This event was held to showcase the research of the UnitedHealth Chronic Diseases Initiative Centres of Excellence.
Chaired by Professor Richard Smith, the researchers of the network presented their findings on the cost effective ways to reduce the burden of non-communicable diseases (NCDs), build capacity and influence health policy in low- and middle-income countries (LMICs).
Here are a few key issues that were echoed throughout the presentations:
The urgency
Professor Naomi Levitt, Director of the Chronic Disease Initiative for Africa opened the meeting by identifying “feasibility, accessibility and cost effectiveness” as the three most important components in developing, implementing and evaluating NCD interventions in LMICs. As the world experiences a pandemic of non-communicable diseases, research is crucial in reducing the suffering, mortality and economic loss caused by NCDs in LMICs. During the sessions the audience of researchers, NCD prevention advocates and students heard alarming statistics, such as almost 20% of people over 25 year old suffer from type 2 diabetes (an NCD) in South Africa. The message was clear that NCDs in LMICs should no longer just be associated with the elderly.
Health policy researcher Professor Adolfo Rubinstein from the Institute for Clinical Effectiveness and Health Policy in Argentina painted a grave picture: by 2030 NCDs will lead to a global loss of £30 trillion dollars globally – which is almost 48% of the world’s GDP. In addition, Professor Rubinstein highlighted that currently there seems to be no relationship between public health aid and the burden of disease – only 3% of public health aid is spent on NCD prevention despite the fact that it is the cause of 60% of deaths worldwide each year.
Capacity building
The key message of the meeting was the need for collaboration, not only between researchers but with key stakeholders; governments, public health policy officers, primary care trusts and the community.
Engaging the community as the key stakeholder is at the heart of Ms Elsa Cornejo’s community intervention programme for the primary prevention of NCDs in Northern Mexico. Cornejo’s findings show that a participatory approach is extremely effective in motivating and empowering healthcare workers and individuals into developing healthier, permanent lifestyle changes. Engaging with the community also sets the focus on health promotion, rather than just disease prevention, which encourages policymakers to respond to their specific needs, equips healthcare workers with the tools they need to generate their own data and become their own healthcare advocates.
Implementation science, which is the process by which research findings are effectively integrated into healthcare policy and practice, was a sentiment echoed throughout the presentations. Professor Adolfo Rubinstein from the Institute for Clinical Effectiveness and Health Policy in Argentina aptly summed up the sentiment with a quote from Confucius (BC 450)
Tell me, and I will forget. Show me and I may remember. Involve me, and I will understand.
The challenges
The audience was informed on the need for interventions at various levels – agenda setting, policymaking and monitoring, for effective ‘scale up’ of community centered approaches to national levels.
Cost-effectiveness and the lack of scope were identified as the key barriers to NCD prevention interventions in LMICs. When quizzed on what they would do if they were given $10 million dollars, most agreed it would be a drop in the ocean.
But as Professor Richard Smith declared in his closing statement, one must ‘think big and start small’.
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