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Saving lives, spending less: A strategic response to noncommunicable diseases

by Public Health Update

A new World Health Organization (WHO) web-based tool shows for the first time country-specific data on investment opportunities for scaling up interventions to prevent and treat noncommunicable diseases (NCDs) in low- and lower-middle-income countries. These diseases are the world’s leading killers taking the lives of around 41 million people each year.
The policy interventions featured in the tool are known as the WHO Best Buys, deemed by global experts to be of the greatest cost-benefit for tackling NCDs. Broadly they include reducing tobacco and alcohol consumption and unhealthy diets; increasing physical activity, and improving the treatment of conditions such as cardiovascular diseases, cancer and diabetes.
By using the online tool visitors are able to view data from 78 countries. The tool allows for calculations to be made on such factors as lives that can be saved; additional per person, per year investment needed to implement the Best Buys; return on investment for each Best Buy intervention; and economic gains generated by increased productivity and reduced health care costs between now and 2030. The data were used as a basis for the WHO report released in May 2018, namely Saving lives, spending less: a strategic response to NCDs.
“On the eve of the Third UN High-level Meeting on NCDs, this information shows that the slow progress in tackling the NCD epidemic can no longer be attributed to a lack of information on the efficacy of interventions or to obstacles to financing their implementation,” says WHO Assistant Director-General Dr Svetlana Askelrod. “These are investments no one can afford not to make”.
“Until today governments did not have a tool to help easily select which interventions to prioritize for implementation,” says WHO Director Dr Etienne Krug. “The data in this web-based tool offer governments and partners the information they need to make strategic decisions and put in motion life-saving interventions for the prevention and control of NCDs”.
If all countries use these interventions, the world would move significantly closer to achieving Sustainable Development Goal 3.4 to reduce premature death from NCDs by one-third by 2030. Low- and lower-middle income countries currently bear a significant share of premature deaths from NCDs: almost half (7.2 million) of the 15 million people who die globally every year between the age of 30 and 70 years are from the world’s poorest countries.
The report Saving lives, spending less: a strategic response to NCDs and related tool clearly present the value in investing in NCDs. They provide governments with data to leverage resources and prioritize the implementation of the Best Buys to save millions of lives and generate billions of dollars.
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Best Buy interventions

Reduce tobacco use

  • Tax – Increase excise taxes and prices on tobacco products
  • Packaging- Implement plain/standardized packaging and/or large graphic health warnings on all tobacco packages
  • Advertising, promotion and sponsorship: Enact and enforce comprehensive bans on tobacco advertising, promotion and sponsorship
  • Smoke-free public places: Eliminate exposure to second-hand tobacco smoke in all indoor workplaces, public places and public transport
  • Education: Implement effective mass-media campaigns that educate the public about the harms of smoking/tobacco use and second-hand smoke

Reduce harmful use of alcohol

tax icon
  • Tax: Increase excise taxes on alcoholic beverages
  • Advertising: Enact and enforce bans or comprehensive restrictions on exposure to alcohol advertising (across multiple types of media)
  • Availability: Enact and enforce restrictions on the physical availability of alcohol in sales outlets (via reduced hours of sale)

Reduce physical inactivity

  • Education: Implement community-wide public education and awareness campaigns for physical activity, including mass-media campaigns combined with other community-based education, motivational and environmental programmes aimed at supporting behavioural change around physical activity levels

Reduce unhealthy diet

  • Reformulation of food: Reduce salt intake through the reformulation of food products to contain less salt, and the setting of maximum permitted levels for the amount of salt in food
  • Supportive environments: Reduce salt intake through establishing a supportive environment in public institutions such as hospitals, schools, workplaces and nursing homes, to enable low-salt options to be provided
  • Education: Reduce salt intake through behaviour change communication and mass-media campaigns
  • Packaging: Reduce salt intake through the implementation of front-of-pack labelling

Manage cardiovascular disease and diabetes: Drug therapy and counselling: Provide drug therapy (including glycaemic control for diabetes mellitus and control of hypertension using a total risk approach) and counselling for individuals who have had a heart attack or stroke and for persons with high risk (≥ 30%) of a fatal or non-fatal cardiovascular event in the next 10 years

Prevent and manage cancer
  • Vaccination: Vaccination against human papillomavirus (2 doses) of girls aged 9 to 13 years
  • Screening: Prevention of cervical cancer by screening women aged 30 to 49 years, either through: visual inspection with acetic acid linked with timely treatment of pre-cancerous lesions; pap smear (cervical cytology) every 3–5 years, linked with timely treatment of pre-cancerous lesions; human papillomavirus test every 5 years, linked with timely treatment of precancerous lesions.

Download: Saving lives, spending less: A strategic response to noncommunicable diseases

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