Addressing the Double Burden of Infectious and Non-Communicable Diseases: A Public Health Perspective

Abstract

The interactive presence of infectious diseases (IDs) and non-communicable diseases (NCDs), often known as the so-called double burden of disease, has become a critical and complicated issue of global population health, especially in low- and middle-income countries (LMICs). This review is a critical analysis of epidemiological transition, determinants underlying it, biological interactions, and systemic challenges of this dual burden. Although the majority of global mortality is nowadays associated with NCDs, infectious diseases remain within the population, including tuberculosis, HIV/AIDS, and emerging infections, which present an overlapping and interacting disease burden. These conditions are interconnected by the similarities of risk factors such as poverty, high rates of urbanisation, environmental exposures, and lifestyle changes as well as by biological processes which intensify the progression and outcome of diseases. The review also identifies some of the important health system challenges such as fragmented service delivery, lack of resources, shortages of the workforce, and lack of proper surveillance systems to effectively manage co-morbid conditions. The health outcomes to the population are immense, including morbidity and mortality, economic burden, and productivity. The solutions to the double burden are people-centred, which involve integrating prevention, early detection, and coordinated care in the context of enhanced primary healthcare. To address the overall determinants of health and secure sustainable changes in population health outcomes, there is a need to adopt policy-based, multi-sectoral strategies.