Where to begin? It is well known that non-communicable diseases (NCDs) receive much less global health funding than other conditions, despite the fact that collectively they remain the largest killers of humans on the planets. If you are reading this, then they will likely kill you. For this and many other reasons, people are starting to wonder why the global health community does not care enough about addressing these issues. One big reason: Addressing the NCDs ain’t going to be cheap.

The Global Health Delivery online community for the endemic non-communicable diseases is currently convening a discussion among a number of panelists about how to fund these challenges. The panelists include Rachel Nugent, now of the University of Washington, Miriam Rabkin, from ICAP and Columbia, Sumi Mehta, from the Global Alliance for Clean Cookstoves, Brian Bilchik, the Director of ProCor, Charlanne Burke and Robert Marten, from the Rockefeller Foundation and others. If you are not a member of this online community, you can sign up at the above link and join the discussion.

The questions they have been posed include:

• What are some of the financial challenges for governments and international institutions in addressing NCDs?

• What are the donors’ roles regarding NCDs, what should different types of donors be contributing, and how can advocates raise awareness about NCDs funding?

• How might donors work with governments and health implementers to promote NCD prevention, care and treatment? What do we know and what should we know about how service integration and health system strengthening can be used to address NCDs?

• Can you share examples of integrated service delivery, health insurance schemes, or innovative partnerships that offer lessons for NCD program and funding development?

These are tough questions with no easy answers. Donors may play a role but at this point I personally don’t think it is realistic to believe that they are going to be able to dramatically scale up funding to any large degree for these programs – and I am not entirely convinced that they should. Health systems in resource-limited settings are skewed to basic primary care and addressing acute illness so infrastructure investments are going to need to be dramatic. So I am looking forward what these experts have to say.

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11 Responses to “What are the funding challenges for Non-Communicable Diseases in Resource-Limited Settings?”

  1. Karen Grepin says:

    What are the funding challenges for Non-Communicable Diseases in Resource-Limited Settings? http://t.co/AWKPVrC (blog post) #globalhealth

  2. Peter Singer says:

    MT @KarenGrepin: wht R the funding challenges 4 NCDs in Resource-Limited Settings? http://bit.ly/jDr8Pb

  3. Peter Singer says:

    Funding opportunity: bit.ly/lxKhfn MT @KarenGrepin: wht R the funding challenges 4 #NCDs in Resource-Limited Settings? http://bit.ly/jDr8Pb

  4. Rogan Kersh says:

    Intriguing blog post from global-health star @KarenGrepin, on funding for disease prevention in developing wld. http://t.co/AWKPVrC

  5. What are the funding challenges for Non-Communicable Diseases in Resource-Limited Settings? http://t.co/AWKPVrC (blog post) #globalhealth

  6. Brian says:

    Prevention is it for most of them. Funding?

  7. April says:

    I share your reservations Karen. I’m disturbed to see the next “global disease emergency” starting to take shape – with it’s inevitable focus on raising funds and narrow disease-program styles solutions.
    There are a couple of NCD activities that global actors can and should support (tobacco control…via, esp. tax increases, but also rules on smoking in public places and education; salt reduction in food). I’m thinking WHO has the comparative advantage here – and that heaps of money aren’t required.
    Action on the rest of the NCD challenge (making health systems in LICs perform better in ways that would support earlier diagnosis; behavior change; better chronic disease management)….I just don’t think either the bi-lats or the multi-lats seem likely to have much to offer here. And most importantly:
    No one ever wants to talk about trade offs, but which global health priority should we shift funding FROM to fund NCD programs? Kick some people off of AIDS treatment? Reduce donor supported mass distribution of malaria nets (people’s immunity to malaria has undoubtedly diminished – so the resulting increase in malaria transmission could have devastating effects). Or maybe we give up on maternal health?

  8. Karen Grepin says:

    April,

    I agree with you completely. I think the opportunity costs are never fully acknowledged. The cost-effectiveness of many of these interventions has been used as an argument to justify investment but one needs to really think of this in an incremental cost-effectiveness framework relatively to existing outlays.

    There is a push within the HIV community to try use the NCD push – I believe – as a way to sustain funding going forward but I think there are huge risks to the HIV programs themselves. I have a forthcoming piece in JAIDS that argues this point.

    Also agree that there might be some quick wins that could be addressed at global level – especially tobacco control – that need to be a priority. But it is not clear to me if the case has been made well enough to justify massive scale up of resources from external actors to start to talk about service delivery interventions. I think until vaccinations are fully funded and other existing commitments are fulfilled there is a risk of displacing these efforts with the NCDs.

    Karen

  9. NYU Wagner says:

    T @KarenGrepin: What are the funding challenges for Non-Communicable Diseases in Resource-Limited Settings? http://bit.ly/jDr8Pb

  10. RT @KarenGrepin: What are the funding challenges for Non-Communicable Diseases in Resource-Limited Settings? http://bit.ly/jDr8Pb

  11. Lilia says:

    Hello Ms. Karen. I’m an aspiring public health professional, currently working on a masters thesis on NCDs in the Caribbean region. So, you can imagine how excited I was when I came across your blog. Thanks for important information. A recent follower at http://www.lilia-lifeinoh.blogspot.com

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