Amber Huett-Garcia has struggled with obesity since she was in first grade.
“Now in adulthood, despite reducing my BMI from 69 to 24 (245 lbs. lost), I still carry the expensive diagnosis of obesity,” she wrote in a recent blog for the Noncommunicable Disease Alliance (NCD Alliance). “I’ve used pharmacotherapy, surgical interventions, mental health care and more to achieve the combination of treatment needed to maintain healthy body weight, but not without cost.”
More than 650 million people are affected by obesity globally. It is an NCD that progresses overtime without medical intervention and lifestyle changes. For many, access to affordable medical care does not exist.
NCDs have become a major 21st century social justice issue, the alliance has 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 Global Week for Action on NCDs, including a special “Invest to Protect” virtual event on September 8 that will open with remarks by World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus and former New York City Mayor Michael Bloomberg, who is now WHO’s global ambassador for noncommunicable diseases and injuries.
We need increased and urgent investment so that noncommunicable diseases (NCDs) are given the attention, prevention, treatment and care that they need.
Let’s INVEST TO PROTECT!
— NCD Alliance (@ncdalliance) September 3, 2022
The Global Week of Action on NCDs aims to get a message across to governments, donors, international agencies and the private sector: Invest in NCDs today, save lives and money tomorrow. Financing for NCDs has stagnated at a pitiful 1% to 2% of development assistance for health for two decades, causing many millions of deaths and pushing millions more into extreme poverty due to health care costs and disability.
“Many NCDs can be prevented through 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’s needed is political will at the highest level.”
NCDs account for deaths of 41 million people a year
NCDs account for seven of the top 10 causes of death around the world, translating to the deaths of 41 million people and 74% of all deaths worldwide. And the number is projected to grow, according to the NCD Alliance, to 52 million people annually by 2030.
These top killers are cancers, cardiovascular disease, stroke, chronic respiratory diseases, diabetes, mental health and neurological conditions and chronic kidney disease.
For perspective: 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, such as Garcia, who is living in the United States, the burden on low- and middle-income countries (LMICs) is much greater. In those countries, an estimated more than 85% of premature deaths between the ages of 30 and 70 are caused by NCDs.
COVID-19 further highlighted the challenges of NCDs, with 60% to 90% of more than six million COVID deaths being people who were living with one or more NCD. It has also likely exacerbated the NCD burden due to missed diagnoses and treatments.
For example, a recent report showed that for every week of lockdown, an estimated 2,300 cancer cases went undiagnosed. In LMICs, the alliance predicted, the situation is likely even worse, as these countries’ levels of undiagnosed NCDs were already extremely high before the pandemic.
“Sweeping changes, including legislation, were made in a matter of 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 expected to cost developing world $7 trillion between 2011 and 2030
NCDs are costing global GDP losses of between 3.5% and 5.9%. The alliance predicted they will cost $7 trillion in losses in the developing world over the period 2011-2030.
Just the five leading NCDs are estimated to cost the world more than $2 trillion annually.
But beyond the dollar signs, it is also costing human capital – in the short term by ending millions of lives and in the long term by leading to disabilities that keep people out of their jobs.
NCDs cause 80% of years lived with disability, according to a report by Institute for Health Metrics and Evaluation. Another report, this one by WHO, found that heart disease, diabetes, stroke, lung cancer, and chronic obstructive pulmonary disease were collectively responsible for nearly 100 million more healthy life-years lost in 2019 compared to 2000.
‘Best Buys” could save 10 million lives
In 2015, the World Health Organization rolled out a series of “Sustainable Development Goals” (SDGs), with member countries pledging among other things to deliver health and wellbeing for all. Item 3.4 called for the world to reduce premature mortality from NCDs by a third by 2030.
According to experts, including a report published by the Lancet, despite few efforts being made to date, if countries start now, this goal could still be achieved.
“All countries – and especially LMICs – can achieve or nearly achieve SDG 3.4, saving 39 million lives by 2030, by introducing a cost-effective package of NCD prevention and treatment interventions,” the NCD Alliance explained in its recent policy brief.
The steps needed were outlined in 2017 by WHO in a series of what it calls “Best Buys,” a set of 16 interventions that work on preventing and managing NCDs for prices that have an unprecedented return on investment. These include steps to reduce tobacco and alcohol use, improve unhealthy diets and increase physical exercise, as well as plans for the management of cardiovascular disease, diabetes and cervical cancer.
Implementation of the Best Buys in LMICs would translate to saving 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 package of reforms would cost on average $18 billion annually between 2023 and 2030 but would generate an average net economic benefit of $2.7 trillion.
“Unless countries follow through on commitments to reduce mortality from noncommunicable diseases such as diabetes and hypertension, we ‘ll be nursing a huge part of the global population living with chronic conditions,” Dain said. “And most of this preventable suffering, illness and death will be amongst people living in poorer communities. We can avoid that future scenario by investing in cost-effective policies now.”
Dain added that “keeping citizens healthy from preventable NCDs is not simply 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.”
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