Cardiovascular diseases, stroke, cancer, diabetes, chronic respiratory illness, and mental and neurological conditions are all conditions that we are either living with ourselves or know someone close to us who is. Many may be living with risk factors such as elevated blood pressure, cholesterol, or blood sugar, without knowing we are at risk. Yet there continue to be misplaced beliefs about noncommunicable diseases: these are “rich-world diseases,” these diseases are “too complex and costly to manage,” and “people are responsible” for their own poor health outcomes when it comes to chronic conditions.
Multiple analyses document the massive — and growing — human and economic cost of noncommunicable diseases, or NCDs, particularly in low- and middle-income countries, and the compelling investment opportunities. The Lancet NCD Countdown 2030 and World Health Organization NCD “best buys” demonstrate the significant return on investment from quality NCD prevention and care. Research has shown a return of $7 for every dollar invested in NCDs in low- and lower-middle-income countries by 2030. Despite this, the underresourcing of NCDs as a global health challenge, relative to its overall disease burden, is a conundrum that we still confront.
The innovative pharmaceutical industry’s investment in NCDs starts with research and development. Almost 300 novel active substances for cancer, cardiovascular diseases, and neurological diseases have been launched in the last decade, transforming the options for patients. Cancer is the top therapy area for investigational drug programs, with over 5,000 active programs in the global R&D pipeline. This is not for no reason: the number of new cancer cases will reach over 35 million by 2050, a 77% rise from 2022. In that year, roughly 1 in 5 people were already estimated to develop cancer during their lifetime. At the same time, the industry is committed to making sure that medicines and vaccines for NCDs reach the people who need them. There are over 150 examples of collaborations on the Global Health Progress portal, involving our member companies, targeted at addressing the NCD burden in LMICs. But the challenge we come up against is often the same: underfinancing of NCDs.
To date, global investment cases have continued to be guided by “conventional wisdom” and traditional policy focuses on domestic mobilization and donor assistance. These are critically important in the long term, but they are unlikely to sufficiently bend the curve in the near term. A major constraint continues to be a lack of fiscal space for governments, which means that traditional forms of domestic sources and international development assistance need to be supplemented by innovative financing mechanisms. The innovative pharmaceutical industry has underscored the importance of action on NCDs as part of universal health coverage and integration with primary health care services. However, many countries still lack comprehensive national NCD prevention and control plans, public health services, and reimbursement lists for NCD medicines — as well as mechanisms for financing the NCD burden in their countries. Collectively, we need to bring new resources to NCDs.
We are not leveraging the full extent of stakeholders on offer who could make a dent on NCD financing. There are opportunities to engage multilateral organizations, health-related NGOs, insurance companies, impact investors, as well as foundations and charities working on health financing.
To build ownership of the NCD agenda, we must work across sectors to harness multisectoral action on unlocking innovative financing for NCDs. We need to recognize that countries will likely need a spectrum of tools that can be complementary to one another. Generating more domestic resources for NCDs is clearly the number one priority, but where there are real challenges to being able to do so, particularly in the short term, other innovative financing mechanisms could provide the extra resources needed. Helping countries understand the array of mechanisms to explore — whether that is government-funded excise taxes private, or community-based health insurance programs, debt for health swaps, health savings accounts, performance-based financing (social impact bonds), blended financing, mobile health financing solutions — is necessary to improve understanding of how to deploy new forms of financing, many of which require fresher ways of working.
Equally, the dialogue on improved and innovative financing for NCDs must focus on achieving policy coherence. Several contributing factors to NCDs originate from nonhealth sectors, and so the response to prevent and control them calls for action from government ministries other than health — agriculture, education, labor, transport, energy, and environmental/climate departments. In the case of NCD prevention, this undoubtedly includes implementing more of the classic “best buys” and in-built resourcing opportunities such as taxing tobacco, alcohol, and unhealthy foods. But we can, and should, also think more creatively about solutions that involve other parts of government.
Tomorrow is the kickoff of this year’s Global Week for Action on NCDs, spearheaded by the NCD Alliance. It will focus on how the world should lead on NCDs — particularly in how we mobilize investment, accelerate implementation, and deliver accountability.
Each of us are leaders in identifying, supporting, and sharing fresh examples of innovative financing for NCDs. With less than one year until the Fourth United Nations High-Level Meeting on NCDs, we must be bold and ambitious in the ways we tackle this global health challenge. Meaningful multisectoral engagement will allow us to identify the best ways to collaborate on the road to 2025 and beyond. The pharmaceutical industry is up for this challenge and will be working toward concrete offers to the NCD — and the wider global health and development — community.
Discover more examples of how the pharmaceutical industry is contributing to a global NCDs response on the Global Health Progress platform.