Saving LIVES by Spending LESS - But where’s the money for NCDs?

A few days ago, the world record for the marathon was broken by Kenyan athlete Eliud Kipchoge, often described as the greatest marathoner of the modern era. He made a very impressive start and finished in a record time of 2:01:39 - breaking a 4-year-old record.

In terms of NCDs, the years 2011 and 2014 – the dates of the first and second High-Level Meetings on NCDs – set a record, of commitments from governments at least. However, the time has come to break this four-year record, especially in terms of resource allocation and financing for NCDs globally.

But who will stand up and be the ‘NCD marathon runner’, someone who can break free of the current sluggishness and inaction in dealing with these devastating diseases?

As expected, the last couple of months have seen momentum and media attention building ahead of the 3rd HLM on NCDs, which will take place on 27 September at the UN General Assembly in New York. NCDs will be in the spotlight again this week and despite governments’ dismal track record to date, expectations remain that we will witness strong political commitment and action after years of lethargy by our leaders. 

Globally, NCDs are the leading cause of death and disability, responsible for the deaths of 41 million people yearly. Of these 41 million, 32 million come from regions which have health systems that are not adequately equipped to handle the NCDs epidemic, including countries from Sub-Saharan Africa and Asia.

So, the question is– Why don’t these countries have health systems that can take care of people living with NCDs?

The answer is simple– There is no money for NCDs! No money from governments, and hardly anything from donors and other development partners.

Lack of interest in funding NCDs has become the norm, and generally acceptable if the lack of global uproar is anything to go by. Despite NCDs being the  cause of 70% of all global deaths annually, they receive a miniscule amount of development assistance for health (DAH) – less than 2%. In absolute numbers, of total DAH of $36.4 billion, NCDs receive $475 million a startling 1.3% of the total!

• Investing in NCDs improves workforce participation and productivity – so people are more healthy and efficient at work;
• Investing not only improves health and saves lives but can also improve a country’s economic productivity;
• It will reduce the financial burden of unexpected health costs from NCDs (for treatment) on individuals and families.

The WHO’s recently released report clearly states that every $US1 invested in NCD prevention and control will yield a return of at least $7 by 2030.This is an excellent return on investment. And investment is particularly important in countries where health systems are weak but the NCD burden continues to rise.

What can we do?

It is time for all of us to be creative and utilize every existing channel that shows promise in yielding increased resources, funding and financing for NCDs.

Donors do not find NCDs ‘sexy’ and appealing. We need to show them that by integrating NCDs into existing health programs, using innovative ways of delivering healthcare at the primary level, we can have a huge impact. This will not only help to make health systems resilient to the NCD epidemic, specifically in low- and middle-income countries, but will also go a long way towards making them ‘sexy’.

As the global health community continues scratching its head trying to find ways to boost NCD financing, it is overlooking one available asset – young people globally.  

2018 is probably the best time to leverage the power of youth as the demographic dividend is larger than ever. Young people have the numbers and are better placed than at any time in history to advocate for more resources for NCDs, starting at the grassroots, up to the highest offices. 

If young people are equipped with the needed information, they will be able to organize and produce the massive ripple effect required in calling for allocation of resources for NCDs. Add to this the fact that many young people today have the technical knowhow of the NCD landscape in their countries and are self-motivated and self-organized to upset the status quo. The evidence is plain to see in the Young Professionals Chronic Disease Network, United Nations Major Group for Children and Youth, International Federation of Medical Students Association and many more. 

One of the likely disadvantages to youth taking up the call for resource allocation for NCDs is the complexity of the issue. Therefore, before we reach too high, it would be wise to build a solid foundation by ensuring that young people understand the importance of increased financing and resources to curb NCDs, know the right people to approach and are convinced and prepared to make ‘the ask’. It is for this reason that a simplified toolkit, Everything you need to know about NCD Financing, has been developed by a group of young people, for young people. It will get youth started on understanding, thinking, and discussing this issue, even as heads of state and government make commitments at this week’s HLM.

As young researchers and global health advocates, we call upon and challenge young people across the globe to:

• Take up the mantle and start demanding that NCDs become priorities in their countries, by asking governments and donor agencies to allocate more resources and funding to address the silent killers of the world.
• Ensure that the commitments made by political leaders in 2011, 2014 and this year will not be forgotten but will be implemented and deliver concrete results at the grassroots level. 

As the hype settles at the end of this week and the countdown to the next HLM begins, let this be a signal for young people to roll up their sleeves and get to work. 

The message is loud and clear – Millions of lives are at stake and we cannot remain inactive. The time to act is now, before it is too late!

About the Authors

Ishu Kataria, (@ishukataria3) PhD, is a Senior Associate - Public Health with the Global NCD initiative at RTI International. Ishu also serves as the Global Coordinator for the Young Professionals Chronic Disease Network (YP-CDN), Special Advisor to the WHO GCM on NCDs, NCD focal point for UN Major Group for Children and Youth (UNMGCY), and Executive Committee member of Universities Allied for Essential Medicines (UAEM). 

Mellany Murgor, (@m_chemu) MD, is a Medical Doctor from Kenya and serves as the NCD focal point for the UN Major Group on Children and Youth (UNMGCY) and as the Africa Coordinator for the Young Professional Chronic Disease Network (YPCDN).