Globally, 7 out of 10 deaths are due to noncommunicable diseases (NCDs). 85% of premature deaths from NCDs occur in low- and middle-income countries (LMICs). Despite the need, many countries are lagging behind on the integration of NCDs into Universal Health Coverage (UHC) benefit packages, putting the lives of millions of people living with NCDs (PLWNCDs) at risk of or pushing them into extreme poverty and jeopardising the attainment of the Sustainable Development Goals (SDGs). For example, half of people living with diabetes do not have access to the insulin they need to survive and, in some populations, over 60% of people living with NCDs have experienced catastrophic health expenditure. The situation for people living with NCDs has worsened with the coronavirus (COVID-19) pandemic, which has exposed the link between NCDs, communicable diseases and health emergencies. The pandemic has also shown NCDs to be the weak link in health systems worldwide and exposed the damage that neglecting NCDs and underinvesting in health, prevention and essential public health services has done over the years in many countries. In addition to PLWNCDs being at higher risk of severe complications and death from COVID-19, 75% of countries have reported disruptions in NCD care and only 38% of countries have included NCDs in their COVID-19 Preparedness and Response Plan’s Essential Health Services.
This policy research report outlines global progress towards integration of NCDs into UHC benefit packages to date. Through analyses of interviews with experts from Australia, Ethiopia, India, Jordan, Mexico, Philippines, Rwanda and Sweden it brokers knowledge by showcasing country-level examples and explores the role of NCD prevention and care to enhance health security in light of the COVID-19 pandemic. It demonstrates that there are tried-and- tested methods to effectively integrate NCDs into UHC at national level in different economic settings, enabling governments to provide care and financial protection to people living with NCDs across the whole population. Such efforts will increase equity and productivity and ensure healthier, more secure populations. Integration of NCDs into UHC as we build back better from the pandemic must be a cornerstone to national and global preparedness for future health threats.
Urgent Actions for Policy Makers
- Recognise the pivotal role of NCDs in UHC at national level and lead reform, meaningfully engaging people living with NCDs and civil society organisations (CSOs), in development and enactmentof legislation and continual review of essential healthcare packages, including essential medicines and financial protection mechanisms, prioritising the marginalised. They must also strengthen data collection systems for the implementation of accountability frameworks.
- Prioritise NCD prevention and care as key to the development of resilient health systems and a vital component of pandemic preparedness and humanitarian responses.
- Adopt an integrated, inclusive, person- centred approach to the provision of NCD services, adapted to the country’s needs and capacities, which recognises that many people live with multiple diseases that are often chronic and lifelong.
- Ensure sufficient funding for NCDs, blending income from tax, community health insurance schemes, development assistance, and double-dividend measures such as taxes on health-harming commodities including tobacco, alcohol, unhealthy foods, and fossil fuels.
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