Health and Healthcare Systems

New initiative aims to take action on non-communicable diseases

Non-communicable diseases (NCDs) account for 71% of deaths per year globally.

Non-communicable diseases (NCDs) account for 71% of deaths per year globally. Image: Freepik.com

Cameron Fox
Project Lead, Shaping the Future of Health and Healthcare, World Economic Forum
Lorna Friedman
Senior Partner, Health Transformation and Sustainability, Mercer
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  • Non-communicable diseases (NCDs) account for 71% of deaths per year globally.
  • The pandemic has left healthcare systems overburdened and under-funded.
  • Renewed focus is needed on NCDs from prevention right through to follow-up care.

In 2003, for the first time in human history, non-communicable diseases (NCDs) surpassed communicable diseases – those that spread from one person to another – as the world’s most lethal maladies. Today, NCDs account for 71%, or 41 million, deaths per year.

From one perspective, this trend is a remarkable example of how far we have come in combatting pathogens and childhood mortality, both of which have markedly decreased due to scientific advancements and coordinated global action. However, these changes also point to the dearth of attention, funding, and cooperation given to NCDs, which receive less than 2% of global health aid despite their unparalleled toll.

The COVID-19 pandemic has made the situation even direr as overburdened health systems shifted their focus to the virus, a double tragedy as people living with non-communicable diseases are at far higher risk of hospitalization or death from COVID-19.

Global Disability-Adjusted Life Years (DALYs) attributable to non-communicable diseases and HIV versus proportion of global health funding. Source: The Lancet.
Global Disability-Adjusted Life Years (DALYs) attributable to non-communicable diseases and HIV versus proportion of global health funding. Source: The Lancet.

The imperative to change the global architecture of NCD treatment is not only ethical, but economic: morbidity and mortality from non-communicable diseases strains healthcare systems, removes people from the workforce, and places an enormous burden on younger generations (often young women) who must cut their education or careers short to act as unpaid caretakers for their parents and grandparents.

Though this is a bleak picture, there are reasons for hope. Coordinated action on diseases such as tuberculosis and HIV/AIDS have shown us what the world is capable of when acting in concert. The pandemic pushed policymakers to update obsolete regulatory barriers and showed us that digital solutions have now reached a level of maturity where they can have real impact on people’s health. And innovative solutions to delivering healthcare locally via community health workers supported by digital learning are taking hold throughout the world.

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As we slowly emerge from the worst of the pandemic, now is the moment to radically rethink how we combat NCDs at every point along the care continuum, from prevention and screening to diagnosis and treatment to follow-up care. To address this pressing issue, the World Economic Forum is launching a new initiative, the Digital Health Action Alliance. Drawing on the insights and expertise of a broad range of partners from the public and private sectors across the globe, the initiative will begin by diving deep on two non-communicable diseases of particular concern: cardiovascular disease and diabetes.

While the role of digital health certainly extends beyond these diseases, they are unique in scale (taken together, they are responsible for one in every three deaths – over 19 million people – each year), they share many risk factors and solution pathways, and their impact is particularly inequitable, impacting disadvantaged communities to a far greater extent than those with consistent access to care.

COVID-19 death rate tends to increase with non-communicable disease burden, or DALYs attributable to NCDs. Source: Council on Foreign Relations.
COVID-19 death rate tends to increase with non-communicable disease burden, or DALYs attributable to NCDs. Source: Council on Foreign Relations.

Using these diseases as a focus point, the Digital Health Action Alliance will divide into four groups along the patient journey: prevention, diagnostics, therapeutic access, and community healthcare.

Targeting prevention of non-communicable diseases

Risk factors such as air pollution, physical inactivity, tobacco use, alcohol consumption, and unhealthy diets are all on the rise across the globe, devastating already marginalized communities and increasing global and local health inequities. Digital solutions provide affordable, scalable, culturally appropriate opportunities to reduce risk factors before disease begins. By implementing the World Health Organization’s “Best Buys”, we can save 7 million lives by 2030, reduce inequity, and see $230 billion in economic gains.

Transforming diagnostics

By far, the biggest gap in the “cascade of care” lies in diagnostics. Among those with diabetes and heart disease, only 44% and 39% of patients, respectively, are aware they have the conditions, and 47% of the world has no access to diagnostics of any sort. Today, advances in digitization, AI, data transfer, and mobile technology in combination with point-of-care testing can change this paradigm. For every 1% increase in diagnosis for hypertension and diabetes in low and middle-income countries (LMICs), 12,000 lives and 500,000 healthy years of life would be added annually.

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Expanding therapeutic access

Hypertension, or high blood pressure, is the world’s single most important preventable risk factor for mortality and morbidity. Today, 1.2 billion people live with uncontrolled hypertension, a number that is unacceptable given the multitude of proven, effective interventions. One class of particularly powerful solutions that have not received enough attention are single-pill combinations, or polypills, which combine multiple blood-pressure medicine in a single pill, reducing complexity for the entire value chain and increasing adherence for patients dealing with multiple medications. More than anything else, this is a problem of coordination among pharmaceutical manufacturers, procurement bodies, and regulatory authorities. Drawing from lessons in pooled procurement from HIV/AIDS and tuberculosis, bolstered by digital infrastructure, the world can ensure medication consistently gets to those who need it at a price they can afford.

Innovating community healthcare

By 2030, the WHO estimates the world will have 15 million fewer healthcare workers than are needed for a rapidly growing global population. Community and primary care providers are in the frontline in the fight against non-communicable diseases, providing an essential link between patients and the care they need. These workers understand what the needs are on the ground, can be rapidly trained and deployed, and often fill gaps where more highly trained professionals are lacking.

Supporting this essential work with digital-first education, AI-backed advice, and care integration solutions can give them the tools they need to keep their communities healthy, even in areas where connectivity is limited, as many programmes are now built as “offline-first”, allowing workers to record data in the field before uploading it.

In the next six months, these groups, working in concert, will identify barriers and bottlenecks and share solutions worthy of scale. Crucially, this will only be the first step: the initiative’s mandate is not to simply provide recommendations or to report on barriers – it is to deliver action. Understanding the barriers amenable to change is important, but it is not enough. We will take our findings and utilize them to develop and deploy novel, digitally integrated public-private partnerships to change the care paradigm. We now possess the capabilities to truly transform the global architecture of non-communicable disease care, and we must accept nothing less.

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