The ace non-communicable diseases (NCDs), such as cardiovascular disease, cancer, lung disease, diabetes, obesity and mental disorders, are usually chronic conditions that develop over a long period of time. Together they are responsible for about 70% of deaths worldwide (and 60% of deaths in Sub-Saharan Africawhere they represent more than 55% hospital admissions in countries like Kenya). Thus, developing countries face a double burden of disease, as communicable diseases such as malaria, HIV and tuberculosis continue to be a big challenge for these countries, and they also face an increasing incidence of MNT.
One would hope that the large and growing burden of NCDs would lead to channeling more funds and resources to address them. However, the fight is chronically underfunded and it remains a lower priority compared to infectious disease control efforts.
There is no global fund for NCDs: in 2019, more than 40% of targeted development assistance came from private institutions. However, efforts to control communicable diseases, the burden of which has significantly decreased Over the years, they have benefited from several specific international financial institutions, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), Gavithe United Nations Population Fund and the Bill and Melinda Gates Foundation. And, even though NTMs are the The main cause of deaths in the world, represent less than 10% from global health budget.
One of the reasons 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. Additionally, NTMs are still very poorly understood. Many people think they are caused solely by the individual person, ignoring all their other social, economic and structural determinants. Neither the weakness of the actions linked to these pathologies by the grassroots community movements, nor the ignorance of the problem by the public sector, have been useful.
Perhaps more importantly, NTMs were not part of the Millennium Development Goals and therefore missed opportunities for more funding over the period from 2000 to 2015. Even now, the reduction in premature deaths from this group of diseases is only one of 169 goals of the Sustainable Development Goals (SDG 3.4), making it difficult to fund this goal. Given that the incidence is likely to increase further, several urgent actions 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 strong links between NCDs and communicable diseases, so that some of the funds already allocated to the fight against the latter can be allocated to addressing these links. For example, many HIV-positive patients have successfully managed their viral load and Up to 40% now he is dying of non-communicable diseases, such as ischemic heart disease and diabetes. Likewise, there is epidemiological evidence showing that NCDs contribute significantly to deaths tuberculosis. Focusing only on one of the two groups of diseases, ignoring the other, will result in less impact in the long run.
Second, we need to strengthen the Universal health coverage with the aim of focusing first on the poorest, who are most affected by NCDs. Poor people who suffer from it often do not have access to medicines, nor can they pay for out-of-pocket expenses or palliative care. Only when the most vulnerable benefit from universal health coverage can we begin to tackle the problem effectively. These plans should also have a comprehensive package focused on health promotion and creation, as well as treatment coverage.
In addition, 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 a specific approach to certain pathologies, while others will adopt a more preventive and promotional strategy.
But whatever approach is taken, building a strong case for investment requires the support of grassroots community movements, because a strong citizen movement will hold governments accountable for the commitments they make. Most governments have signed the Abuja Declaration, that public health expenditure 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 significant effect on these diseases.
Finally, a broader national development strategy can allow countries to reap greater benefits. By linking built environment and infrastructure projects to tackling NCDs, we can create public spaces that encourage walking and other physical activity, while reducing air pollution. Likewise, 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, tackling NCDs requires a partnership approach. Contrary to the widespread popular belief that these diseases are caused by individual behavior, research continues to show that the environment and the Government policies they also have a great effect on these diseases.
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.
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