Health challenges of the 21st century - Empirical essays on the health and economic burden of non-communicable diseases and climate change in Southeast Asia

In the ongoing 21st century, low- and middle-income countries will face two health challenges that are thoroughly different from what these countries have been dealing with in preceding centuries. First, they are confronted with surging rates of non-communicable diseases (NCDs), and second, climate change will take its toll and is predicted to cause catastrophic health impairments and exacerbate chronic health conditions further. Both will pose a disproportionate health and economic burden on low- and middle-income countries, which are also the countries least able to cope with them. By threatening individual health and socioeconomic improvements, and by putting an immense burden on already constrained health care systems, they impede the progress in poverty reduction and widen health inequities between the rich and the poor.

Against this background, this thesis investigates the potential of NCD prevention and treatment measures in the context of Southeast Asia, with case studies in Indonesia. Specifically, it seeks to understand what kind of health interventions have the potential to be (cost-)effective considering the cultural background, lifestyle, health literacy and health system capacities in the region. Further, this thesis analyzes the interplay between NCDs and climate change and assesses the financial burden that both might pose in the decades to come. Hence, this thesis contributes to a better understanding of how the two health challenges of the 21st century, NCDs and climate change, can be addressed in the context of Southeast Asia and offers insights into what type of health policies and interventions can play a supportive role.