guest post by Louis Galambos and Jeffrey L. Sturchio
The New Year is traditionally a time for people to take stock of the past year and identify small ways to improve their lives. Policy makers should likewise make New Year’s resolutions. This year, we humbly suggest one—make tackling noncommunicable diseases (NCDs) a priority for 2014.
There’s a common misconception that NCDs—cancer, diabetes, chronic respiratory disease, and heart disease—primarily affect people in wealthy nations. In fact, 80 percent of deaths from these diseases occur in low- and middle-income countries. The NCD epidemic currently looms as the biggest threat to global health: two-thirds of all deaths are due to NCDs.
Governments in developing countries have a significant role to play in stemming the threat and reducing the burden of NCDs. The foundation for any successful policy is a strong government commitment and the development of an evidence-based action plan. As we discuss in more detail in our recent book from Johns Hopkins University Press, Noncommunicable Diseases in the Developing World: Addressing Gaps in Global Policy and Research, there is an urgent need to adopt the following policies in countries across the globe:
- Enhancing prevention by limiting exposure to such risk factors as tobacco use, sedentary lifestyles, and diets high in salt, sugar, and fats. The World Health Organization estimates that 30 percent of NCDs can be prevented through lifestyle and behavior changes such as stopping smoking, increasing exercise, and eating healthier foods.
- Strengthening health systems. Effective prevention, treatment, and care will only become possible for the majority of people if routine screening and treatment for chronic diseases are integrated into existing primary health services. Improving the speed and quality of regulatory review will help bring new tools to those in need sooner, as will tightening the efficiency of supply chains for health products
- Improving access to essential medicines and diagnostic technologies. Many individuals with NCDs in developing countries do not know that they have an NCD and many of those that are diagnosed lack access to the drugs they need—often available as generics.
- Implementing policies across sectors. Coordination between the health sector and the agricultural, transportation, urban planning, and environmental sectors can decrease the onset of NCDs dramatically. And involving communities, civil society organizations, and the private sector in the fight against NCDs has been shown time and again to improve health outcomes.
Lower- and middle-income countries are beginning to address these issues with plans suited to their situations—epidemiological, economic and social. Success factors remain the same in developing and developed countries. If left unchecked, we will see an inexorable rise in the burden of NCDs worldwide within the next ten years. Pragmatic, inclusive policies can change this unsustainable trajectory and prevent millions of avoidable deaths—if we act now.
Louis Galambos is a professor of history at Johns Hopkins University and co-director of the Institute for Applied Economics, Global Health, and the Study of Business Enterprise. Jeffrey L. Sturchio is senior partner at Rabin Martin, a visiting scholar at the Johns Hopkins Institute for Applied Economics, Global Health, and the Study of Business Enterprise, and former president and CEO of the Global Health Council.