Opinion: An industry playbook for addressing NCDs in LMICs

Noncommunicable diseases, or NCDs, such as cancer, heart disease, and diabetes not only afflict high-income countries, they are now the leading cause of death in low- and middle-income countries, or LMICs, requiring a reorientation of health systems once focused almost entirely on infectious disease. As cities expand, diets change, and people live longer, more individuals are developing chronic conditions — straining systems that now must respond to both communicable and noncommunicable diseases.

This growing challenge of NCDs in LMICs is an opportunity for the health care industry to bring its products and services to new markets while improving the health and well-being of millions more people around the world. But the same playbook that companies have used for high-income countries cannot simply be copied. Success depends on tailoring approaches to meet the distinct economic, social, cultural, political, and regulatory realities of LMICs — and on the health care industry’s ability to evolve its way of working. In this sense, a broad understanding of innovation will be key: Beyond the research and development breakthroughs in therapies and diagnostics that remain the backbone of the sector, health care companies looking to be truly global in reach will need to adapt and adjust to ensure that new populations and communities can benefit from medical advances.

Such innovation should entail the adoption of strategies that are patient-centered, looking more holistically at health systems and how they can be strengthened to deliver care for chronic diseases. There is evidence that the shift toward such an approach is already underway: Health care companies are raising awareness of diseases and reaching people with screening and diagnostics earlier, before they develop advanced conditions that are harder to treat — using data and technology to guide decisions about addressing disease burden and resource allocation more efficiently, and designing interventions that align countries’ economic and health priorities.

Improving access to screening and diagnostics

Innovative partnerships are already transforming how the health care industry tackles NCDs in LMICs. In January, the Pfizer Foundation launched a three-year, $15 million investment to improve breast cancer care in Rwanda, Ghana, and Tanzania and address the significant disparities in health outcomes between women living with breast cancer in LMICs and those living in high-income settings. Studies have found that the five-year survival rate can be as high as 90% in high-income settings, while rates average under 50% in sub-Saharan Africa. In part, this is due to high rates of late-stage diagnosis — in other words, women are being diagnosed too late, when their cancer is already advanced.

To address this, the Pfizer Foundation, in partnership with Jhpiego and Partners In Health, is collaborating with the ministry of health in each country to bring services closer to people and deliver critical screening and diagnostic results faster so that women can receive appropriate treatment earlier. Together, they are raising awareness of breast cancer, expanding community-based screening, and broadening access to diagnostics and treatment. These multiple steps along the patient journey are paving the way for early detection and increased survival rates for women with breast cancer.

Leveraging data and technology to improve health outcomes

Health care companies are also making headway leveraging data and technology to improve NCD prevention efforts, specifically for cardiovascular disease. The Novartis Foundation’s CARDIO4Cities program in São Paulo (Brazil), Dakar (Senegal), and Ulaanbaatar (Mongolia) improved hypertension rates within two years by taking a systemwide, data-driven approach. The secret wasn’t a new drug — it was working with local governments to co-design data-based interventions.

These partnerships with the public sector helped establish easy access to blood-pressure measurement tools that monitor hypertension in health facilities and public spaces such as subway stations and samba schools. The CARDIO4Cities program provided public sector officials with the data to help tailor interventions to the populations they served, including via the implementation of a digital screening and referral system in São Paulo’s primary health centers.

In response to its early success, CARDIO4Cities is now seeking to improve cardiac health in up to 30 cities. The Novartis Foundation is also leveraging digital innovations such as artificial intelligence to improve health outcomes: Its AI4HealthyCities initiative uses artificial intelligence to map how factors such as housing, pollution, and income influence heart health, helping policymakers act earlier and smarter.

Drawing on industry expertise to meet national priorities

Aligning private sector expertise with national priorities is another area where companies can expand access to NCD prevention and care in a sustainable way, as MSD has done in Indonesia. Instead of relying only on donor programs such as Gavi, the Vaccine Alliance for vaccines, the Indonesian minister of health partnered with the private sector to bring vaccine manufacturing to the country. This move meant Indonesia could produce human papillomavirus, or HPV, vaccines at a lower cost, improving access while also creating jobs and boosting the local economy. By drawing on industry know-how to meet health and economic priorities, the effort is making strides toward cervical cancer elimination and building more resilient markets and communities.

A shift in mindset

What unites these examples is a mindset shift. Innovation does not only happen in a research lab: It’s co-created in clinics, in communities, and in the offices of local policymakers. It’s about combining scientific and health breakthroughs with trust, relevance, and sustainability.

For leaders in the health care industry, the playbook to address NCDs in low- and middle-income countries demands that companies do business differently, by:

• Understanding the entire patient journey and the gaps and opportunities at each juncture and integrating access plans from the start.

• Putting local expertise at the center of program design and leverage real-time data and technology to support decisions about resource allocation.

• Testing financing solutions that make care affordable and scalable.

• Building partnerships with governments and communities.  

Done right, this approach will lead to healthier populations, stronger health systems, and sustainable markets for years to come.

Learn more about Rabin Martin here.