Tracking down the world's number one killer

Travelling from Monaco to Afghanistan, Dr Rodrigo Rodriguez-Fernandez discusses one global epidemic that threatens these two very different locations.


As I arrive in Monaco, I enter the upscale belle epoque-style Metropole hotel which dates back to 1886 - just across from the Casino Monte Carlo hotel. I head to my room where I am greeted by a meal designed by the most decorated Michelin starred chef in the world, the late Joël Robuchon; titled at one point "Chef of the Century" by the guide Gault Millau in 1989. I had been celebrating a milestone birthday and thought I would treat myself this weekend.


Now, before you start to feel too sorry for me and my harsh living conditions in Monaco, know that this was only a 24-hour trip. Within a day, I went from one of the richest independent city-states in the world (162,000 USD GDP per capita) to one of the most dangerous countries in the globe.1



What stands out from this particular trip was that there is one similarity in these two very different locations; it was the number one killer in both countries’. A killer that, a decade ago, would target the rich rather than the poor, men rather than women and the old rather than the young. Today this killer claims the highest death toll in both countries and is killing more women, and the poorest of the poor than it ever has before. Globally, it kills more than terrorist attacks, HIV, tuberculosis, malaria, road traffic accidents, war or maternal and child deaths combined. This killer is cardiovascular diseases.


To put things into further perspective, raised blood pressure, a type of cardiovascular disease, was estimated to affect 1.13 billion (of our 7.3 billion population) in 2015. An estimated 17.9 million people die each year of CVD, an estimated 31% of all deaths according to the World Health Organization.


Both locations are facing the same global epidemic, and each can offer cultural insight as to how to tackle this deadly disease. Afghan culture is very much outcome oriented and while it recognises the triumph in starting somewhere, when it comes to chronic, non-communicable disease (NCDs) prevention, it has its mind set on what the National Action plan will actually achieve. In Afghanistan I was helping the Ministry of Health draft the National Strategy to tackle chronic NCDs for the next decade. Both countries, although religiously, politically, demographically and economically different are faced with increased exposure to fast food, increased childhood obesity rates, lower physical activity rates, rising blood pressure and associated heart disease rates.


In Monaco I was able to spend some time with a billion-dollar offshore company that, in recent years, has seen its bottom line devastated by the rising medical cost associated with chronic disease, including cardiovascular disease.


I have been on the tailcoats of this killer for nearly 15 years now. I have followed it through every continent around the globe and seen the increasingly devastating effects it has had on families and friends from every race, religion and creed. The astonishing thing is that this killer can be stopped. 80% of premature heart disease and strokes are preventable. And with this in mind I will continue, looking glass and Sherlock cap in hand, to chase this killer until it is stopped through health prevention for populations at large, so that future generations will continue to outlive their parents around the globe.


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1 Travel Risk Map 2019

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