Professional Documents
Culture Documents
Non-Communicable
Diseases in Indonesia
April 2015
Contents
Overview and purpose
Conclusion
11
12
35%
1.1
0.1
0.6
29.1%
26.6%
27.8%
2.6%
6.9%
4.8%
Obesity (2008)
Source: World Health Organization, 2014
Injuries
7%
Communicable,
maternal, perinatal
and nutritional
conditions
22%
Cardiovascular
diseases
37%
Other NCDs
10%
Total
3%
Females
67%
Diabetes
Chronic respiratory
6%
diseases
5%
Cancers
13%
Prevalence
The most prevalent NCDs in Indonesia today are
cardiovascular diseases, cancers, chronic respiratory
diseases and diabetes. In 2012, non-communicable
diseases accounted for more disability-adjusted life
years (DALYs) than communicable ones approximately
476million and 240million DALYs, respectively (WHO,
2014).
Diabetes is of particular concern by 2030, the number
of people with diabetes will nearly double, from 7.6million
in 2013 to 11.8million. With an annual growth in diabetes
prevalence of 6%, this far exceeds the countrys overall
annual population growth rate (Blueprint for Change
Program, 2013).
Data sources
The disease-specific mortality projections and the
population projection for Indonesia are based on WHO
Global Burden of Disease estimates through 2030. Labour
projections are based on International Labour Organization
estimates of labour force participation rates. Data on
economic variables were obtained from Abegunde and
Stanciole (2006), the World Development Indicators &
Global Development Finance database, the International
Monetary Funds World Economic Outlook database, and
the Penn World Tables.
Expected economic output loss for Indonesia:
$4.47trillion lost due to NCDs ($17,863 per capita)1 from
2012 through 2030
Table2 presents the model estimates for the NCD burden
in Indonesia in 2010 US$. The first two columns show the
WHO disease domains and the diseases addressed in
the EPIC model, respectively. The third column shows the
output of EPIC for individual diseases. The fourth column
shows the scaling factors calculated from the associated
DALYs. The last column presents the scaled value of the
disease burden in each of the five WHO-defined domains.
Table 2: Scaling of EPIC output for 2012-2030 to match the five WHO NCD domains for Indonesia
WHO disease
EPIC disease
EPIC raw
output
Diabetes
0.2
Ischemic heart
disease
0.9
Cerebrovascular
disease
Respiratory disease
Cancer
Diabetes
Cardiovascular
disease
0.20
0.46
(IHD+CBD)/0.77
1.77
COPD
0.45
COPD/0.547
0.82
Breast cancer
0.07
Breast cancer/0.1
0.70
Total physical
Mental illness
Overall total
3.49
(Total physical)x(0.28)
0.98
4.47
Source: Authors
Figure 2: Contribution of each disease to overall loss of GDP output, Indonesia 2012-2030
Cardiovascular disease
39.60%
Mental health
21.9%
Respiratory disease
18.4%
Cancer
15.7%
Diabetes
4.50%
0.00%
0%
5.00%
5%
10.00%
10%
15.00%
15%
20.00%
20%
25.00%
25%
30.00%
30%
35.00%
35%
40.00%
40%
45.00%
45%
Source: Authors
A total cost estimate of $4.47 trillion due to NCDs from 2012 through 2030 is a substantial amount by any measure: it is 5.1
times Indonesias GDP in 2012, and almost 170 times Indonesias total health expenditure in 20123 (see Figure 3).
3
Data for total health expenditure is obtained from the Global Health Expenditure Database (GHED) of WHO, updated in 2014
25
20
15
10
0
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Comparison between
Indonesia, India and China
The NCD burden in Indonesia is more severe than among
its neighbours. Figures 5-7 provide comparisons of the
output lost due to NCDs between Indonesia, India and
China.4 Indonesia will suffer a larger total output loss than
India ($4.47trillion versus $4.32trillion) during the period
2012-2030, with only one-fifth of Indias population and onehalf of its annual GDP.
4 The calculations for China and India follow from Bloom et al. (2014); notice that the
values are different, since here we updated the results with a corrected version of
WHO EPIC model (See Appendix for details of the corrections)
Figure 4: Proportional mortality due to NCDs in Indonesia, India and China, 2014 (% of total deaths, all ages, both sexes)
China
India
87%
71%
60%
12%
7%
8%
5%
al
,
p
To
ta
l
er
in
in
ju
N
CD
rie
s
at
a
l a
r
N
CD
Ot
Total NCDs
Injuries
nd
es
ira
ica
bl
Ch
e,
m
ro
n
at
er
n
ic
re
sp
as
io
v
Ca
rd
28%
Communicable,
maternal and
perinatal
Other NCDs
he
d
to
ry
Diabetes
et
nc
Ca
10%
12%
6%
6%
2%
2%
ab
er
es
as
ise
Chronic
respiratory
disease
22%
Di
Cancers
cu
la
r
d
13%
11%
5%
as
Cardiovascular
diseases
23%
13%
7%
ise
45%
37%
26%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Indonesia
Co
m
un
Figure 5: Comparison of lost output between Indonesia, India and China, 2012-2030 (2010 US$ trillions)
35
29.42
30
25
20
15
8.73
10
5
0.20
0.14
0.59
Source: Authors
Diabetes
1.77 2.05
Cardiovascular
Disease
7.34
0.82 0.93
0.70 0.25
Respiratory
disease
Indonesia
7.06
India
Cancer
5.69
4.47 4.32
0.98 0.94
Mental Health
Total
China
The Economics of Non-Communicable Diseases in Indonesia
Figure 6: Comparison of lost output per capita between Indonesia, India and China, 2012-2030 (2010 US$)
35
29.42
30
25
20
15
8.73
10
5
0.20
0.14
0.59
Diabetes
1.77 2.05
Cardiovascular
Disease
7.34
0.82 0.93
0.70 0.25
Respiratory
disease
Indonesia
7.06
India
Cancer
5.69
4.47 4.32
0.98 0.94
Mental Health
China
Source: Authors
China
India
Indonesia
0.00%
0%
100.00%
100%
200.00%
200%
Indonesia
Source: Authors
10
300.00%
300%
India
400.00%
400%
China
500.00%
500%
600.00%
600%
Total
Conclusion
11
Appendix
12
References
13