Opinion: We need new ways to fund NCDs. Development assistance isn't enough.

A health worker checks a patient’s blood pressure. Photo by: CEHURD / CC BY

We have to be on the money if we want to bend the noncommunicable disease curve. It is not only political action that we need to see at the U.N. High-Level Meeting on Noncommunicable Diseases this September in New York. Just as fundamental will be the financial ask. We’ve long known that we’re at a NCD tipping point and that failure to act now will result in millions of cases of preventable illnesses and deaths across the globe, impacting most heavily on low- and middle-income countries. Globally, a lack of action on the prevention and control of NCDs will cause a loss of approximately $47 trillion from 2011-2030, or the equivalent of 5 percent of global GDP.

We are at a crossroads: NCDs constitute 70 percent of health-related deaths, but receive less than 1.3 percent of development assistance of global health budgets. NCDs are killing more people earlier in developing countries than in the developed world: Over 80 percent of the 15 million NCD deaths that take place between ages 30-69 are in low- and middle-income countries.

We know that the current progress across the board is insufficient and won’t deliver on the SDG target of reducing by one-third premature mortality from noncommunicable diseases by 2030.

One of the key gaps in the response has been financing. We must go beyond the traditional narrative of the donor and recipient and look for innovative mechanisms and models of financing, including social investment bonds, divestment, and public-private partnerships, giving due regard to real or perceived conflicts of interest.

The Lancet Taskforce on NCDs and economics last week released the most comprehensive analysis to date of evidence on expenditure, behavior, and socioeconomic status. The taskforce made a strong case for taxing unhealthy products that would subsequently produce major health gains for the poorest in society, especially if tax revenues were used to fund pro-poor programs.

There must be emphasis on exploring new financing streams like these to develop and implement national NCD responses for SDG 3.4, including blended finance, public-private partnerships, pooled funding structures, and innovative financing mechanisms. And importantly, we need to showcase concrete examples of mechanisms to mobilize resources and increase financing for national NCD responses.

Relying on development assistance for health and donor-specific funds is not sustainable. Domestic resource mobilization — for example, via taxation of unhealthy commodities such as tobacco, alcohol, and sugar-sweetened beverages — can be sustainable, while also reducing consumption and raising resources for development and health. However, we know that while domestic resource mobilization is critical, for low-income countries allocating less than 5 percent of GDP to health, progress on NCDs will be impossible without catalytic funding from donors.

In these instances, there certainly needs to be improvement in the way resources are tracked. Currently, there are no mechanisms to do so, but it is an encouraging sign that that the OECD Development Assistance Committee recently agreed to purpose codes to track development assistance for NCDs.

Addressing new and emerging issues has to be a key part of the NCD agenda moving forward. The sector needs to continue to consider a raft of issues: the context of recent bilateral and multilateral efforts to promote international development cooperation; the current evolving development cooperation landscape; the interrelationship of all sources of development finance; the synergies between financing SDG 3.4 and exports of health-harming products; and the need to support SDG 3.4.

This week in Copenhagen at the WHO Global Dialogue on Partnerships for Sustainable Financing of NCD Prevention and Control, we have an important opportunity to demonstrate that committing to NCDs and health is an investment — something that potential partners such as development banks, investment groups, and philanthropic foundations must see prior to becoming involved in the NCD response.

The dialogue comes at a key moment in the implementation of the 2030 Agenda for Sustainable Development, with President of the U.N. General Assembly Miroslav Lajčák convening a High-Level Summit on Financing the Sustainable Development Goals in New York in June. Quite simply, we have got to be on the money in Copenhagen if we want to bend the noncommunicable diseases curve.

Update, April 10, 2018: This article has been updated to clarify that Miroslav Lajčák, president of the U.N. General Assembly, will be convening a High-Level Summit on Financing the Sustainable Development Goals in New York in June.

About the author

  • Katiedain ncda

    Katie Dain

    Katie Dain is the CEO of the NCD Alliance, a Commissioner on the WHO Independent High-Level Commission on NCDs, and co-chair of the WHO Civil Society Working Group on the Third High-Level Meeting on NCDs.