NCDs Are Ready For Their Close Up

GENEVA – Noncommunicable diseases are having a bit of a moment. They are sprinkled throughout this year’s World Health Assembly agenda and highlighted in numerous side events. And, of course, NCDs will be spotlighted this fall at a UN high-level meeting that aims to persuade heads of state to invest in prevention initiatives against heart disease, cancer, diabetes, etc.

Running point for Bloomberg Philanthropies is Kelly Henning, who directs its public health efforts. GHN caught up with Henning on Monday afternoon outside the UN Palais des Nations, site of #WHA71. In the following Q&A, Henning discusses the new “Saving lives, spending less” report on returns on investment for NCD programs, goals for the lead-up to the high-level meeting, and her other priorities for the WHA.

Is talking about the financial benefits of tackling NCDs a new tactic?
The report was really aimed at getting that return on investment number so ministers of finance would have that number and have some clear direction about what would the benefit really be of investing in noncommunicable disease prevention and management areas. And I think it was successful, I think it was clear that for every dollar you invest, you have $7 return.

It really compliments some work that Mike Bloomberg started recently which is convening a taskforce on fiscal policies for health with Larry Summers. That committee and that taskforce is really [about connecting] ministers of finance and economic finance specialists [and] trying to get the word about NCDs beyond even just the health sector, but out into the fiscal policies space.

Did you hear from the finance ministers themselves in terms of the importance of making this case rather than just saying how many people die each year from NCDs?
So we hear from ministers of finance that they want to save lives. They're totally on board with that principle, but they need to understand where does this fit with the main priorities that they have that they need to address each year during their budget period. And it occurred to us that we really hadn't laid that case out clearly on NCDs. Other areas have done that—maternal and reproductive health, mental health. Clearly the investment and the return are very similar to some of these other high priority areas.

What would be your ultimate goals for the high-level meeting? What would you like to see come out of that?
I'd like to see a very clear demonstration of high-level political will around this issue. I think we know the burden of NCDs is enormous and we know the best buys really work. Now we have the fiscal information becoming more and more available so what we need now is really the political will to move this agenda forward and the heads of state are well placed to do that with the data that's now available.

Do you have other ideas on persuading heads of state to take on NCDs?
I think we sometimes forget that there is a really important personal element here and the governments can not only reduce the burden of disease, but improve people's lives [and] at the same time increase economic opportunities for their countries so I think there's really a win-win here on NCDs that's important to point out.

And the agenda is really focused around premature mortalities. So we're not talking about end of life NCDs as a final medical event. We're really talking about people 35 to 70, in that age range who are becoming ill and really incapacitated often in terms of caring for their families and working and so it's really younger ages which I think is often lost in the dialog.

What are your other priorities here at the World Health Assembly?
I'm having some meetings with ministers of health, talking about tobacco work, our obesity prevention work, data for health, which is our birth and death registration program. And I just had series of meetings on road safety. [We have] invested about $259 million in global road safety. And road crash deaths are the 9th leading cause of death in the world and the leading killer in adolescents and young adults. And again another underappreciated major cause of death.

How receptive are developing countries to this?
I think they're very receptive because almost everyone knows someone who's been killed in a car crash. It's a very major problem, but we find that they need assistance, particularly in training up traffic police on best practices around enforcement of traffic laws. And in some cases even assistance with crafting the best road safety laws. Some of these laws are very old. In India, the traffic law was recommended in 1949.

With all of the needs out there, how do you guide governments in terms of where to put the funds across all the NCDs. I mean, tobacco is important. Road safety is important.
So, the ideal situation is for the governments to have good data so that they can understand what their leading causes of death are and what they're spending the most health dollars on. That's another thing that guides the prioritization. But if you're talking about globally trying to reach the sustainable development goals we've put forth, reducing premature mortality by 2030, you really have to do comprehensive tobacco control and you really have to address heart disease, cardiovascular disease by reducing high blood pressure, salt, and trans fats.


Ed Notes: See the latest news from #WHA71 here.
Want to share a #WHA71 tip or a story idea? Want to connect with GHN editor-in-chief Brian Simpson in Geneva? Please be in touch.

Michael R. Bloomberg is a benefactor of the Johns Hopkins Bloomberg School of Public Health, which publishes Global Health NOW.
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