How to UNite against non-communicable diseases

Photo courtesy of www.trinitycarefoundation.org (Creative Commons)

Preventing non-communicable diseases (NCDs) like cardio-vascular diseases, cancer and diabetes is now a development priority. The world has agreed on a set of voluntary global targets to ensure that progress is made.

Did you know?

• NCDs—mainly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes—are the world’s biggest killers.


• More than 38 million people die annually from NCDs (63 percent of global deaths).


• More than 16 million people who die too young are under the age of 70.


• Low- and middle-income countries bear 82 percent of the burden of these premature deaths, resulting in cumulative economic losses of $7 trillion over the next 15 years and millions of people trapped in poverty.

I was in Kenya and India recently and witnessed the epidemic of NCDs first hand. Low- and middle-income countries face a ‘double burden’ of disease – both communicable diseases and NCDs. The economic impact of NCDs for countries like India and Kenya are an increasing concern.

Witnessing the impact of NCDs in Kenya

In Kenya, one person said to me, “I didn't know I had diabetes until I became sick. I went into hospital and was told: ‘Your blood sugar level is way up’”. For this person, the diagnosis of diabetes has set her on a life-long path of medical treatment. The ongoing costs are a serious financial burden on her family.

“I am on medication every day,” she said. “If you don't take it, you find that you are again admitted to the hospital. You must have a lot of money to buy the medication. We are no longer able to afford the things we used to do.”

Experts from the Ministry of Health confirms that NCDs are on rise in Kenya: “If you walk into any hospital, you will find more than half the occupancy of hospital beds is due to NCDs. Almost half of deaths reported by hospitals are due to NCDs”. Looking at the statistics, it is clear that increased consumption of unhealthy foods, tobacco use, harmful use of alcohol and declining physical activity are major risk factors for the NCD epidemic.

Witnessing the impact of NCDs in India

In India I found that NCDs were also on the increase. Given the huge population the absolute numbers are shocking: 5.9 million deaths every year from NCDs. This means that 11 Indians are dying from one of the four main NCDs every minute.

My World Bank colleagues estimate that India stands to lose $4.58 trillion before 2030 due to NCDs and mental health conditions, with cardiovascular diseases accounting for $2.17 trillion.

The solution is prevention – and collaboration

Preventing NCDs requires all parts of government to work together. And all parts of the United Nations system to support these efforts. As well as development partners. Engaging with NGOs and selected private entities is necessary (though we never engage with the tobacco industry).

While there are some effective treatments for NCDs, the only viable solution is preventing NCDs in the first place. The United Nations system has established the UN Task Force on the Prevention and Control of NCDs to act ‘as one’ in  helping governments to implement what works.

Here is what works

There are very cost-effective interventions to reduce tobacco use, harmful use of alcohol, physical inactivity and unhealthy diet. And to prevent and treat cardiovascular disease, diabetes,  cancer, and chronic respiratory disease.

• Reducing the affordability of tobacco and alcohol products by increasing tobacco and alcohol taxes;


• Banning all forms of tobacco advertising, promotion and sponsorship and restricting or banning alcohol advertising and promotions;


• Reducing salt intake and replacing trans fats with unsaturated fats;


• Implementing public awareness programmes on diet and physical activity.

These initiatives require different parts of government to work together and the involvement of actors in non-health sectors. For example, if we are tasked to reduce salt consumption we would require collaboration across silos and sectors:

• health sector – for treatment and prevention;


• communication  - to deliver mass media campaign to modify consumer’s behaviours and choices;


• agriculture, trade and industry ‑ to reformulate products towards reduction of sodium content in food;


• education and social welfare ‑ to ensure healthy foods in schools and teach healthy sodium-related behaviours, etc.

Your experience may help

Getting NCDs into UN Development Assistance Plans is important if the UN system is to work strategically as one in countries to support governments respond to the NCD epidemic.  A key question for the UN today is how to incorporate NCDs into plans and policies across the UN system? It would be very useful to hear your experience.