Addressing the Rise of NCDs – Taking a Multi-sectoral Approach


28 March 2013
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Non-communicable diseases (NCDs) – including cardiovascular diseases, diabetes, cancer and chronic respiratory disease – have become a global epidemic. They do not simply affect the industrialized world – 80% of the deaths from these diseases occur in low- and middle-income countries. Collectively NCDs have surpassed infectious diseases as the leading cause of death in all regions of the world with the exception of Africa.

In collaboration with Princeton’s Woodrow Wilson School, Rabin Martin co-convened the event Building a Multi-Sectoral Response to Non-Communicable Disease around the Globe, which highlighted findings from Addressing the Gaps in Global Policy and Research for Non-Communicable Diseases.  The event, moderated by Jeffrey L. Sturchio, Senior Partner at Rabin Martin, featured presentations by Sir George Alleyne, Director Emeritus, Pan American Health Organization and Tsung-Mei Cheng, Health Policy Research Analyst, Woodrow Wilson School of Public and International Affairs, Princeton University.  The dynamic presentations grappled with the complex challenges facing the global health community and proposed models for building unique partnerships between the public and private sectors to combat the rise of NCDs.

Dr. Sturchio began the conversation by comparing the growing NCD epidemic to other crises that the global health community has faced in the past – multi-sectoral solutions have been a key component in tackling public health issues in recent decades.  With health care costs rising in all regions, the NCD epidemic presents a unique challenge to governments and other stakeholders; more expensive diseases will have to be fought at the same time that budgets are being cut.

Sir George Alleyne recalled UN Secretary-General Ban Ki-moon’s observation that “NCDs are like a public health emergency in slow motion.”  He presented the challenges countries are facing as they combat NCDs, including motivating individuals to modify the unhealthy behaviors that may lead to poor health outcomes.  He explained that there are certain situations in which the interests of government, business and academe align.  These opportunities present the possibility for collaboration across sectors, which Sir George Alleyne referred to as the “triple helix of innovation” to bring solutions to individuals in the most direct and often most cost-effective ways.

Building upon the understanding of where multi-sectoral partnerships are possible, Dr. Cheng outlined the policy levers through which the public and private sectors may collaborate.  Due to the decline of infectious disease, increase in longevity and the pursuit of unhealthy lifestyles, there is often mutual interest for partners to encourage behavior change and prevention. She described the models through which the public and private sector can work alone or in partnership to provide services to individuals, stating that in some situations there is an obligation for government to take the lead in protecting citizens through enforcing regulation, modifying private behavior and maintaining a clean environment. Dr. Cheng illustrated this point by describing the Taiwanese government’s cervical cancer screening program; since the program started, stage 3-4 diagnoses have been rare.  She noted that mixed models – publically financed with private production – are often the most successful at cultivating innovation and ensuring equitable distribution of services to the population.

The panelists also described the role of motivation, prevention and incentives to encourage individual behavior change – specifically if individuals are more responsive to reward or punishment.  Sir Geroge Alleyne explained the need for research in this area, particularly on the type of motivation tactics to which individuals most likely respond.

Important questions remain about the role of the private sector, government and other players in tackling global health issues.  This event was an excellent opportunity to start the conversation around multi-sectoral partnerships to tackle NCDs – an issue that will define the coming years in global health.

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