Opinion: Scaling NCD interventions is an investment, not a cost

Many noncommunicable diseases aren’t only killing us — they’re robbing us of years in good health.

In recent research, the Institute for Health Metrics and Evaluation, or IHME, estimated that noncommunicable diseases, or NCDs, such as cancer, heart conditions, and diabetes, account for 46 million deaths a year — and that millions of these could be prevented.

NCDs are not only a matter of death, but of life. Dealing with poor health can strip away joy, making daily activities painful or distressing. And finally, NCDs also carry an economic cost. In the workplace, they translate into higher absenteeism and lower productivity. For the global economy, NCDs could be a $36 trillion drag on GDP by 2050, according to recent research from McKinsey Health Institute, or MHI.

But it doesn’t have to be this way. While not every disease can be prevented or eradicated, it is possible to do much better. For example, thanks to its screening and vaccination efforts, Australia is on track to eliminate cervical cancer. And the introduction of a new class of weight management drugs could mean fewer obesity-related conditions and better metabolic health generally.

There are evidence-based, cost-effective interventions across the different types of NCDs. Expanding access to these is far from impossible — and the benefits, in the form of healthier lives and longer life expectancy, would be substantial. Scaling access to these known interventions could prevent around 28 million deaths and add nearly 400 million years of healthy life annually by 2050. In economic terms, this improvement in the health of the world could add $11 trillion to global GDP by 2050, with a return of $4 for every dollar spent.

The potential is particularly great in low- and middle-income countries, or LMICs. While these generally have younger populations, many are aging fast, and the prevalence of NCDs rises with age. Also, conditions such as kidney disease and diabetes are more likely to be undiagnosed or unmanaged.

In India, for example, most individuals diagnosed with hypertension or diabetes don’t receive treatment. In Ghana, half the regions don’t have a single dialysis facility. In many LMICs, where there is equipment, maintenance and training is inadequate. Even modest improvements would therefore bring substantial benefits. By mobilizing domestic resources and forming innovative partnerships, LMICs can strengthen their health systems and go a long way toward improving treatment of NCDs.

Here are a few promising approaches.

Improve primary health care

This is obviously good in and of itself. But improving primary health care, or PHC, is also critical to treating NCDs, which need reliable prevention, detection, and treatment capabilities.

Money is certainly a factor. Per capita, PHC spending in LMICs runs far short of their needs. Government agencies alone cannot fill the gap. One approach is to work with partners to expand coverage of health insurance. Citizens in Rwanda, for example, can buy health insurance for $2 a year, which gets them into the formal health care system. Remaining costs are paid by the government and donors. Ghana’s National Health Insurance Scheme has successfully increased access, including to private facilities.

There’s room to improve quality of care — and for that, quality information is essential. Information can help spread best practices, reveal weaknesses, and help to ensure that patients get similar care wherever they are. In a digital age, it has never been easier or more affordable to compile, analyze, and share data. For example, Kenya’s health information system integrates interoperable data from both public and private health facilities to improve coordination of care across the health sector.

Engage people directly

There is much to be said for giving people an incentive to invest in their own health, even if their resources are limited. Pakistan gives pregnant women and new mothers a conditional stipend to use for diet, immunizations, and health checkups. In 2007, Bangladesh expanded a voucher system that significantly increased usage of prenatal, delivery, and postnatal services. This has contributed to declines in maternal and infant mortality and also to higher immunization rates for children.

Work with local and regional life sciences companies

Local knowledge can be a powerful force. People who are intimately familiar with conditions are better placed to establish priorities and have a greater incentive to find lower-cost but effective solutions.

Local biopharma players should be part of the search for solutions all along the way, from setting the research and development agenda to the development and manufacture of new treatments. Partnerships can be an effective way to tap into this expertise, such as GSK’s Africa Open Lab initiative. The lab conducts epidemiological, genetic, and interventional research to enhance understanding of NCDs in Africa. One study, for example, identified the best drug combination to treat high blood pressure in sub-Saharan Africa.

Yes, NCDs can be complicated, resulting from a mix of genetic, social, and personal factors. Addressing them, then, is not going to be simple. And yes, health care is a cost. But it is also an investment in human capital — with enormous potential for economic improvements. If countries can exert their will, the way can be found.

To learn more about the health and economic returns of investing in NCDs, visit: mckinsey.com/mhi.