriminately, dropping people like flies.
The phrase appeared several times in a chapter introducing certain characters who died immediately after being introduced. These characters, despite being resistant to the contagion and surviving amidst the deaths around them, soon met their demise through other avoidable circumstances. However, some of these characters were not good people or were inconsequential to the main story. Thus, they were no great loss.
Recently, I started reflecting on that phrase when I came across an Instagram post featuring several deceased celebrities. The causes of their deaths ranged from heart attacks to diabetes, kidney failure, and other non-communicable diseases (NCDs).
In the comments section, someone pointed out how we collectively mourn celebrities because they are remarkable people whose deaths shock us, shake Nollywood, and leave fans heartbroken. Their deaths are seen as great losses, consequential and felt nationwide. But what about the thousands of people who die every day from these same diseases, their deaths unnoticed because they were not in the public eye? Losses felt only by their families and other loved ones. No great loss?
There is no such thing as a loss that is not great. The impact of a loss is debilitating on those affected, rippling through families and communities, leaving pain and grief in its wake. What makes it more tragic is that many of these deaths are avoidable, just like those characters in The Stand who survived the contagion only to perish through preventable means.
While communicable diseases are also largely preventable—follow the guidelines, and you might avoid getting infected—prevention often depends on external factors beyond one’s control, as it usually takes more than one person to spread such diseases.
In contrast, most non-communicable diseases (NCDs) involve only one participant, making them seem easier to avoid. Yet, this is not the case. According to the World Health Organisation, NCDs account for 74 per cent of all global deaths. It appears we are losing the fight against NCDs. Indeed, it would be one great loss.
The growing burden of NCDs
In recent decades, healthcare has made tremendous strides in combating infectious diseases. However, the tide has shifted towards a new, quieter epidemic: non-communicable diseases (NCDs). These illnesses—including cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases—are not transmitted from person to person. Yet, they have become the leading cause of mortality worldwide, with devastating impacts on individuals, families, and economies. Each year, the question looms larger: Have we lost the fight against NCDs?
According to the WHO, NCDs account for approximately 41 million deaths globally each year, about 74 per cent of all deaths. Low- and middle-income countries (LMICs) bear the heaviest burden, accounting for more than 85 per cent of these premature deaths.
Cardiovascular diseases, cancers, respiratory diseases, and diabetes are the culprits, wreaking havoc on millions of lives. While these diseases may lack the viral immediacy of communicable diseases, their slow, insidious nature makes them just as dangerous. NCDs often creep up on individuals, offering no clear signs until it is too late.
In Nigeria, for instance, NCDs are responsible for about 29 per cent of all deaths, with cardiovascular diseases alone accounting for 11 per cent of deaths, followed by cancer (4 per cent), respiratory diseases (2 per cent), and diabetes (2 per cent).
The burden of these diseases is multidimensional. It is not just about the mortality rate but also the significant morbidity they cause. The long-term nature of NCDs often results in chronic suffering, disability, and a diminished quality of life. Patients grapple with extended treatments, hospitalisations, and financial strains.
Moreover, NCDs tend to hit working-age populations, creating a double blow to national productivity and increasing the economic load on healthcare systems that are already stretched thin, particularly in Africa. The economic burden of these illnesses is immense, leading to reduced productivity, higher healthcare costs, and further strain on already fragile healthcare systems.
Conclusion
While the current statistics paint a troubling picture, we must remember that many NCDs are preventable and manageable with the right interventions. In the next edition, we will explore the roles of healthcare providers. Pharmacists, as accessible healthcare professionals, can play a critical role in reducing the burden of NCDs through medication management, health screenings, lifestyle counselling, and advocacy.
No loss is ever no great loss. Every life taken by NCDs is significant, and every preventable death is a failure of the system. But with concerted efforts from healthcare providers, governments, and communities, we can turn the tide in the fight against non-communicable diseases. The battle may be long, but it is a battle we can win.
Pharm. (Dr) Onyinye Chiekwe Bridget, PharmD, MPH, ABMP
pharmbree25@gmail.com
