Non-communicable diseases (NCDs) kill 41 million people globally every year, more than a third of them prematurely. The four major NCDs – cardiovascular diseases, cancer, chronic respiratory diseases and diabetes – account for over 80 percent of all premature NCD deaths, of which 85 percent occur in low- and middle-income countries, including in the WHO South-East Asia Region. Key NCD risk factors such as tobacco use, physical inactivity, harmful use of alcohol and unhealthy diets also contribute to and exacerbate mental health disorders, such as depression and anxiety. Amid the ongoing COVID-19 response, the time is ripe for all countries in the region to accelerate action to prevent, detect and control NCDs, and bring treatment to everyone who needs it.
People living with NCDs are at higher risk of severe COVID-19-related illness and death. They are among several groups who have been particularly affected by the pandemic, which has been marked by the interaction of SARS-CoV2 infection with a broad range of NCDs, which are themselves mediated by social and economic disadvantage. Amid the ongoing waves of infection, WHO will continue to support countries in the region to aggressively respond, while also enhancing health equity and maintaining essential health services, including for NCDs. High-impact innovations such as telemedicine, extended prescriptions, and door-step delivery of medicines must continue to be leveraged, and all at-risk groups actively encouraged to get vaccinated, in line with national deployment and vaccination plans.
The region’s progress against NCDs must not be halted, much less reversed. Since 2014, the region has intensified action to prevent and control NCDs as a Flagship Priority. All countries continue to implement national multisectoral NCD action plans. Even amid the COVID-19 response, they remain committed to achieving the global 2025 and 2030 NCD targets. Most countries have developed national mental health policies, which must continue to be strengthened in the months and years to come. For the region to protect and defend its many gains, and to catalyse more, several priorities require targeted attention.
First is taking full advantage of new initiatives. For example, in April, WHO launched its Global Diabetes Compact, which aims to ensure all people can access quality diabetes diagnostic tools, medicines and other medical products, without financial hardship. The region has in recent years made significant progress in increasing access to quality-assured insulin, however, barriers persist, especially for the most vulnerable. In the coming months, the Compact is set to drive new innovations in technology and pricing, which all countries in the region must harness and apply to maximum effect.
Second, implementing “best buy” interventions that we know work. Evidence shows that by increasing taxation of unhealthy products, policy makers can drive down consumption, enhance overall health, and reduce individual and public health costs. In the process, they will increase fiscal revenue, which if allocated toward health, will help achieve health and economic recovery from COVID-19 that is more equitable, resilient and sustainable. Restrictions on the marketing of unhealthy products are likewise essential, however, must cover surrogate advertising, which aims to cultivate brand loyalty among the young.
Third, strengthening action to address NCDs within health systems, especially on the frontlines. The region’s 2016 Colombo Declaration emphasizes the need for all people to have access to quality, integrated NCD services at the primary level, including healthy lifestyle counselling, targeted screening for early diagnosis, and quality medicines and medical devices for effective NCD management. All countries in the region have made tremendous progress in each of these areas and more, which WHO’s new Operational Framework for Primary Health Care can help accelerate throughout the COVID-19 response, recovery and beyond.
People-centred policy is the need of the hour. By intensifying community outreach and engagement, policymakers can ensure people from all walks of life understand the signs and symptoms of NCDs, and how to get tested and treated. Crucially, they can also increase health and NCD literacy more generally, inspiring people to take preventive action, such as regular and adequate physical activity, healthy eating and abstinence from tobacco and other unhealthy products.
Achieving whole-of-government, whole-of-society buy-in is essential. Policy makers should intensify engagement with key actors across sectors, and also seek out the insights and perspectives of people living with NCDs, who can best identify the existing gaps. WHO is committed to amplifying the voice of affected populations, and to ensuring they are invited to partner on, and continue to co-create, people-centred policy solutions.
Renewed and ramped up action against NCDs cannot wait. Amid the COVID-19 response, WHO will continue to provide all countries in the region critical support in all areas of health, including NCDs, a pressing threat to health, well-being and sustainable development. Together, we must reduce NCD risks and ensure all people have access to quality care and treatment that is equitable, comprehensive and affordable. Every opportunity must be grasped, and every innovation harnessed. No one can be left behind.
(The writer is World Health Organization Regional Director for South-East Asia.)