Communicating noncommunicable diseases

BARCELONA — The terms "noncommunicable diseases" and “NCDs” don't exactly lend themselves to snappy and exciting communications campaigns and, for many, the definition isn’t clear. But mention heart disease, cancer, diabetes, stroke, or mental health individually, and people have some level of knowledge and personal connection.

Still, with common prevention tactics and risk factors uniting them, grouping these diseases together under the NCD umbrella is necessary to achieve maximum impact to change policy, acquire funding, and raise awareness.

“I think the biggest challenge is trying to marry this term of NCDs, that is mandated by the World Health Organization, and finding a way for it to connect with policymakers and ministers — because it’s not really connecting at the moment,” said Lucy Richards, executive director of NCDFREE, a crowdsourced global social movement dedicated to getting NCDs on the map for young people everywhere.

With renewed energy around this global health issue — thanks to a new WHO Independent High-level Commission on NCDs, inclusion in the Sustainable Development Goals, and the upcoming Third U.N. High-level Meeting on NCDs — the existing dialogue around NCDs is set to change.

Competing against the marketing efforts of multimillion-dollar global industries, however, such as the tobacco, fast food, and alcoholic beverages industries — all products associated with increased NCD risk factors — poses one of the biggest challenges.

“We're really going to need to up our game so that we can counter that messaging,” said Maisha Hutton, executive director of Barbados-based Healthy Caribbean Coalition. “Perhaps we, as public health community and civil society advocates, need to do a better job of building basic awareness around this term and what NCDs are; I think collectively we've failed in that area.”

How can successful communications around NCDs be built so that potential funders, policymakers, and individuals beyond the health sphere understand what the diseases are so they too can join the efforts in tackling them? How do we communicate the noncommunicable?

Frame it in relation to other issues

According to Jimena Márquez Donaher, communications director at the NCD Alliance — a union of 2,000 civil society organizations working to improve NCD prevention and control worldwide — framing NCDs in relation to other issues when it comes to communicating with donors, governments, leaders, heads of states, and civil society, is one such way.

“We say our position is that addressing NCDs is critical for economic growth and to tackle poverty and social injustice,” she said. “We frame it as a human rights issue, the right to health, indivisible and interdependent. We also speak about the role of globalization and determinants of health.”

For example, the NCD Alliance’s “Enough” campaign does not directly cite the NCD abbreviation in its title, but with the tagline, “our health, our right, right now,” connects the issue to health and human rights more broadly.

Put people living with NCDs front and center

Along with a careful use of language, the “Enough” campaign has individuals living with, or affected by, NCDs talking about their experiences as an effective way of communicating the issue. Their “voices of change” include people such as George Kwayu who has diabetes and is chairman of Tanzania Diabetes Youth Alliance, and Rafael Camacho Solis from Mexico, who lives with emphysema.  

“My advice would be listen to what people living with NCDs are saying and involve them in any effort you would make to bring these [issues] to the forefront,” advised Márquez Donaher.

Having powerful voices advocate for change conveys what NCDs mean for the millions at risk and adds names and faces to what can otherwise sound like a technical and dry topic.

“In the Caribbean, most of the community is either living with an NCD or knows someone who has died or is living with an NCD, so there’s no shortage of champions,” said Hutton. “But I think, to a certain extent, we've become almost numb to them because they're everywhere, and we really need to do a better job of getting champions who can share those stories.”

Hutton also explained that those working to communicate the issue could draw on lessons learned from HIV, another acronym that, after successful communications and advocacy campaigns, now connects many on an emotional level.

“We've done a really poor job of creating a sense of outrage, where people actually want to get out in the street … confronting all of those elements which are promoting NCDs and creating the environment where NCDs continue to cause unnecessary suffering,” said Hutton.

Know when to break it down and bring it back together

Unlike HIV, however, the term NCDs covers more than one disease and while our experts agreed that it was important to communicate about them as a group, they also emphasized the need, at times, to talk about each one individually.

“I think it depends on the issues and I think for childhood obesity, that's been a lot more effective because people can relate to unhealthy diets, junk food in the environment, and the fact that the built environment isn’t supportive of exercise,” said HCC’s Hutton, citing Jamaica Moves as a good example of an effective communications campaign. It focuses solely on promoting physical activity and nutrition by using hashtags on social media such as #MoveItMonday, #MealPrepSundays, and #JaMoves to convey an important message in an engaging way.

When talking about cancer and diabetes though, Hutton felt it was more effective to use the term “chronic diseases.” HCC then underscores the four main types — cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, plus mental health issues — and risk factors before making the link back to the term NCDs.

NCDFREE’s Richards echoed this: “It's about breaking down those things and talking about them in isolation, but then also talking about them as a whole at the same time,” she said.

The movement has tried to do this via “Feast of Ideas.” This is a campaign encouraging young people to host an event using NCDFREE materials to talk about nutrition and alcohol as part of a curated conversation.

“For us, it's about providing the starting point, the lighter, the ignition, the fuel for the conversation and then empowering the people who are attending the feasts to have these conversations themselves,” Richards said.

Learn from each other

While there may be a renewed focus on the issue right now, NCDs are not a new threat. In fact, the global health community have been tackling them for years, but progress isn’t accelerating, particularly in low- and middle-income countries such as Mexico. The previous efforts mean there isn’t a blank communications slate to start from and those new to the space can learn from what others have done in the past.

“You often don't have the resources to create your own innovative impactful campaigns, but the machinery of social media exists and it's low cost,” said Hutton. “It's just really getting the right content out there ... that's going to achieve the objectives that you've set out.”

For those operating on a limited budget, building on something that already exists — such as the “Enough” campaign or World Obesity Federation campaign — or recycling campaigns can still generate interest. HCC did just that.

“We've just launched a campaign and it's really built on the NCD Alliance’s “Enough.” They've done a brilliant job of saying ‘OK, we had resources to create this and we're making it available to all of our civil society organizations,’ which has already put us ahead of the game,” explained Hutton.

Engage youth

One strategy that all the experts agreed on was the need to engage young people in this issue and harness their creativity in communicating the diseases and risk factors. Making young people aware of positive lifestyle behaviors earlier in life can ensure a reduction in levels of NCD prevalence in the future.

Last year, the United Nations Development Programme’s Pacific Office in Fiji, alongside The Pacific Community, solicited project proposals from young people designed to sensitize the youth population on NCDs. One winning entry, a hip hop music video by group Confliction, garnered over 50,000 views, showing that creativity around the communication of the subject can result in further reach.

HCC also harnessed the youth voice with a recent campaign in conjunction with the Global Health Advocacy Incubator. Children wrote letters to their local leaders asking them to make childhood obesity a priority.

It seems that while the term NCD, and its corresponding issues, is complex to convey in a communications campaign, it can be done.

“It just requires a new way of looking at it,” said NCDFREE’s Richards. “I think that's a challenge and, as an industry or an NCD community, we should be challenging ourselves to be a lot more creative.”

For more coverage of NCDs, visit the Taking the Pulse series here.