This piece was submitted as a supplement to our ongoing op-ed series. We’re delighted to share it here.
By Gloria Sangiwa, MD
Chronic diseases — notably cancers, cardiovascular diseases, chronic lung diseases, and diabetes — now account for nearly 35 million deaths annually. The human and economic burden of chronic diseases are staggering,especially in developing countries. Left unchecked, by 2030 the epidemic will kill twice as many people in low- and middle-income countries as it does today.
One year ago, the world came together to address this emerging global epidemic. Country representatives, policy makers, and civil society convened in New York for the United Nations (UN) High-Level Meeting on Non-Communicable Diseases (NCDs), and the UN General Assembly adopted a declaration, promising to strengthen and accelerate the response.
Since the meeting last September — despite the fact that the meeting adjourned without any major new funding – we have observed political will and commitment unprecedented since the 2001 UN General Assembly Session on HIV/AIDS and momentous achievements by the global health community. Governments, industry, and civil society have held themselves accountable for curbing the epidemic by setting and adopting policies to support surveillance, prevention and comprehensive chronic disease prevention, treatment and care programs.
And, perhaps most significantly, Ministers of Health at the 65th World Health Assembly in Geneva agreed to a goal of reducing premature deaths attributed to chronic diseases by 25 percent by the year 2025.
The aim is high and skeptics worry that we will not be able to meet the targets set out. But the chronic disease community (NCDs community) is confident that we can achieve these aspirational targets. Already, governments and health professionals have scaled up the use of evidence-based tools, knowledge, and skills, and began leveraging existing service delivery platforms in which the global health community has so heavily invested — e.g. HIV/AIDS; maternal, newborn and child health; as well as reproductive and family health programs.
But, the current responses are not enough in the face of the magnitude of the growing burden in developing countries. Nearly 90 percent of the nine million deaths annually among youth, women and adults under the age of 60 occur in low- and middle-income countries. Their health systems are double burdened by communicable diseases, such as HIV/AIDS, tuberculosis (TB), and malaria, as well as high rates of maternal and child mortality.
The problem is likely to get worse before it gets better, and we know that changing the human behaviors contributing to the epidemic – such as getting people to exercise, eating healthy, smoking cessation, and alcohol reduction – is one of the hardest challenges in chronic disease prevention efforts.
Design Health Interventions for Scale-Up
That is why MSH believes in the need for innovative, evidence-based “game-changing” solutions which can be designed for scale up from the start. We must instill healthy lifestyle choices within communities that not only address the risk factors for chronic diseases, but also the current public health challenges — high rates of maternal and infant mortality rates, malnutrition, and preventable and treatable diseases (HIV/AIDS, malaria, and TB) — that can hinder us from achieving the 2015 millennium development goals.
As we move forward with a global response, MSH believes the following tried and true key ingredients are necessary to ensure we “push the envelope” and achieve our targets:
- Involve the whole society in response – public, private, and civil society;
- Work towards universal health coverage (UHC) – a financing base to reduce out-of-pocket expenses, which accounts for more than 50 percent of total health expenditures in poor countries;
- Ensure a “diagonal approach” to health programming in which chronic disease advocacy efforts; interventions, and health financing are integrated into the broader health system;
- Promote innovative, multi-risk factor health promotion and primary prevention interventions, and advocate for healthy living and wellness principles;
- Guarantee efficient, effective and cost-conscious actions at every step – especially given the current economic climate and inadequate financial commitment to address chronic diseases.
Together, implementing these evidence-based and game-changing approaches, we can continue the momentum from last year’s meeting andreduce the chronic disease burden on low- and middle-income countries.
To learn more about MSH’s work helping managers and communities fight chronic diseases, please visit our website.
Colin Gilmartin contributed to this post.
Gloria Sangiwa, MD, is Management Sciences for Health’s global technical lead for chronic non-communicable diseases and the director of technical quality and innovation in MSH’s Center for Health Services.