Opinion: Early detection and diagnosis a critical link for effective NCD management

A patient has her vital signs checked by a medical worker. Photo by: Simone D. McCourtie / World Bank / CC BY-NC-ND

Accurate and early diagnosis is crucial in order to overcome the noncommunicable disease burden, and must be integrated with prevention and treatment — particularly in low- and middle-income countries that are hit the hardest, with 86 percent of premature NCD deaths occurring in these nations.

At this year’s 73rd session of the United Nations General Assembly, which had a strong focus on NCDs, I was impressed and humbled to learn how these countries try to cope with a double burden of disease — emerging NCD epidemics, in combination with major infectious diseases that survived the 20th century.

My takeaways from the sidelines of UNGA

During UNGA 2018, I participated in an expert panel session co-hosted by Philips, the World Economic Forum, and Devex on early detection and diagnosis of NCDs — a lively discussion facilitated by Raj Kumar, president and editor-in-chief at Devex. Here are my five takeaways:

1. There is an economic argument for investing in early detection and diagnosis.

2. Improved training and education for community health workers is needed.

3. Opportunities are available to redesign health systems to revolutionize health care.

4. Technology and innovation are important as enablers, but are not a silver bullet.

5. The key is bringing private and public actors, and civil society together.

There are many successful examples of real-world implementations where early screening, detection, and diagnosis prevent symptoms and complications of NCDs from progressing, thus eliminating the need for longer term treatment and reducing mortality rates. There were also many discussions of how digital, people-centric technologies — when applied in an appropriate context — could be used as a powerful tool to help make early diagnosis affordable and accessible.

Treatment for NCDs still receives disproportionate attention in our current health systems. Nearly everyone agrees that early detection and diagnosis are critical to bringing down costs of NCD treatment, yet they are underprioritized. Looking at the whole care spectrum, we want to find out how health systems can respond to the NCD challenge by bringing early diagnostics into the common pathways of NCD management.

How do we get there? How can we apply solutions and technologies to tackle NCDs in a sustainable way?

This summer, Devex and Philips set out to examine the specific role early detection and diagnosis play in the fight against NCDs. Over 1,200 health professionals were surveyed and more than a dozen NCD experts were interviewed to understand where and how early detection and diagnosis fit into effective NCD management.

Strengthened by the findings of this survey, I strongly believe that by following these three steps, we can make significant strides in fighting NCDs:

1. Develop and strengthen early detection and diagnosis capacity in primary care systems.

Creating a strong primary care system with the capacity to deliver prevention strategies, and early, first-time right diagnosis and treatment capabilities is key. In our survey, we found that health professionals agree that NCDs can best be tackled at primary care level, with 45 percent mentioning its potential contribution for early detection and diagnosis. However, primary health care is currently not fit to address NCDs — we need to reorient it toward NCDs, and invest in its infrastructure.

2. Educate and empower community-level health workers with basic tools and training to facilitate early diagnosis.

Community health care workers and primary health care service provision are at the core of the solution and should be strengthened. Despite the fact that early diagnosis can change the course of NCDs, 92 percent of our survey respondents believe most LMICs lack early detection equipment, tools, and training that could combat and help control NCDs.  

Innovations in medical devices and digital technologies can effectively advance diagnosis efforts, for example by bringing care to people’s homes. In our survey, health professionals point out that many diagnostic roles do not require doctors, but rather can be played by local community health professionals — this can facilitate early diagnosis while reducing cost.

Philips Lumify is a mobile, app-based diagnostic ultrasound solution that enables ultrasound-guided diagnoses in the field. Targeted treatment can be initiated as quickly as possible, avoiding delays or the need for patients to travel.

As the use of digital diagnostics expands, these systems and tools can produce valuable data to guide future medical decision-making, and further reduce health care costs. At the same time, we should work on a strong diagnostic referral for the next steps of care.

Jan Kimpen, chief medical officer at Philips. Photo by: Amy Sussman

3. Step up to the NCD challenge by designing and implementing efficient policies and solutions.

A change in the primary care set-up to address NCDs requires strong policies. Political will and leadership from developing country governments are critical, with 90 percent of our survey respondents believing most developing country governments lack strong policies on NCDs.

More sustainable and comprehensive solutions require leadership at the highest levels of government, with other ministries such as trade, agriculture, information and communication technology, and finance engaging in NCD policy decisions and resource planning.

A “one-size-fits-all” approach won’t work — it is important to work together with local communities on new business and financial models to build facilities, train health care workers, and bring diagnostic innovations.

In this context, I also see an advanced role for private-sector companies in achieving universal health care coverage to fight NCDs. We can commit resources, contribute innovations, and work in partnership with governments and civil society at global, national, and subnational levels, including offering early detection and diagnostic technology and tools suitable to confront NCDs in various contexts.

Results of co-creation between governments, health ministries, local experts, NGOs, and the private sector can be seen in examples coming from Kenya, Ethiopia, India and Indonesia.

Partnering for success: Ripple Effect

In the Ripple Effect video series, Devex explored projects from partners Philips, Novo Nordisk, and Novartis to explain just a few of these challenges through the perspective of health care workers and individuals living with NCDs in three different countries.

Take a look at the series here.

The highly engaging panel discussion in New York City deepened the conversations we had already started. We found a global health community that is energized about tackling NCDs, and in full agreement that we must transform today’s conversation into meaningful action. More can and should be done to achieve an integrated health care system in which early detection and diagnosis play a key role to tackling NCDs, thereby improving people’s lives.  

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

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About the author

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    Jan Kimpen

    Jan Kimpen leads the clinical leadership team at Philips — working with physicians, research teams and customers to co-create integrated health care solutions that support improved patient outcomes and better experiences at lower cost. He joined Philips from UMC Utrecht, one of the largest health care organizations in the Netherlands, where he served as CEO.