Noncommunicable diseases have overtaken communicable diseases as the primary cause of premature deaths and disabilities globally. NCDs usually demand chronic treatment requiring decades and decades of treatment. Smoking, drinking, poor nutritional habits, lack of exercise, obesity, stress, air pollution, crowded large cities, and the lifestyles billions of people have adopted have increased the number of people living with NCDs, and — just as our lifestyles are products of multiple inputs — addressing NCDs similarly requires action on multiple fronts.
Their costs to economies, health systems, and individuals are increasing each hour, and gains from years of sustained economic growth and poverty reduction programs are starting to be at risk of being reversed as more people are finding themselves living below the poverty line as a result of NCDs.
What’s not working
Last July, the Asian Development Bank convened nearly 200 experts, country representatives, medical practitioners, academics, and policy-makers from across the world to share experiences on innovations and actions, particularly around health financing to help address the burden of NCDs in Asia.
The need for increased financing for the fight against NCDs was highlighted by Thaksaphon Thamarangsi of the World Health Organization when he bemoaned the sad reality that countries are not investing enough against NCDs and are “fighting the NCD monsters with plastic guns.”
“The lack of investments in many countries therefore makes it crucial to reframe NCDs as a development issue rather than simply a health issue.”— Eduardo P. Banzon, principal health specialist, ADB
The “best buys for NCDs,” are one such mechanism, several experts talked about fiscal and non-fiscal measures part of these measures that have been proven effective in reducing tobacco use and promoting healthy diets and lifestyles in several countries, yet many other countries have yet to adopt them.
Both social prescribing and expert patient programs for disease management are approaches that build on patients’ knowledge of their condition — an approach that includes family, community, and social networks to address NCDs, but these programs are unfortunately not incentivized nor used in many countries.
The creative use of social media to advocate behavioral change, the use of digital health tools to promote integrated and coordinated care, and partnerships between government and the private sector to improve access to diagnostics and medicines, were under-utilized and under-financed tools for fighting NCDs.
By 2016, cancer cases had gone up to an estimated 17.2 million causing 8.9 million deaths. In 2010, the total annual economic cost of cancer — not including longer-term costs to families and caregivers — was estimated at approximately $1.16 trillion while the cost of new cancer cases was estimated at $290 billion.
Depression accounts for 4.3 percent of the worldwide burden of disease and is among the largest single cause of disability worldwide. In 2010, the estimated cost for mental health conditions was $2.5 trillion and is expected to rise to $6 trillion by 2030.
Diabetes is part of the lives of an estimated 422 million adults globally in 2014 compared to 108 million in 1980. In 2014, the estimated direct annual cost of diabetes globally was more than $825 billion, with the impact being especially marked with families in LMICs as they now have higher prevalence rates of diabetes than high-income countries.
All these contribute to 41 million deaths due to NCDs annually, accounting for 71 percent of all deaths — 15 million deaths among the productive 30-69 years of age and 85 percent of deaths in LMICs.
How to change it
The lack of investments in many countries therefore makes it crucial to reframe NCDs as a development issue rather than simply a health issue. The costs due to the increasing numbers of NCDs should be emphasized repeatedly and the adverse impact of these numbers and costs to economic growth and poverty reduction consistently highlighted.
As a development issue, tackling NCDs should be more than just about NCD investments competing with other health sector demands for increased financing of their respective drugs and services, but as a development concern that needs investments in responsive health service delivery systems, savvy health communication approaches, and improved access to medicines and diagnostics; investments accompanied by fiscal and nonfiscal policies that would encourage changes in behavior whether better nutrition, increased physical activity, cessation of smoking and other use of tobacco products, and avoidance of alcoholic drinks.
It demands the strategic use of existing financing mechanisms from government budgetary allocations, national health insurance systems, bilateral and multilateral developmental assistance, private sector philanthropies and partnerships, and other mechanisms to finance this wide range of actions and innovations against NCDs — demands fully endorsed by those who were in the Innovations and Actions Against NCDs meeting convened last July and actions and innovations that we look forward to helping take seed and grow.
For more coverage of NCDs, visit the Taking the Pulse series here.