Non-communicable diseases also need money

Non-communicable diseases are the leading cause of death in the world. Richard Catabay

Noncommunicable diseases (NCDs), such as cardiovascular disease, cancer, lung disease, diabetes, obesity, and mental disorders, are often chronic conditions that develop over a long period of time.

Together, they are responsible for around 70% of deaths globally (and 60% of deaths in sub-Saharan Africa, where they account for more than 55% of hospital admissions in countries such as Kenya).

Thus, developing countries face a double burden of diseases, since communicable diseases such as malaria, HIV and tuberculosis continue to be a great challenge for these countries, and they also face a growing incidence of NCDs.

One might hope that the large and growing burden of NCDs would lead to the channeling of more funds and resources to address them.

However, the fight is chronically underfunded and remains a lower priority compared to efforts to tackle infectious diseases.

There is no global fund for any NCD: in 2019, more than 40% of targeted development aid came from private institutions.

However, efforts to combat communicable diseases, whose burden has decreased significantly over the years, have several specific international funding institutions for them, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), Gavi, the United Nations Population Fund and the Bill and Melinda Gates Foundation.

And, despite NCDs being the leading cause of death worldwide, they account for less than 10% of the global health budget.

One reason for this disparity is the relative lack of evidence-based research.

Funders have a duty to invest in data-driven strategies, so they have tended to focus elsewhere.

Furthermore, NCDs are still largely misunderstood.

Many people think that they are caused only by the individual person, and ignore all the other social, economic and structural determinants of it.

Neither has the weakness of the actions related to these pathologies by grassroots community movements, nor the misconception of the problem by the public sector, been helpful.

Perhaps most significantly, NCDs were not part of the Millennium Development Goals and therefore missed opportunities for more funding during the period 2000-2015. Even now, the reduction in premature deaths for this group of ailments is only one of the 169 targets of the Sustainable Development Goals (SDG 3.4), which makes it difficult to finance this goal.

Given that incidence is likely to rise further, several urgent steps are needed to bring about a shift in global funding priorities.

NCDs were not part of the Millennium Development Goals and therefore missed opportunities for increased funding between 2000 and 2015

The first step is to emphasize the close links between NCDs and communicable diseases, so that some of the funds that are already being channeled into fighting the latter can be directed to addressing those links.

For example, many HIV patients have successfully managed their viral loads and up to 40% now die from non-communicable diseases such as ischemic heart disease and diabetes.

Furthermore, there is epidemiological evidence showing that NCDs contribute significantly to tuberculosis deaths.

Focusing solely on one of the two groups of diseases, disregarding the other, will result in less long-term impact.

Second, we must strengthen universal health coverage in order to focus first on the poorest, who are most affected by NCDs.

Poor people who suffer from them are often unable to access medicines, nor can they pay for out-of-pocket costs or palliative care.

Only when the most vulnerable benefit from universal health coverage can we start to tackle the problem effectively.

Such schemes should also have a comprehensive package that focuses on health promotion and creation, as well as treatment coverage.

Furthermore, countries should use relevant research and data to develop a financial case for investment at the national level.

Priorities will vary by country and region.

Some will follow an approach that is specific to certain pathologies, while others will adopt a more preventive and promotional strategy.

But whatever approach is taken, building a strong case for investment needs the support of grassroots community movements, as a strong citizen movement will hold governments accountable for the commitments they make. assume.

Most governments signed the Abuja Declaration, according to which spending on public health should represent at least 15% of the total national budget.

However, in many countries, especially in Africa, it represents less than 5%.

Research continues to show that the environment and government policies also have a large effect on these diseases.

Finally, a broader national development strategy can allow countries to reap greater benefits.

By linking built environment and infrastructure projects with the idea of ​​combating NCDs, we can create public spaces that encourage walking and other physical activities, while reducing air pollution.

Similarly, by working with the food industry, we can improve package labeling, eliminate trans fats, and increase taxes on sugars, salts, and unhealthy foods to encourage people to improve their diets.

Clearly, the fight against NCDs requires a partnership approach.

Contrary to widespread popular belief that these ailments are caused by individual behavior, research continues to show that the environment and government policies also have a large effect on these illnesses.

All of these suggestions underscore the importance of building strong health care systems that can achieve the ultimate goal of a strong and healthy society in which noncommunicable diseases are prevented, managed, and controlled.

Once we look at the big picture, it becomes clear that reducing its global burden in a sustainable way is a goal the world cannot afford to miss.

Stephen Ogweno

is founder and CEO of Stowelink Inc., and recently launched a mobile app called NCDs 365 that provides information on noncommunicable diseases.

Translation from English: Rocío L. Barrientos

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