Health Economics of Non-Communicable Diseases

By Mahika Govil, Edited by Niyanta Desai





The global burden of non-communicable diseases (NCDs) is growing rapidly and accounts for 70% of the total deaths (WHO, 2018). The ever-growing numbers of NCDs indicate significant economic and social costs that threaten to diminish the quality of life, impoverished families and increase the health inequalities worldwide. On the other hand, less than 2% of global donor health funding is directed towards preventing these diseases. A lack of bold policy commitments is cited as one of the contributors to limited progress in NCD prevention and management. For the most part, donors have been reluctant to make significant investments in NCDs, including mental health because NCDs are not considered to be an immediate risk to others, and responsibilities to control the risk lie with the individual behaviour. Moreover, communicable diseases have established low-cost strategies for management within the health sector which are easier to deliver than complex behaviour change strategies and a social approach for NCD prevention and control which are multi-sectoral (BioMedCentral, 2021).


The source of the development of NCDs is due to a poor lifestyle, regular smoking, and obesity. To tackle the rise of NCDs at the earliest in individuals and society, a comprehensive approach is needed requiring all sectors, including health, finance, transport, education, agriculture, planning, and others, to collaborate to reduce the risks associated with NCDs, and to promote interventions to prevent and control them. An important way to control NCDs is to focus on reducing the risk factors associated with these diseases. The multi-sectoral approach will ensure a comprehensive system for better awareness and prevention of NCDs leading to a reduced impact on people's overall well-being.


The impact of NCDs cannot be separated from the viewpoint of the Global North and the Global South where there is a deep disparity in terms of access to healthcare. Almost three-quarters of all NCD deaths, and 82% of the 16 million people who died prematurely, or before reaching 70 years of age, occur in low- and middle-income countries (WHO, 2021).


The main obstacle causing an increase in the number of patients with NCDs in low and middle-income communities is the absence of a well-designed plan to stop disease occurrence and spreading. Each country needs to prepare its management plan, not just with coping models from high-income countries. Several successful models have been verified, taking into consideration the low-cost strategies to prevent, diagnose and treat NCDs. For example, a cost-effective strategy has been developed in Kenya to diagnose diabetes and hypertension in the early stages of life. While health workers are visiting homes to examine human immunodeficiency virus (HIV) infection, they also measure blood glucose levels and blood pressure.


India particularly faces a major burden of NCDs such as cardiovascular diseases, cancers, diabetes, and hypertension. NCDs not only affect health but also have a detrimental impact on productivity and economic growth. The probability of dying during the most productive years of one’s life (ages 30-70) from one of the four main NCDs mentioned above, namely cardiovascular diseases. Cancers. Diabetes and hypertension are a staggering 26%. Moreover, an aging India, whose population is growing more susceptible to NCDs, is likely to add economic stress on both private households and healthcare delivery systems.


Primary prevention of NCDs, built upon robust early screening and strong healthcare infrastructure, is a promising area for reaping favourable returns on investment in the Indian context. Interventions that focus on screening (in the case of hypertension), vaccination (for human papillomavirus [HPV]) and prevention of tobacco use were assessed as promising in their feasibility of achieving a 15% ROI (Harvard School of Public Health, 2014).


Moreover, improved budgetary allocations to support primary health care systems should be put in place in order to provide health services to all community members. To achieve large-scale progress, a collaboration between governments and various non-governmental organizations, schools, and universities, to provide advice on lifestyle modifications and to warn people about the risks of NCDs should be encouraged. At the society level, research centers and institutes can significantly contribute to the prevention of NCDs by conducting research projects and programs that make the masses more aware of the preventive measures one can take to avoid NCDs and the potential risk factors they hold.





References


Harvard School of Public Health. (2014). world economic non-communicable diseases. World Economic Forum. https://www3.weforum.org/docs/WEF_EconomicNonCommunicableDiseasesIndia_Report_2014.pdf


National Health Portal. (2019). Non-communicable Diseases | National Health Portal Of India. Https://Www.Nhp.Gov.in/Healthlyliving/Ncd2019. https://www.nhp.gov.in/healthlyliving/ncd2019


DISEASE CONTROL PRIORITIES. (2016). Economic Dimensions of Noncommunicable Diseases in Latin America and the Caribbean. Https://Iris.Paho.Org/Bitstream/Handle/10665.2/28501/9789275119051_eng.Pdf?Sequence=1&isAllowed=y. https://iris.paho.org/bitstream/handle/10665.2/28501/9789275119051_eng.pdf?sequence=1&isAllowed=y


PubMed. (2021). Economic impacts of overweight and obesity: current and future estimates for eight countries. Https://Pubmed.Ncbi.Nlm.Nih.Gov/34737167/. https://pubmed.ncbi.nlm.nih.gov/10522101/


Jailobaeva, K. (2021, June 29). An analysis of policy and funding priorities of global actors regarding non-communicable disease in low- and middle-income countries. Globalization and Health. https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-021-00713-4


WHO. (2021, April 13). Non-communicable diseases. Https://Www.Who.Int/News-Room/Fact-Sheets/Detail/Noncommunicable-Diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases