Cardiovascular Health in the Developing World

De: procor-bounces@healthnet.org [mailto:procor-bounces@healthnet.org]
Em nome de "Maria Inês Reinert Azambuja"
Enviada em: quarta-feira, 26 de julho de 2006 18:07
Para: Cardiovascular Health in the Developing World
Assunto: [ProCOR] Re: ProCOR seeks your input (6)

Dear Catherine,
It is indisputable that, today, the main determinants of ill health and early mortality in Brazil and other countries of the Region are poverty and social exclusion.

Our population is ageing, and as well discussed by Leeder and colleagues in "A Race Against Time," chronic diseases shall become a huge problem here during the next decades, accompanying this demographic trend. Poverty-related deaths will tend to follow the demographic track. With less children, the main burden of poverty-related diseases and deaths will fall upon the adult population. As recognized in 1946 by two eminent cardiologists from our Medical School (FAMED-UFRGS) in Brazil,"Rich cardiac patients have a relatively long and tranquil life. The poor fall fast and recurrently in heart failure and stand still; their lives are short and painful" (Prof. Álvaro Barcelos Ferreira, 1943[1])

"Rest and adequate exercises, appropriate hours of work and leisure, hygienic housing and so on, are conditions which are out of the reach of the poor. It is even painful to prescribe them care, good life and treatment which they can not follow or afford. Soon after compensating a heart failure, they are obliged to go back to work - almost invariably inadequate to their condition, to the fight for life which throw them again in the failure of their central circulatory organ." (Prof. Thomaz Mariante[2], 1943)

Probably the great challenge that we need to address is how to plan feasible interventions to prevent and control the impact of chronic diseases in Brazil in the next years in a way that they become a component of the macroeconomic agenda towards Brazil development, and could contribute to lessen the social and health inequalities which have prevented us to grow.
And additionally, how to convince central economies of the advantages of this approach...

Overall population health results much more from production of services, insumes, medications and equipements (meaning economic strength) than from their consume. If our countries are not able to overcome the levels of urban poverty that exist today, political instability will increase and with it, ill health and deaths (overall).

The challenge that I would pose to the PROCOR team would be: how to use Chronic Diseases Prevention policies to reduce destitution and stimulate the economic growth of third world countries?
Best regards,
Maria Inês Azambuja, MD
School of Medicine
Universidade Federal do Rio Grande do Sul Porto Alegre, RS Brazil miazambuja@terra.com.br
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[1] Ferreira AB. The social problem of the cardiac patient. In: Panteão Médico Rio-Grandense. Cultural and historical synthesis: progress and evolution of Medicine in the State of Rio Grande do Sul, Brazil, 1943.
[Portuguese]

[2] Mariante T. The problem of angiocardiopathies in Rio Grande do Sul. In:
Panteão Médico Rio-Grandense. Cultural and historical synthesis: progress and evolution of Medicine in the State of Rio Grande do Sul, Brazil, 1943.
[Portuguese]
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