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MSK Diseases Capture World Attention — Arthritis Takes the Stage
In this issue Hazes and Woolf describe an exciting new initiative that should interest rheumatologists everywhere1. Both authors are members of the international steering group that will see announced this month the official launch of the Bone and Joint Decade from World Health Organization headquarters in Geneva. United Nations Secretary General Kofi Annan along with representatives from many different disciplines and nations all recognize that networks must be established to reduce the growing burden of musculoskeletal (MSK) disability throughout the world. The authors also note that in many developed countries the population over age 50 will have doubled by 2020, signifying a vast increase in the impact of bone and joint disease1,2. Moreover, the number of women with arthritis is much higher than men2. And in Canada the economic burden of MSK disorders is similar to or greater than that for cancer3. The prime focus for the Decade pinpoints disease and injury of the joints and spine, affecting adults and children alike, all areas of interest to rheumatologists. We also know that patients with rheumatoid arthritis (RA) with the poorest functional status and the most joint involvement show a reduced survival, similar to stage IV Hodgkin’s disease or triple vessel coronary artery disease4. Thus, our current emphasis on aggressive disease control of RA represents a strategy calculated to prevent not only longterm disability but also mortality3. As rheumatologists we try to provide the best possible comprehensive care of each of our patients with arthritis, but in keeping with the Bone and Joint Decade we know that our mandate extends to working with others to prevent MSK disability in the population at large. Moreover, in Canada the Decade proposal is especially timely because our federal government has recently established the Institutes for Health Research that has prompted a proposal for a National Bone and Joint Disease Institute.
The international Bone and Joint Decade initiative described by Hazes and Woolf should help us to better inform our governments and health policy decision makers that MSK disorders are a major health problem deserving a top priority in health care planning1.
DUNCAN REFERENCES
1.Hazes JMW, Woolf AD. The Bone and Joint Decade 2000-2010. 2.Badley E, Wang PP. Arthritis and the aging population: projections of arthritis prevalence in Canada 1991 to 2031. J Rheumatol 1998;25:138-44.
3.Badley E. The economic burden of musculoskeletal disorders in Canada is similar to that for cancer, and may be higher. 4.Pincus T, O’Dell JR, Kremer JM. Combination therapy with multiple disease-modifying antirheumatic drugs in rheumatoid arthritis: a preventive strategy. Ann Intern Med 1999;131:768-74. 5.Gordon DA, Inman RD. Musculoskeletal disability and rheumatology [editorial]. J Rheumatol 1994;21:387.
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