New approach to help low- and middle-income countries reduce premature mortality from NCDs

Most of the world’s countries have made little progress towards a goal adopted by the United Nations in 2015, which called on the world to reduce premature mortality from non-communicable diseases by one-third by 2030. Non-communicable diseases include common ailments such as heart disease. , cancer, chronic respiratory diseases and diabetes. These conditions are increasingly prevalent around the world due to economic development, aging populations, and other factors.

Today, in a health policy article in The Lancet, contributors to Countdown 2030 on Non-Communicable Diseases present an approach to help low- and middle-income countries get back on track to achieve this goal, called Sustainable Development Goal 3.4. They offer guidance on the types of interventions that can accelerate progress against noncommunicable diseases in 123 low- and middle-income countries. They also describe the resources needed to make these interventions more widely available to the general public.

The authors of the article say they believe that with concerted action and investment in a few high-cost health interventions, most countries could meet the global goals. They also predict that the return on investment for governments would be high in terms of lives saved and economic gains.

The Covid-19 pandemic has cast a harsh light on the vulnerabilities of health systems across the world.”

Dr. David Watkins, Assistant Professor, Division of General Internal Medicine and Department of Global Health, University of Washington School of Medicine

He is the main author of the health policy document.

He has worked with collaborators from the World Health Organization in Geneva, the NCD Alliance (a non-profit organization that campaigns for the reduction of non-communicable diseases), Imperial College London and others. The complete list of authors is available on the article published in The Lancet.

Watkins points out that the pandemic has disproportionately affected people living with non-communicable diseases like heart disease, cancer and chronic lung disease. Their medical care has been severely disrupted by pandemic measures and they are at a higher than average risk of dying from Covid-19.

Watkins, who is based at the new Hans Rosling Center for Population Health at UW, called for renewed action around the world against these life-shortening and often debilitating disorders.

“Over the past decade, world leaders have repeatedly pledged to tackle non-communicable diseases, but progress has stalled. It’s time to reset the international agenda,” he urged. .

He explains that the new report presents a practical set of investments that national governments can make to rebuild their health systems in the area of ​​noncommunicable diseases. These investments could help achieve, or nearly, a reduction in death rates from non-communicable diseases of around one-third by 2030, the same level as specified in the United Nations target.

The greatest benefits are expected to occur in reducing deaths from heart attacks and strokes, particularly through better treatment of risk factors like high blood pressure and diabetes.

The interventions, which are based on findings from the Disease Control Priorities Project (, include 15 clinical services and six government policies relating to the taxation and regulation of tobacco, alcohol and foods high in sodium. and trans fats.

The most cost-effective combination of clinical intervention strategies may vary by country and region of the world. But addressing behavioral risks, such as smoking, harmful use of alcohol and excessive sodium intake, would be relevant everywhere.

“Our framework is particularly relevant to health policy in low- and middle-income countries,” he said, “and is intended to help governments in these countries spend their limited healthcare resources wisely. health”.

The authors of the guidance document estimate that the cost of scaling up these interventions globally would require an additional US$18 billion per year from 2023 to 2030. This investment could avert 39 million premature deaths over this period and generate a net economic benefit of $2.7 trillion, with the benefits outweighing the costs 19-t0-1.

Financing these interventions would likely require the mobilization of additional government resources, which could be difficult in low-income countries whose budget deficits have been exacerbated by the COVID-19 pandemic.

According to the report, financing the non-communicable disease agenda would require a combination of domestic spending by governments and catalytic assistance from international development agencies, which have historically been reluctant to invest under such conditions.

But donor support for strengthening primary health care systems could benefit both noncommunicable diseases and traditional targets of development assistance such as HIV and tuberculosis.

The authors expect the report to have an influence on global health policy. On April 12, the President of Ghana, the Prime Minister of Norway and the Director General of WHO are hosting an international policy dialogue on non-communicable diseases.

The meeting will establish a new international political compact on non-communicable diseases and call for additional strategic investments by countries and donors. The Lancet paper provides concrete guidance and a ‘costed’ action plan for non-communicables that directly addresses the needs of policy makers.


Journal reference:

NCD Countdown 2030 Contributors., (2022) NCD Countdown 2030: Effective pathways and strategic investments to accelerate progress towards Sustainable Development Goal target 3.4 in low- and middle-income countries. The Lancet.