Implications for South Asia

Population aging is a major feature in South Asia and will result in a demographic dividend due to favorable dependency ratios. However, as noted in Chapter 1, aging is occurring rapidly and without the social changes that accompanied aging in developed countries decades ago. In addition, the international health community has become increasingly concerned with the shift of the disease burden toward NCDs while a residual burden for MCH remains.

This shift is not only because NCDs are more common with aging, but also due to changes in lifestyles and environments (especially diet, physical activity, and tobacco use) associated with globalization and development. NCD-related illness, disability, and unhealthy aging all threaten gains from the demographic dividend. Countries such as the Russian Federation, where little attention was given to NCD for decades, are already experiencing the impact in multiple dimensions.

Many implications from these transitions are evident. First, the NCD burden will grow with continued aging and strain health sectors that will struggle to be more responsive to these additional demands.

With most health care financed with private out-of-pocket resources, some people may never escape poverty or be driven into poverty, some will forgo treatment and suffer excessively, and household consumption patterns will be switched from other human development investments such as education.