NCDA: Investing in cost-effective NCD policies now could save lives and money later

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Amber Huett-Garcia has struggled with obesity since she was a freshman.

“Now as an adult, despite my BMI reducing from 69 to 24 (lost 245 pounds), I still carry the costly diagnosis of obesity,” she wrote in a recent Blog for the Non-Communicable Diseases Alliance (NCD Alliance). “I’ve used drug therapy, surgery, mental health care and more to get the combination of treatments needed to maintain a healthy body weight, but not without cost.”

More than 650 million people are affected by obesity worldwide. It is an NCD that progresses over time without medical intervention or lifestyle changes. For many, access to affordable medical care does not exist.

NCDs have become a major social justice issue in the 21st century, the alliance said. They push poor households further into poverty and prevent developing countries from achieving strong and sustainable economies.

This week, the NCD Alliance will host the annual meeting Global Action Week on NCDs, including a special “Investing to protect” virtual event on September 8, this will open with remarks from the Director General of the World Health Organization, Dr. Tedros Adhanom Ghebreyesus, and former New York Mayor Michael Bloomberg, who is now the global ambassador of WHO for non-communicable diseases and injuries.

The Global NCD Action Week aims to send a message to governments, donors, international agencies and the private sector: Invest in NCDs today, save lives and money tomorrow. Funding for NCDs has stagnated at a pitiful 1% to 2% of development aid for health for two decades, causing many millions of deaths and pushing millions more into extreme poverty due to the costs of care health and disability.

“Many NCDs can be prevented with a set of cost-effective interventions,” explained NCD Alliance Executive Director Katie Dain. “We have the solutions, we have the tools, we have the know-how to prevent and treat NCDs. What is needed is political will at the highest level.

NCDs are responsible for the deaths of 41 million people a year

NCDs account for seven of the 10 leading causes of death worldwide, leading to the death of 41 million people and 74% of all deaths worldwide. And that number is set to grow, according to the NCD Alliance, to 52 million people a year by 2030.

These main killers are cancers, cardiovascular diseases, strokes, chronic respiratory diseases, diabetes, mental and neurological disorders and chronic kidney diseases.

As a reminder: in 2020, some 1.5 million people died from tuberculosis, 627,000 from malaria and 680,000 from HIV/AIDS.

Moreover, although they hit everyone and every country, like Garcia, who lives in the United States, the burden on low- and middle-income countries (LMICs) is much greater. In these countries, it is estimated that more than 85% of premature deaths between the ages of 30 and 70 are caused by NCDs.

COVID-19 has further highlighted the challenges of NCDs, with 60% to 90% of the more than six million COVID deaths being people who were living with one or more NCDs. It also likely increased the burden of NCDs due to missed diagnoses and treatments.

For example, a recent report showed that for each week of confinement, around 2,300 cases of cancer went undiagnosed. In LMICs, the alliance predicted, the situation is likely even worse, as levels of undiagnosed NCDs in these countries were already extremely high before the pandemic.

“Sweeping changes, including legislation, were made within weeks to protect the public from COVID-19,” Dain said. “We need the same urgency to stop the premature morbidity and mortality caused by NCDs.”

NCDs are expected to cost developing countries $7 trillion between 2011 and 2030

NCDs cause global GDP losses of between 3.5% and 5.9%. The alliance predicted that they would cost the developing world $7 trillion in losses over the period 2011-2030.

The top five NCDs alone are estimated to cost the world more than $2 trillion a year.

But beyond dollar signs, it also costs human capital – in the short term by ending millions of lives and in the long term by causing disabilities that prevent people from working.

NCDs cause 80% of years lived with disability, according to a report by the Institute for Health Metrics and Evaluation. Another one reportthis one from the WHO, found that heart disease, diabetes, stroke, lung cancer and chronic obstructive pulmonary disease were collectively responsible for nearly 100 million years of healthy life lost in 2019 compared to 2000.

What are non-communicable diseases really? This infographic revisits all the basics to allow you to consolidate your knowledge.

‘Best buys’ could save 10 million lives

In 2015, the World Health Organization launched a series of “Sustainable Development Goals” (SDGs), with member countries pledging among other things to ensure health and well-being for all. Point 3.4 called on the world to reduce premature mortality from NCDs by one third by 2030.

According to experts, including a report published by The Lancet, despite little effort to date, if countries start now, this goal could still be achieved.

“All countries – and especially LMICs – can achieve or come close to achieving SDG 3.4, saving 39 million lives by 2030, by introducing a cost-effective package of NCD prevention and treatment interventions,” explained the NCD Alliance in its recent guidance note.

The necessary steps were outlined in 2017 by the WHO in a series of what it calls “Best buys“, a set of 16 interventions that work on the prevention and management of NCDs for prices that have an unprecedented return on investment. These include measures to reduce tobacco and alcohol consumption, improve unhealthy diets and increase physical exercise, as well as plans for the management of cardiovascular disease, diabetes and cervical cancer. uterus.

Implementing Best Buys in LMICs would save 10 million people from heart disease and stroke, for example. It would also add 50 million years of healthy life.

Moreover, on the financial side, the Lancet NCD Countdown 2030 showed that implementing this reform package would cost an average of $18 billion per year between 2023 and 2030 but would generate an average net economic benefit of $2.7 trillion. dollars.

“Unless countries follow through on their pledges to reduce mortality from non-communicable diseases such as diabetes and hypertension, we will be treating a large portion of the world’s population living with chronic diseases,” Dain said. “And most of this preventable suffering, disease and death will be among people living in the poorest communities. We can avoid this future scenario by investing in cost-effective policies now.

Dain added that “keeping citizens healthy against preventable NCDs is not just about a government’s choice to invest in health, it is an investment in a country’s economic stability and security, in its own pandemic preparedness.

Picture credits: oncommunicable Disease Alliance, Non-Communicable Disease Alliance.

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