Alison Cox, NCD Alliance, on the left and Ibtihal Fadhil, Eastern Mediterranean NCD Alliance, on the right.

Care and crisis: Prioritising noncommunicable diseases in the humanitarian agenda

12th March 2024

Dr Ibtihal Fadhil, founder and chairperson of the Eastern Mediterranean NCD Alliance and Alison Cox, Director of Policy and Advocacy at NCD Alliance (NCDA) reflect on the outcomes of the Global High-Level Meeting on NCDs in Humanitarian Settings held in Copenhagen, Denmark last month.

Living with noncommunicable diseases (NCDs) poses significant challenges, especially in humanitarian settings where health systems are strained and access to care is limited. Factors such as disrupted healthcare services, lack of medicines, and increased exposure to NCD risk factors exacerbate these challenges.

Despite the high prevalence of NCD-related deaths in low- and middle-income countries facing humanitarian emergencies, NCD prevention and care have been historically overlooked in such contexts as the response is usually focused on immediate needs while NCDs require sustainable resources and long-term interventions Also, one of the challenges has always been a lack of data on how many people in humanitarian crisis need NCD care.

The Global High-level Technical Meeting on NCDs in Humanitarian Settings, held in Copenhagen in February 2024, aimed to address this gap. Co-hosted by the Governments of Denmark, Kenya and Jordan, with the support of the World Health Organization and UN High Commissioner for Refugees (UNHCR), the meeting brought together various stakeholders, including governments, UN agencies, civil society organisations, and affected communities. Discussions emphasised the urgent need to integrate NCD prevention and control into humanitarian responses.

While immediate medical needs often take precedence in crises, neglecting the long-term effects of NCDs can prolong suffering and impede recovery efforts. Therefore, there is a collective call for governments and the international community to prioritise NCDs within humanitarian response frameworks, adopting a multi-stakeholder and solution-oriented approach to address these pressing health challenges.

The NCD Alliance plays a pivotal role in advocating for NCDs during health crises, such as COVID-19. They have emphasised the urgency of addressing NCDs in humanitarian settings, especially since 2015, aligning with Sustainable Development Goals (SDGs) aiming at reducing premature mortality from NCDs and achieving universal health coverage.

As representatives of NCDA at the meeting, we took part in two-panel discussions, providing insights from NCDA's efforts toward integrating NCDs into humanitarian contexts. We shared key findings and lessons from a preparatory brief titled "Neglected and in Crisis: NCDs as a Priority in Humanitarian Settings," which features case studies from Kenya, Lebanon, and Ukraine.

NCDA also facilitated the participation of individuals living with NCDs from Palestine, Syria, Sudan, Yemen, and Afghanistan, allowing them to share their experiences and challenges during humanitarian crises. Also, referring to the new series of NCD Diaries, recently launched by NCDA, you can read personal stories of three people living with NCDs - Modina Khatun, a refugee from Myanmar, Noura Arnous, a refugee from Syria, and Nfortentem Aaron living in conflict-affected areas in Cameroon.

The primary recommendations arising from the discussions include:

Governments have to support the integration of NCD services throughout emergency cycles, ensuring access to vital services such as primary care and medication, and reducing exposure to NCD risk factors.

It is emphasised that multisectoral collaboration and sustainable financing models are essential for advancing this agenda.

Community protection and engagement are highlighted as crucial components in strengthening local-level, community-based initiatives, leading to improved outcomes for people living with NCDs in humanitarian settings.

The absence of comprehensive data on the burden and impacts of NCDs in humanitarian settings underscores the importance of data collection and monitoring for informed resource allocation.

The meeting's recommendations will feed into the 2024 progress report for the UN Secretary-General, guiding preparations for the Fourth UN High-level Meeting on NCDs scheduled for 2025.

It is crucial for the discussions from Copenhagen to continue at all levels – international, regional and national. Our world is facing many humanitarian needs fuelled by armed conflicts and the climate crisis leaving estimated 300 million people needing assistance in crises settings in 2024 We cannot afford to overlook the NCD burden in this population.

NCD community looks forward to the High-Level Meeting on NCDs in 2025 to bring about some progress on the NCD Global Compact’s commitment to protecting 1.7 billion people living with NCDs, including those living in humanitarian settings, by ensuring that they have access to the medicines and care they need in during crises and ensure more resilient health systems which leave no one behind.

About the authors:

Dr Ibtihal Fadhil is the founder and chairperson of the Eastern Mediterranean NCD Alliance. A medical doctor with an MSc and PhD in public health, she has worked on NCD control at government and civil society (CSO) levels. As WHO Regional Adviser on noncommunicable diseases, Dr. Fadhil has worked with most of the regional CSOs for more than eight years and developed the core regional network of CSOs working against noncommunicable diseases. She has worked jointly with the World Health Organization and other regional partners to develop the civil society organization capacity-building program. This program has been instrumental in uniting CSOs at national and regional levels.

Alison Cox is the Policy and Advocacy Director with NCD Alliance. She began her career with environmental campaigning organisations including Greenpeace International, and then went on to lead strategy development and direct advocacy for global public health alliances: for the Framework Convention Alliance, bringing the civil society to voice to the WHO treaty on tobacco control, and in the early years of the NCD Alliance leading on Rio+20 advocacy to ensure NCDs were recognised in what became the Sustainable Development Goals, and on developing NCDA’s first strategy. As Prevention Director at Cancer Research UK, she led successful national campaigns for restrictions on tobacco and junk food marketing and built an international programme to support tobacco control advocacy in LMICs. As Policy & Research Director for the Global Climate & Health Alliance, she coordinated the delivery to the global climate summit, COP26, of the Healthy Climate Prescription from organisations representing 46 million health professionals worldwide.