Since the middle part of the last decade, El Salvador has carried out comprehensive health reforms. Among other issues, the government began to focus intensively on a looming national health challenge: the rising incidence of non-communicable diseases across the country.
Since the middle part of the last decade, El Salvador has carried out comprehensive health reforms. Among other issues, the government began to focus intensively on a looming national health challenge: the rising incidence of non-communicable diseases across the country. Indeed, as one study subsequently reported, “non-communicable diseases are a leading cause of early death among the adult Salvadoran population.”
El Salvador’s own 2015 National Survey on Non-communicable Diseases (NCDs) in the Adult Population –which the World Bank helped fund– revealed high levels of factors that can trigger non-communicable diseases, such as sedentary lifestyles, at-risk drinking, smoking, poor nutritional choices on salt, sugar or highly processed foods. For example, the survey confirmed that nearly 94% of Salvadorans nationwide consumed few fruits and vegetables, and almost as many consumed high levels of sugar-sweetened beverages. The study also showed a relatively high prevalence of overweight and obese adults.
Moreover, the survey shined a light on the widespread and growing prevalence of chronic kidney disease. About 12% of El Salvador’s population has the disease, in particular a non-traditional form unrelated to typical risk factors: diabetes and age-related kidney degeneration. This non-traditional form of chronic kidney disease has increasingly shown up in Salvadorans in their 30s and 40s, which is unusually young for this disease. It is associated with hypertension, consumption of anti-inflammatory medication, insufficient hydration, and exposure to agrochemicals in many Salvadoran work environments.
“It’s a silent problem, mostly among young men, an increasing number of whom need dialysis for the rest of their lives,” says World Bank senior economist and project leader Amparo Elena Gordillo-Tobar. “This is very expensive for the country and, of course, it’s unfortunately reducing the quality of life and lifespan of many people.”
El Salvador’s experience is hardly isolated. Globally, about 41 million people die each year from non-communicable diseases –representing 71% of all deaths. Also, NCDs are the leading cause of death for countries at all income levels, though low- and middle-income countries are least equipped to combat them.
So, in 2018, El Salvador set out to grapple with its own struggle against non-communicable diseases. To help, the World Bank, in collaboration with Access Accelerated (a partnership of over 20 biopharmaceutical companies committed to helping achieve the Sustainable Development Goal target of reducing premature deaths from NCDs by one-third by 2030) supported the Ministry of Health’s preparations of a project named “El Salvador Addressing Non-communicable Diseases.” The project included pilot initiatives in three selected regions of the country to “improve the prevention, early detection, and treatment of cervical cancer as well as the prevent