NCDs, poverty and sustainable development: Norway's integrated strategy
NCDs are far more than a health issue. They represent one of the major barriers to achieving a more prosperous and sustainable world for all.
NCDs are far more than a health issue. They represent one of the major barriers to achieving a more prosperous and sustainable world for all.
In 2015, all UN Member States committed to the Sustainable Development Goals, a global call to action to end poverty, protect the planet, and ensure that by 2030 all people enjoy peace and prosperity. Among the 17 SDGs and their specific targets, there is one that stands out for its cross-cutting benefits – it's SDG target 3.4 to reduce by one third premature mortality from noncommunicable diseases (NCDs) through prevention and treatment. Achieving it would bring significant progress to other goals, like eradicating poverty (SDG 1) and reducing inequalities (SDG 10). For instance, 85% of premature deaths (between the ages of 30 to 70) from NCDs occur in low- and middle-income countries (LMICs). This costs millions each year to LMIC economies through lost productivity, and out-of-pocket payments for health expenses push an estimated 100 million people worldwide into extreme poverty every year.
While tackling NCDs has been rising on the global agenda, action and investment have been severely lacking so far. Bilateral donors (e.g. national governments or their development agencies) are the main source of funding for global health, but until now they have simply been absent in the field of NCDs – development aid for NCDs has stagnated at just 1-2% for the past two decades.
NCDs are the most underfunded global health issue relative to the billions of people impacted, and bridging this investment gap offers the world’s greatest potential to save and improve lives by 2030: approximately 80% of the 15 million annual premature deaths from NCDs in LMICs can be prevented or delayed.
With its Better Health, Better Lives strategy, Norway is the first OECD country to translate the inclusion of NCDs within the SDGs into their overseas development policy, and back it up with much-needed resources. With a budget of US$133 million (1.2 billion NOK) from 2020 to 2024, Norway aims to combat NCDs with actions that span various sectors and SDGs, including education, sustainable food systems, climate and environment, renewable energy, humanitarian work, people with disabilities, digitalisation and good governance. This is in line with the integrated approach of the SDGs, which recognize that action in one area will affect outcomes in others, and that development must balance social, economic and environmental sustainability. It also supports WHO’s Health in All Policies approach, which takes into account the cross-cutting nature of the social and economic determinants of NCDs.
Even though US$133 million may seem like a modest sum in comparison with the magnitude of the NCD burden, this already positions Norway as one of the top three supporters of NCD prevention and control, well ahead of the US, UK, France, Germany and Canada. Norway’s step forward is a true story of change that sets a precedent for other countries to develop their own integral strategies to turn the tide on NCDs.
A 2022 NCD Countdown 2030 paper has demonstrated that the initiatives in NCD prevention and care required to reach SDG target 3.4 are realistic and cost effective - with an average return on investment of 19 to one. 39 million lives will be saved from premature death between 2023 and 2030 if ministries of health contribute just 20% of their budgets to high-priority NCDs.
All countries – and especially LMICs – can achieve or nearly achieve SDG 3.4 by 2030 by introducing a cost-effective package of NCD prevention and treatment interventions, that are fully aligned with the WHO best buys for NCDs and tailored to their local contexts. And achieving SDG 3.4 means significant progress will have been made towards achieving other Sustainable Development Goals and targets.
Find out how you can get involved in improving NCD prevention and care through this year’s Global Week for Action on NCDs. The theme this year is investment, and as always, everyone has a role to play!