By integrating health policies and funding, we can create a sustainable future for NCD and mental health responses, with the goal of improving outcomes for people around the world.
Last week, the World Health Organization (WHO) and the World Bank convened a Global Dialogue on Sustainable Financing of Non-Communicable Diseases (NCDs) and Mental Health, bringing together health policy and finance stakeholders, including IFPMA and its members. It was encouraging to see these stakeholders come together to discuss how to integrate NCDs and mental health responses into health planning and financing plans.
With the UN High-level Meeting on Noncommunicable Diseases and Mental Health (UNHLM) coming up next year, now is the time for the global health community to work to establish innovative and sustainable targets for funding for noncommunicable diseases at both the global and country levels.
The Need for Change
We urgently need to come together to address the global burden of NCDs and mental health. NCDs, such as cancer, cardiovascular disease, diabetes and respiratory diseases, are responsible for 41 million deaths each year, 74% of all deaths worldwide. One in six people living with a disability is affected by a mental health illness, and people with severe mental health illnesses die 10-20 years earlier than the general population. Moreover, the global burden of NCDs is growing, with 77% of NCD deaths occurring in low- and middle-income countries (LMICs).
Thankfully, we know there are solutions that have the potential to improve outcomes for people around the world, including integrating essential NCD treatment and care into Universal Health Coverage (UHC) benefit packages, addressing social and commercial determinants of health, addressing key modifiable risk factors, implementing WHO Best Buys, improving access to early screening and diagnosis, and improving access to innovative and generic medicines targeting NCDs.
The challenge we now face is to deliver these solutions to those who need them most, while at the same time managing the costs of NCDs and mental health care, estimated to cost US$ 47 trillion between 2010 and 2030. Addressing this NCD burden on society and the economy requires rapid, effective and ongoing diagnosis, treatment and support, as well as appropriate, innovative financing approaches. As an innovative life sciences sector, we are ready to help tackle this deepening global emergency.
As a global community, when we set health policy targets without a clear understanding of how they will be funded, we often find that reality does not keep pace with our ambitions.
Time to discuss funding
As a global community, we set health policy targets without a clear understanding of how they will be funded, and reality often lags behind our ambitions. The latest data suggests that only around 6-14 countries are expected to achieve SDG 3.4 on NCDs and mental health by 2030. We need to accelerate progress towards meeting our commitments, and to do so we need to ensure the financing we need for NCDs.
Following last week’s dialogue on NCD funding, three key takeaways stood out to IFPMA.
First, we need to go beyond traditional financing models for NCDs and bring in new expertise to make this happen. While recent financing dialogue has focused much of its attention on reducing out-of-pocket payments and mobilizing domestic resources, the harsh reality is that many low- and middle-income countries continue to struggle to secure adequate funding for NCD prevention and control. The financial constraints countries face are exacerbated by infectious diseases, conflict, climate change, rapid ageing and urbanization.
Diverse financing expertise across government departments and stakeholders can strengthen the conception and implementation of sustainable financing models to overcome the burden of NCDs, while regional insights, evidence and best practices can also foster cross-border learning between countries and within the region.
Second, innovative financing approaches for NCD interventions exist and can be leveraged: Pharmaceutical companies producing products for complex NCDs such as cancer have been exploring new financing mechanisms, such as value-based pricing and public-private insurance schemes, for many years.
One example is the Nigeria Cancer Health Fund, which Roche supports alongside other private partners and public institutions to provide access to funding for breast, cervical and prostate cancer treatments not covered by health insurance. Another collaborative effort is Access Accelerated, which partners with the World Bank to bring together leading private life sciences companies to address the burden of NCDs in low- and middle-income countries. In six years, Access Accelerated has supported more than 40 projects in 36 countries, catalyzing more than $4 billion in health systems investments in NCDs.
Other tools more commonly used in the infectious disease sector, such as debt swaps, social impact bonds (SIBs) and advanced market commitments (AMCs), are also gaining prominence in the NCD financing discussion.
Third, while last week's high-level dialogue marked an important next step in NCD financing, more remains to be done to strengthen multilateral and multi-stakeholder collaboration. The private sector brings a wealth of capabilities and resources to the table when it comes to developing financing solutions that go beyond traditional references to “sin taxes”, domestic resources and overseas development assistance (ODA).
Health promotion stakeholders, such as the pharmaceutical industry, can play a key role in working with others to find new ways to raise funds from non-traditional sources. Indeed, a recent policy brief on NCD financing solutions from the NCD Alliance recognises the role of the private sector in closing the NCD and mental health financing gap, stating that WHO and the World Bank are helping to create an enabling environment for private sector contributions and engagement.
Towards sustainable investment in non-communicable diseases
Last week’s Global Dialogue brought the global community together to express the importance of NCD financing to global health and development, and above all, people’s lives. But it was another reminder that our efforts have a more meaningful impact when we work together.
Health leaders must be prepared to leverage innovative financing mechanisms, set realistic, short- to mid-term, time-bound global funding targets for NCDs and mental health, and support them through international and domestic funding. By enabling the sharing of best practices and promoting whole-of-society and cross-sectoral approaches, the global health community can address barriers to care and support local implementation that enables the best outcomes for people living with NCDs and their communities.
author
Tamara Schudel, Chair, Global Health & Access, IFPMA; Vice President and Head of Global Policy, Roche
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