CARDIOVASCULAR Diseases (CVD) were responsible for less than 10 per cent of all global deaths at the dawn of the 20th century. By 2001, CVDs were responsible for about 30 per cent of all deaths worldwide, fuelled mainly by the rapid rise in the epidemic of cardiovascular diseases in low and middle-income countries.

According to the World Health Organisation (WHO), 17 million deaths occur annually from cardiovascular diseases accounting for one-third of all global deaths. Currently, an estimated 80 per cent of the global mortality and disease burden from cardiovascular diseases occur in developing countries — a reflection of the evolving and shifting pattern of the burden of the global CVD epidemic.

In Latin America and the Caribbean, CVD, accounted for about 31 per cent of all deaths in 2001, but that figure is expected to rise to 38 per cent by 2020.

The rising prevalence of cardiovascular diseases in developing countries is linked to changes in lifestyle and diet, rapid urbanisation and increase in the prevalence of traditional cardiac risk factors like obesity, hypertension, diabetes, and smoking. Of the estimated 1.1 billion smokers worldwide, more than 800 million are in developing countries with the African region experiencing the fastest rise in smoking rates at 4.3 per cent per year.

The economic impact of cardiovascular diseases in developing economies is devastating, largely because working-age adults account for a high proportion of the CVD burden. In the Caribbean and South America, diabetes and cardiovascular disease will be responsible for three times more deaths and disability by 2025, affecting mainly individuals in their most productive years of life, thus precipitating economic decline and underdevelopment. It is estimated that each year, at least 21 million years of future productive life are lost in Brazil, China, India, Mexico, and South Africa because of CVDs.

The demand for effective care for cardiovascular diseases will exert major economic pressure on health systems in developing countries like Jamaica in the years ahead and will further threaten social order and structures, unless innovative and ingenious approaches are identified to mitigate the circumstances.

Despite the high burden of CVDs in Jamaica, access to major technological advances to address cardiovascular diseases are currently not routinely or universally available to large segments of the population because they are often expensive, unaffordable and complex and not readily adaptable. Furthermore, access to appropriate care or modern and advanced therapeutic interventions is further limited by absence of trained personnel and clinical expertise and therefore inaccessible to many of those who need it the most.

This should not be the case. The ultimate value of quality health care hinges on access, which, in low-resource nations like Jamaica, is primarily determined by affordability and availability. In order to bridge the accessibility gap between the rich and poor nations of the world, we must demand and encourage access to expertise and modern technology anchored on affordable, innovative and sustainable solutions that are appropriate and adaptable to our environment. The inability of health care service providers and other stakeholders to innovate and adopt affordable and adaptable technology platforms in response to the changing demography of cardiovascular diseases is a reflection of flawed and unimaginative thinking.

The rising tide of cardiovascular diseases presents a unique opportunity for innovative thinking to meet the needs of our citizens. This requires rethinking of our current mode of operation and smart use of technology, leveraging technological advances to distribute clinical expertise, extend and improve the quality of care for the majority of Jamaicans. This underlies our mission and commitment at the Heart Institute of the Caribbean (HIC).

Professor Ernest Madu, founder of the Heart Institute of the Caribbean, is an internationally acclaimed cardiologist and expert on innovative health solutions. HIC is a centre of excellence for cardiovascular care in the English-speaking Caribbean. Please send questions and comments to emadu@caribbeanheart.com