International Journal of Noncommunicable Diseases

EDITORIAL
Year
: 2019  |  Volume : 4  |  Issue : 2  |  Page : 35--37

Noncommunicable diseases need an urgent and systematic response


Mukesh Kapila 
 CEO, The Defeat-NCD Partnership, United Nations Office of Project Services, Geneva, Switzerland

Correspondence Address:
Dr. Mukesh Kapila
The Defeat-NCD Partnership, United Nations Office of Project Services, 11-13 Ch Des Anemones, 1219 Chatelaine, Geneva
Switzerland




How to cite this article:
Kapila M. Noncommunicable diseases need an urgent and systematic response.Int J Non-Commun Dis 2019;4:35-37


How to cite this URL:
Kapila M. Noncommunicable diseases need an urgent and systematic response. Int J Non-Commun Dis [serial online] 2019 [cited 2019 Aug 23 ];4:35-37
Available from: http://www.ijncd.org/text.asp?2019/4/2/35/262465


Full Text



There s an old adage, “Health is wealth.” The premise is simple – good health is worth more than money could ever buy. But, for the people of low-income countries, medical care comes at a steep price, if it comes at all.

When wealth is necessary to maintain health, and the poor lack equitable access to health care, the inexorable rise of noncommunicable diseases (NCDs) spells personal and family disaster, for example, when a diabetic is obliged to ration their lifesaving insulin, or when a hypertensive ends up disabled by a stroke. Such individual tragedies add up to the most significant global health challenge of our times.

NCDs are the leading cause of death and disability worldwide, accounting for 71% of all deaths in 2016.[1] A shocking 85% of these premature deaths occur in low- and middle-income countries (LMICs). That means each year, 15 million people between the ages of 30 and 69 years die prematurely from an NCD.[1]

With the global NCD pandemic growing so rapidly, we must take immediate action to reverse the trend. We have arrived at a tipping point – it is time to tip the scales in our favor. Enormous effort has been put into advocacy, sensitizing the public and increasing awareness. Similarly, health professionals have prepared the necessary technical recommendations and treatment plans. But, impact is too slow. We must walk the walk and talk the talk, to scale up action and provide the services that people suffering from NCDs desperately need, right now.

 The Escalating Burden of Noncommunicable Diseases in Low-resource Countries



Rapid demographic, sociocultural, and economic transitions are driving a surge in the number of people impacted by NCDs in LMICs.[2] These include aging, urbanization, environmental pollution, and the globalization of unhealthy lifestyles.

In LMICs, sickness, disability, and death from NCDs are increasing faster than the rate of decline from communicable diseases.[3] For example, in 2015, Africa, a region made up mostly of LMICs, was the only continent in the world where more people suffered poor health and died from infectious diseases than NCDs.[3] This balance will soon change as the region experiences the full impact of the increase in NCDs. An estimated 40 million Africans will be affected by diabetes alone by 2045, more than twice the current number.[4]

The large unmet need for NCD services is exacerbated by the poor availability, accessibility, and affordability of essential NCD medicines, diagnostics, and related equipment. Globally, some two billion people are denied their fundamental human right to access basic medicines.[4]

Availability and affordability of essential medicines and technologies are impacted by several global and national barriers including weak procurement and supply chains, insufficient financing, inadequate health systems, overburdened regulatory structures, and conflicting national essential medicine lists.[5] Remedying these would allow people with NCDs to prevent or delay complications and lead healthy and productive lives.

 The Defeat-noncommunicable Disease Partnership – Driving Action on Noncommunicable Diseases



To tackle such constraints is why The defeat-NCD partnership was launched at the United Nations General Assembly in September 2018. From premature death and sickness to the associated social and economic impacts of NCDs, the partnership enables and assists LMICs to scale up sustained action, specifically in order to progress Sustainable Development Goal (SDG) 3.4: “By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.” The path to that is via achieving “universal health coverage (SDG 3.8), including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”

Defeat-NCD is anchored in the United Nations System and guided by the World Health Organization technical norms and standards. The partnership includes governments, multilateral agencies, civil society, academia, philanthropic foundations, and the private sector. We drive on-the-ground action by mobilizing global and national knowledge, tools, capacities, and financing to benefit LMICs according to their specific needs and defined and costed NCD action plans.

The partnership's initial focus is on diabetes, hypertension, certain cancers, and chronic respiratory conditions, which, taken together, constitute 80% of the global burden of NCDs.[2],[5] The partnership drives action along four interconnected tracks: national capacity building; community-centered scale-up of services; expanding affordable access to medicines, diagnostics, and equipment; and sustainable financing.

 National Noncommunicable Disease Capacity Building



We support governments and national ministries of health in assessing gaps in their institutional capabilities and health systems to help establish or update national costed NCD action plans.

Assistance includes epidemiological, economic and service delivery studies, training and technical advice, procurement and distribution capacity planning, developing domestic public–private partnerships, and support with organizing financing. We prioritize national expertise, institutions, and civil society to ensure an inclusive and participatory process.

The overall objective is to ensure that partner countries have credible action plans and financing frameworks to tackle NCDs in a sustainable manner.

 Community-centered Scale-up of Noncommunicable Disease Services



Confronting the rising NCD epidemic requires close interlinkage between community-based and primary health-care systems, as well as strong partnerships with private caregivers. The partnership works to increase the provision of NCD services through community action and by strengthening health systems.

We work with national and local partners to bring NCD services directly to more people. By scaling up community education and screening for risk factors, early disease management, and increasing the use of digital tools, we expand affordable access to treatment. Primary health-care facilities are equipped and supplied, and health-care workers are trained to identify those at risk and treat those with an NCD.

Defeat-NCD also has an emergency response facility to support people with NCDs who find themselves in disaster or conflict situations.

The overall objective is to promote earlier diagnosis and intervention, as well as avoiding complications that demand costly secondary and tertiary treatment.

 The Defeat-noncommunicable Disease Marketplace



Defeat-NCD works through a specially designed marketplace to make the provision of essential NCD supplies simpler and more cost-effective. With market-sizing and price-tracking studies conducted in LMICs, the marketplace creates a competitive environment that serves the interests of both buyers and suppliers while bringing transparency to the process.

By leveraging market dynamics, such as pooled purchasing power, the marketplace, including its online procurement facility, achieves lower prices, improved quality control, standardization, and more effective supply chains.

Financial returns from the marketplace are then reinvested into country programs to help build stronger national procurement and supply-chain management capacities.

The overall objective is to help countries improve procurement and distribution of essential NCD medicines and technologies, to ensure consistent availability and affordability.

 Noncommunicable Disease Financing Facility



Defeat-NCD provides support to secure financing for universal health coverage for NCDs.

The partnership advises countries in finding the fiscal space that would enable them to invest more in the prevention and management of NCDs from their own national and social welfare budgets.

However, LMICs still face significant financing gaps, which is why the partnership is establishing an NCD financing facility. Its mix of approaches includes schemes such as microfinancing and insurance, innovative commercial investing via public–private partnerships, social and philanthropic funding, and additional development assistance from bilateral and multilateral partners.

The overall objective is to establish a long-term sustainable business model for improving access to treatment and care, recognizing that NCDs are lifelong conditions requiring permanent attention.

 Conclusion



The Defeat-NCD partnership offers a comprehensive, interconnected approach to supporting countries along their long journey to controlling NCDs. Although one size does not fit all, the initial member nations of the partnership, such as Haiti, Kenya, Myanmar, Rwanda, Tajikistan, Tanzania, and Zimbabwe, are showing leadership and pioneering solutions that hold promise for all the 90 or so low-resource countries that are eligible for services and support under the partnership. Such collaboration within and among countries is central in facing up to and defeating NCDs.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1World Health Organization. Noncommunicable Diseases Fact Sheet; 2018. Available from: http://www.who.int/mediacentre/factsheets/fs355/en/. [Last accessed on 2019 Jun13].
2World Health Organization. Time to Deliver: Report of the WHO Independent high-level Commission on Noncommunicable Diseases. World Health Organization; 2018.
3World Health Organization. Global Health Estimates 2016: Disease Burden by Cause, Age, Sex, by Country and by Region, 2000-2016. World Health Organization; 2016.
4World Health Organization. Ten Years in Public Health 2007-2017. World Health Organization; 2017.
5PATH. Diabetes Supplies: Are they there when needed? Seattle: PATH; 2015.