The world is sleepwalking into a sick future. Noncommunicable Diseases - cardiovascular diseases, cancer, chronic respiratory diseases, diabetes and mental illness – have long accounted for more suffering and death than infectious diseases but the global response has to date been, relatively, dormant.
The numbers paint a bleak picture, the stories are confronting.
Noncommunicable diseases (NCDs) kill 41 million people each year, equivalent to 71 per cent of all deaths globally. Each year, 15 million people die from an NCD between the ages of 30 and 69 years and over 85 per cent of these "premature" deaths occur in low- and middle-income countries. The world’s most marginalised populations are most at risk, exacerbating health inequalities and hindering social and economic development.
Global preventable death, disability, and suffering from NCDs continue to rise because of governments’ failure to act and invest for health. At the current rate of progress, more than half of all countries in the world will fail to meet the Sustainable Development Goal (SDG) 3.4 for NCDs to reduce the rate of premature deaths from NCDs by one third by 2030.
Decisive new action is urgently needed to halt the tsunami effect of NCDs - on people, families, communities, and economies. Over the coming decade, millions will lose loved ones to avoidable and early death. Millions more will suffer pain, disability and anguish because of lack of diagnosis and treatment. Millions more will struggle with entrenched poverty caused by catastrophic out of pocket expenditures.
Are world leaders up to the challenge of meeting this global health emergency head on?
I believe there’s reason to be cautiously optimistic.
The recent United Nations High Level Meeting (HLM) on NCDs was a watershed moment for the NCD movement.
Whilst the meeting´s Political Declaration is by no means perfect, the display of leadership throughout its negotiations from several countries in Latin America, the Caribbean, and the Pacific Region was inspiring, with demonstrable commitment to their people and communities. The inclusion of a paragraph in the 2018 UN Political Declaration on engaging civil society and people living with and at risk of NCDs in national NCD responses is a clear indication that governments have seen the value of working with civil society and the people most affected. The increased prominence of voices of people living with NCDs, and recognition of civil society’s role during the meeting shows a changing narrative, the kind that inspired action for the AIDS movement.
The recognition of mental health and environmental risk factors for NCDs as core components of the NCD response is a definitive and crucial step towards more fully inclusive action for NCDs. The Political Declaration successfully concluded with a compromise on the language concerning the Trade-Related Aspects of Intellectual Property Rights (TRIPS), which has important implications for essential medicines like morphine for treatment and care for millions of people living with NCDs worldwide. And, for the first time, an NCD Declaration includes language on respecting human rights obligations. This lays strong foundations for preparations towards the 2019 UN HLM on Universal Health Coverage - in which we expect to see NCD prevention and control fully integrated.
We have the tools to move forward.
Actions to save lives are simple and extremely cost-effective; investing in the tried-and-tested WHO Best Buy interventions yields a seven-fold return in low and lower-middle-income countries. When it comes to NCD prevention, Best Buys interventions include taxation, regulation and legislation and the much-publicised taxes on Sugar, Tobacco and Alcohol (STAX).
Implementing the 16 Best Buys worldwide would save 9.6 million lives by 2025, according to new data by WHO. The enormous life-saving potential of these proven, cost-effective measures includes, for example, nearly 70,000 lives in South Africa, 134,500 in Nigeria, 150,000 in Egypt, 340,000 in Germany, 193,000 in Spain, over half a million in the US, 1.3 million in India and over 1.7 million in China. The failure to comprehensively implement these measures —and to try to block others— to save all these lives is inexcusable.
And yet it came to pass.
The absence of strong language on implementing the Best Buys is a glaring omission from the Political Declaration but looking at the process with the glass half full I think resistance to the measures are an indication that we´ve struck a nerve too.
We will continue to implore leaders: talk to your people and hear their stories, look at the data and commit to action for the sake of the people that the numbers represent, and ask yourselves: are you doing enough to ensure the health and well-being of your people, your societies, and your economies?
Katie Dain (@KatieDain1) is the CEO of the NCD Allianceand widely recognised as a leading advocate and expert on NCDs. She is currently a member of the WHO Independent High-Level Commission on NCDs, co-chair of the WHO Civil Society Working Group on the UN High-Level Meeting on NCDs, and a member of The Lancet Commission on NCDIs of the Poorest Billion.