Timor-Leste or East Timor is a small low income country in Southeast Asia with a population of 1,114,000. It has years of conflict, violence and brutality, and a tumultuous past with Portuguese and Indonesian forces. The conflict and political upheaval have left its marks on all aspects of development in the country. In 2002, Timor-Leste became an independent nation.
Being one of the newest countries in the world, Timor-Leste’s current WHO Country Cooperation Strategic Agenda 2009-2014 is primarily focused on developing a robust health system and improving capacity building. Key health issue focus areas are infectious diseases, maternal and child health and nutrition. There is an immediate need for data and adequate focus on chronic conditions, especially among the adult and elderly population. Although Timor-Leste has the lowest number of publications in medicine, available preliminary data particularly on cardiovascular diseases and diabetes highlights the growing burden of chronic conditions among the elderly. With increased urbanization and improved economic conditions, there is a need to address this growing burden among the elderly population.
Among the 50-96 year population, cardiovascular and circulatory diseases account for approximately a 25% of the total disability adjusted life years (DALYs). For the population aged 70 years and above, these diseases account for approximately 36% of the total DALYs. Specifically, ischemic heart disease in 2010 accounted for approximately 12% and 16% of the total DALYs for 50-69 year and 70+ year population respectively. The disease burden of diabetes mellitus (in terms of DALYs) among the 50-69 and 70+ year population has also increased from 3.6% to 4% of the total disease burden affecting this population. The overall diabetes prevalence in Timor-Leste is currently low at 2.9%. Available data indicates that 7 out of 10 cases occur in those over 40 years. Furthermore, there is very low awareness of diabetes in the country which is a risk factor for increased diabetes prevalence. Urbanization and economic development have the potential to rapidly increase the prevalence rate. Currently, Timor-Leste does not have a national strategy in place to address the diabetes.
As Timor-Leste works on creating a robust and comprehensive health system, it will be imprudent if chronic conditions affecting older populations are not taken into account. With increased economic growth, access to health services and urbanization, the rising burden of chronic conditions can lead to the high prevalence of communicable and non-communicable diseases i.e. the double burden of disease. Collection of valuable data and surveillance, and strategies to improve awareness and reduce the current burden of chronic diseases are ideas for sustainable good health in Timor-Leste.
Namratha Rao is currently pursuing her MSPH in International Health in Social and Behavioral Interventions at the Johns Hopkins University Bloomberg School of Public Health.