Moving Towards Optimized Noncommunicable Disease Management in the ASEAN Region: Recommendations from a Review and Multidisciplinary Expert Panel

Abstract

Introduction

Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality in the Association of Southeast Asian Nations (ASEAN) member states. Progress has been slow despite the World Health Organization action plan for the prevention and control of NCDs in the region. This paper presents recommendations focused on practical strategies for optimizing NCD management in the ASEAN region.

Methods

A multidisciplinary group of experts from six ASEAN member states convened for two face-to-face meetings to discuss barriers and possible recommendations for optimizing NCD management, focused on cardiovascular diseases and mental disorders, in the region. Multiple approaches, ie, analysis of insights from the meetings and a review of existing literature on NCD programs in the ASEAN region were followed. The proposed recommendations were also based on selected successful interventions in ASEAN member states, thus providing actionable strategies.

Results

The gaps identified in NCD management for cardiovascular diseases and mental disorders in the ASEAN region were classified into gaps relating to policies and to clinical and public health practice. The proposed solutions addressing policy gaps include fostering multisectoral public–private partnerships, employing “whole-of-government” and “whole-of-society” approaches and promoting “health-in-all policies approach” to manage issues with financing, accessibility, efficiency and quality of health services. Whereas proposed solutions to bridge clinical and public health practice gaps entail strengthening primary care services, building the capacity of trained healthcare workers and employing collaborative care for holistic management of patients.

Conclusion

The scale of premature and preventable deaths from NCDs in the ASEAN region remains a serious public health concern and requires a “whole-of-system approach”. The interventions proposed in this paper build on regional collaborations and knowledge sharing to help develop a concerted and targeted response to NCDs.

Keywords:

• cardiovascular disease
• mental health
• prevention strategies
• public health

Acknowledgments

The authors would like to thank Tanaya Bharatan, Scientific Communications, Pfizer, and Kaveri Sidhu, Scientific Communications, Pfizer for providing medical writing support funded by Pfizer.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

NTC has received personal fees from Pfizer for this work and received grant and personal fees from Pfizer, consultancy fees from United Laboratories (UNILAB) and personal fees from Johnson & Johnson (Philippines) outside of the submitted work. RB has received personal fees for lectures from Pfizer (Philippines). YCC has received grants, personal fees and non-financial support from Pfizer. DVD has received personal fees and travel support from MSD, Pfizer and AstraZeneca and received personal fees from Nestlé, Roche, Sandoz, Novartis and Astra-Zeneca. CHN has received personal fees from Pfizer. YR has received meeting honorarium from Pfizer. HZ has received nonfinancial support from Pfizer as an invited speaker. GEB, PR, MT and AM are employees of Pfizer. GEB, PR and AM also hold shares in Pfizer. The authors report no other conflicts of interest in this work.

Additional information

Funding

This manuscript is based on the insights gathered at two face-to-face meetings which were sponsored by Pfizer. The development of this manuscript was funded by Pfizer. The view and opinions expressed in this manuscript are those of the authors.