The Emerging Crisis of Noncommunicable Diseases
Congressional Briefing on Non-Communicable Diseases
July 14, 2016
First CFR Task Force Devoted to Global Health
Task Force Members
David Agus
Barbara Bryne Dan Glickman Betsy Nabel
J. Brian Atwood Jean- Paul Chretien
Eric Goosby David Satcher
Sandy Berger Mitchell Daniels* Vanessa Kerry Donna Shalala
Karan Bhatia Steve Davis Michael Klag Ira Shapiro
Tom Bollyky Thomas Donilon* Risa Lavizzo-Mourey
Tommy Thompson
Nancy Brinker Ezekiel Emanuel Christopher Murray
Questions
• Are NCDs an emerging crisis in low- and middle-income countries?
• Do the United States and other donors have interest in addressing that crisis?
• Why Now? in it?
Are NCDs an emerging crisis in low- and middle-income countries?
Causes of NCD deaths in LMICs
Proportion of NCD Death & Disability that Arises under 60
Worse Outcomes
Not Merely a Byproduct of Success & Unhealthy Lifestyles
Bollyky et al., Health Affairs (2015)
Source: The Gapminder Foundation Source: Institute for Health Metrics and Evaluation, Global Health Spending Database (2013).
Source: United Nations, World Urbanization Prospects (2014)
Top Health Risks in LMICs
The Case for Greater Engagement on NCDs
US FY13 Global Health Budget
Health Burden in U.S. Priority Countries
Proportion of DALYs due to NCDs by Age
Source: Bloom et al., World Economic Forum (2011)
Why Now?
Case for Engaging on NCDs Now
Thank you!
Rachel Nugent, Ph.D. RTI International, Vice President
One-third reduction in premature mortality from NCDs
Thank you!
Health and the Economy: The Impact of Wellness on Workforce Productivity
The urgent need for public private partnerships to address the rise of chronic disease John F. Steele Senior Director, International Government Affairs Eli Lilly and Company
Presentation Topics
• Victoria University multi-country study on the increasing economic toll of NCDs—and the increasing engagement of the business community in addressing this threat to their workforces
• Closer country level look: South Africa
• The role the private sector can play working with governments
• Lilly case study of an on-going public-private partnership in NCDs
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Chronic Disease Economic Impact Study
• Study about the link between health and productivity
• Estimates the economic impact of: • Absenteeism (sick and absent from work) • Presenteeism (present at work but not working at full capacity due to illness ) • Early retirement due to ill health (retired 50-64 due to ill health)
• Multi-country study of 18 countries • Using mainly international data sources
• Presentation draws on four reports sponsored by : • APEC Life Sciences Innovation Forum • APEC Business Advisory Council • US Chamber of Commerce
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Ageing is rapidly increasing the proportion of older workers in many countries
Some countries have a rapidly ageing workforce e.g. China and some other developing countries.
Some countries, e.g. Japan, and the United States, already have ‘old’ workforces.
Both types of countries need older experienced workers. Therefore, keeping older workers healthy and working becomes an issue for economic growth and development.
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Source: International Labour Organization 2016, ILOSTAT Database.
Burden of disease: Non-communicable diseases (NCDs)
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NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes and mental illness) are generally thought of as a challenge only for developed economies, when in reality the disease burden of NCDs is as high among DEVELOPING economies as developed economies.
Source: Institute of Health Metrics and Evaluation (IHME) 2015, GBD Data.
Among the countries surveyed, NCDs, as measured by years lived with disability (YLDs) are as high for developing as developed countries. NCDs are 86% of the total morbidity disease burden.
The double challenge: Ageing and the burden of disease
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The burden of NCDs rises steeply with age. On average the burden at age 65 is about 50% higher than at age 45.
Productivity loss 2015
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% GDP
Presenteeism averages 3.3% of GDP compared with 1.3% for absenteeism and 2.4% for early retirement
Presenteeism, that is, sick but at work, is a far greater cost to productivity than absenteeism.
Absenteeism, presenteeism and early retirement, 2015
0123456789
Early retirement due to ill health as % GDPPresenteeism as % GDPAbsenteeism as % GDP
SOUTH AFRICA RELATIVE MORTALITY - HIV vs T2 DIABETES – [PRIVATE SECTOR]
Lilly NCD Partnership
Finding new community-based solutions that can be
adapted, replicated and scaled.
Partnering with leading
health organizations
Strengthening healthcare systems
Expanding access to
medicines
Creating shared value
Leveraging Lilly’s Research, Report, and Advocate
framework
Focusing on 4 countries with high diabetes & NCD
burdens: Brazil, Mexico, India, South Africa
Company Confidential ©2015 Eli Lilly and Company
Global Health Programs
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Problem definition Context: Rising burden of Type 2 diabetes
in settings with high prevalence of HIV/AIDS and TB
One of world’s highest rates of obesity
Socio-economic disparities lead to challenges in specific settings (urban, rural)
National shortage of qualified MDs
Gap: • Current diabetes care model
does not fully utilize the capabilities of other healthcare providers, such as nurses and community healthcare workers
Making Life Better
Partnership Approach(es) • Train community-based health workers to diagnose
and refer patients, launch peer support groups to raise awareness and manage diabetes, and strengthen clinics
• Conduct an assessment of current HIV/AIDS
treatment capabilities and apply a similar model to diabetes care
Expected Impact • Increased access to diabetes prevention services,
integrated diabetes and hypertension treatment primary care services, improved diabetes self-management, improved quality of life.
SOUTH AFRICA
Global Health Programs 43 Making Life Better
Partners • Donald Woods
Foundation
• Project HOPE Locations • Mbashe Region, Eastern Cape • Zandspruit, Johannesburg
SOUTH AFRICA
Key takeaways
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• With aging populations, conserving labor supply by extending working lives becomes an issue for economic growth and development
• High and increasing levels of NCDs are imposing significant social and economic costs on economies and threaten economic development
• Need for government and business to work in partnership to address NCDs, for example through:
• Prevention and treatment – Workplace wellness programs, screening and early
detection, health education, leveraging technology and innovation in delivery systems
• Organizational innovation – A “whole of government” approach (i.e., dedicated interagency team) and “whole of society approach (i.e., national NCD action plan)
• Financing – Innovative financing schemes
• Healthcare infrastructure – Primary care and building a health workforce that includes allied workers and community practitioners
Thank you!
http://www.ncdroundtable.org/
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