Accelerating an Integrated Approach to NCD Prevention and Control Globally

Over the past 18 years, I’ve worked with Ministries of Health and other partners in 180 countries to advance CDC’s overarching global health goals and accelerate strategies for the prevention and control of noncommunicable diseases (NCDs) and injuries. NCDs and injuries are responsible for millions of premature deaths, especially in low- and middle-income counties (LMICs). As public health practitioners, we have an important opportunity to work collaboratively to accelerate and scale up implementation of proven prevention and treatment strategies and measure their impact.

Impact of NCDs and Road Traffic Injuries

Globally, NCDs cause two out of every three deaths, resulting in an annual toll of 36 million deaths. About 80 percent of these deaths are in LMICs, among people less than 60 years old and in the prime working years of life. Cardiovascular diseases, stroke, cancer, diabetes, and other NCDs are caused by tobacco, alcohol, unhealthy diet, hypertension, and physical inactivity. According to the World Health Organization, road traffic injuries are responsible for 1.2 million deaths per year and 91 percent of those deaths occur in LMICs. The growing prevalence of NCDs has a trickle-down effect resulting in increased health care costs and productivity losses which impact national economies and sustainable development.

Despite these challenges, we know how to prevent illnesses and deaths from NCDs. The World Health Organization (WHO) World Economic Forum has provided guidelines for reducing the economic impact of NCDs in LMICs by accelerating the implementation of evidence-based, cost-effective interventions – grouped as “Best Buys”. “Best Buy” interventions include raising tax on tobacco and alcohol products, reducing salt consumption, eliminating trans-fats in the food supply, promoting physical activity and detecting and treating NCDs early. The total annual cost of implementing all of the “Best Buys” is US$11.4 billion, with the added benefit of improving quality of life and saving millions of lives. By contrast, the estimated losses due to inaction in LMICs is US$ 500 billion annually. Monitoring progress is also fundamental to measuring the impact of our investments and the goal to reduce premature deaths by 25% by 2025.

CDC’s Response
CDC is working with Ministries of Health, WHO and a wide array of partners to leverage existing programs and resources and accelerate the development and implementation of evidence-based technical packages. Examples include:

• MPOWER for tobacco control
• THRIVES for violence against children
• Global Standardized Hypertension Treatment Toolkit for health care professionals
• The Bloomberg Data for Health Initiative to improve systematic monitoring of vital records and risk factors and improve public health policy.

Several of these and other NCD initiatives are highlighted in the Summer 2015 issue of Updates from the Field, a quarterly newsletter developed by CDC’s Division of Global Health Protection. This issue of the newsletter draws attention to the work CDC is doing to protect health and enhance NCD capacity globally. While these initiatives are making a difference, sustained investments, accelerated implementation of evidence- based policies, and provision of better treatment options and monitoring systems are needed to protect lives and achieve the United Nations Sustainable Development Goals, and meet the WHO NCD global targets by 2025.

It is also important to highlight a recent Council on Foreign Relations Independent Task Force Report which suggests that NCDs represent an opportunity to build on existing U.S. global health platforms and models, especially in infectious diseases such as HIV/AIDS and Tuberculosis. For example, NCD prevention and treatment strategies can use similar protocols that are integral to infectious diseases management — promoting healthy lifestyle policies; promoting adherence to medications; monitoring treatment outcomes; engaging patients; and training the health care workforce.

Partnerships and Innovations

While the health sector bears the major impact of NCDs and injuries, it has limited influence to change the trajectory, without the commitment of other sectors- such as finance, trade, commerce, agriculture, transport, and technology. For example, the technology and mobile phone industry, with over 6 billion mobile connections, is already making striking contributions to not only GDP growth but also to cross-sector innovations, including the health sector, chronic illness care and monitoring, smoking cessation, and medicine compliance. Collaborative networks of public-private partnerships working together can ensure global health security.

The Way Forward

CDC is working collaboratively with national and international partners to promote healthy lifestyles and prevent premature deaths and disabilities due to NCDs, injuries, and environmental health hazards. CDC’s Global NCD Program advances a coordinated global approach to NCD prevention and control by:

• Strengthening surveillance, monitoring, evaluation and information systems;
• Expanding the evidence base and developing and disseminating technical packages for effective prevention and control interventions;
• Enhancing workforce capacity for integrated, systematic training and technical exchange;
• Leveraging external partnerships and resources;
• Coordinating with other CDC offices engaged in global NCD activities; and
• Increasing NCD awareness and support through strategic communication.

To learn more, please visit: http://www.cdc.gov/globalhealth/ncd/default.htm or contact Dr. Samira Asma, Chief, Global NCD Program, CDC at sea5@cdc.gov.