ABSTRACT

This chapter discusses the reader through a series of global transitions, ranging from general economic to specifically health economic conditions, and discusses the implications for health systems around the world. The transition to, and towards, middle-income status of the countries in which the majority of the world’s population resides, or ‘economic transition’, is one of a series of related transitions affecting health and wellbeing globally. The term ‘non-communicable diseases’ is to some extent a misnomer as non-communicable diseases (NCDs) can be spread through social networks, viruses, environmental conditions including available food choices and marketing, and intergenerational transmission of both genes and lifestyles. The failure to manage complications imposes further costs on health systems that can swamp health capacities and complicate cost-effectiveness assessments. The problem of low service coverage for NCDs is compounded by analyses which suggest that NCDs are associated with increasingly high levels of out-of-pocket spending.