'Best buy' interventions for NCDs

A patient gets tested for diabetes, a noncommunicable disease. In 2012, 38 million or 68 percent of deaths worldwide were due to NCDs. Photo by: Oskar Annermarken / CC BY-SA

Fighting noncommunicable diseases isn’t as straightforward as tackling polio or malaria.

Although there are factors that complicate health professionals’ efforts to combat infectious diseases — health workers providing anti-polio vaccines in Pakistan have been killed by militants, for example — vaccines are often enough to prevent incidences.

This is not the case with NCDs. Insufficient physical activity, when coupled with poor eating habits, could lead to obesity, which cannot be prevented with a vaccine.

But as the problem continues to rise — 38 million or 68 percent of deaths worldwide in 2012 were due to NCDs, and this is projected to increase to 52 million by 2030 — the World Health Organization urges governments and other players in the international development space to take NCDs more seriously and quit delaying actions to reduce their burden worldwide.

WHO member states agreed in 2013 on nine time-bound NCD targets that they hope would pave the way for countries to align their priorities. And this applies to both high- and low-income economies. While insufficient physical activity among adults aged 18 and above is low in many developing economies, for example, this is the opposite in many developed nations like Saudi Arabia and Kuwait, and emerging economies like Malaysia, Colombia and South Africa.

Meeting these targets is voluntary, however, which means the global body cannot compel countries to comply. And since there is very little information on which interventions work best, it can be difficult to convince donors to allocate a portion of their health aid budget to tackle NCDs, or for governments to make them a priority.

But in fighting NCDs, funding is just one part of the issue.

Here are five things the international development community can learn — and ponder on — about combating NCDs, based on some of the “best buys” or initiatives WHO presented in a new report that aims to inform stakeholders on the global progress on NCD prevention and control.

While these are in the context of dealing with NCDs, many of these best buys can be applied for many development problems as well.

1. Strong government leadership.

Turkey had suffered from high tobacco consumption among its citizens aged 15 and above. In 2012, the government decided to raise tobacco taxes to 80 percent of retail price, enlarge warning labels, and put in place a total ban on tobacco advertising, promotion and sponsorship. This, according to WHO, is one of the “best buy” interventions as it reportedly led to a 13.4 percent decline in smoking in the country.

A similar approach was taken by Australia, where smoking rates dropped to 12.8 percent in 2013 after the government strongly enforced a law requiring tobacco products to be sold in packages with huge graphic images showing the different negative effects of smoking on one’s health, like lung cancer.

2. Private sector collaboration.

In 2013, the Kuwaiti government launched a national campaign and collaborated with the food industry to lessen the salt content in bread, which is a staple food in the country. The result: a bakery was able to reduce its products’ salt content, including pita bread, by 20 percent. Now the government is working with another major food producer to reduce the use of salt in another staple item — cheese.

3. The value of inclusive dialogue.

Tonga has one of the highest number of women who are overweight or obese worldwide. This is primarily because several cultural and social norms prevent them from engaging in many physical activities, like sports. Most women still need to inform their husbands where they will be going before they can leave the house, which makes engaging in exercise and sports difficult.

With funding from Australian aid, the government in 2012 launched the Kau Mai Tonga: Netipolo campaign in which a national tournament for women is now being held annually for them to play netball. The campaign was developed with women’s feedback, which contributed to its success. There are now more than 20 netball clubs in the country involving women.

4. The need to understand interventions that suit a particular context.

There’s a lot of good will in the development space, but not everyone usually benefits. In the Iranian capital of Tehran, for example, the government introduced a bicycle-sharing scheme that not only reduced pollution, but also encourages more physical activity among commuters. But many women found it difficult to participate in the program, given the country’s strict dress code.

5. More quality case studies.

Increasing taxes for goods like tobacco, in the case of Turkey for example, has proven to be effective in bringing down the numbers of smokers in the country. But how did the government win against the tobacco industry? What challenges did they face and how did they overcome them?

There’s a lack of sufficient evidence from which other countries that may be facing similar tobacco problems can learn from. And the same is true for other interventions. What specific communication strategies were employed to get women in Tonga to participate in the country’s netball program, for example.

Publicizing examples and specifics on successful interventions is an important tool for the development community, especially if it is intent on reducing the burden of NCDs in this decade. WHO’s nine targets are due in 2025.

Do you agree with these “best buy” interventions? How else can the development community strengthen the fight against noncommunicable diseases? Let us know by leaving a comment below.

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About the author

  • Ravelo jennylei

    Jenny Lei Ravelo

    Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.