Systemic Solutions for Addressing Non-Communicable Diseases in Low- and Middle-Income Countries

Abstract

Non-communicable diseases (NCDs) have been on the rise in low- and middle-income countries (LMICs) over the last few decades and represent a significant healthcare concern. Over 85% of “premature” deaths worldwide due to NCDs occur in the LMICs. NCDs are an economic burden on these countries, increasing their healthcare expenditure. However, targeting NCDs in LMICs is challenging due to evolving health systems and an emphasis on acute illness. The major issues include limitations with universal health coverage, regulations, funding, distribution and availability of the healthcare workforce, and availability of health data. Experts from across the health sector in LMICs formed a Think Tank to understand and examine the issues, and to offer potential opportunities that may address the rising burden of NCDs in these countries. This review presents the evidence and posits pragmatic solutions to combat NCDs.

Graphical abstract

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Keywords:

• low- and middle-income countries
• multisectoral
• non-communicable diseases
• public–private partnership
• universal health coverage

Acknowledgments

The authors would like to thank Professor Phua Kai Hong, Health and Social Policy, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore for his valuable insights during the Expert Forum meeting, which were critical for drafting this article. The authors sincerely appreciate the medical writing support provided by Dr Sajita Setia, Executive Director, Transform Medical Communications, Auckland, New Zealand, and editorial support provided by Dr Veena Angle, Singapore on behalf of Transform Medical Communications.

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

This article is based on the dialogue that occurred at the “Expert Forum on NCDs in Emerging Nations” convened by Pfizer in Dubai, UAE, 27–28 September 2019 and attended by all authors. Honoraria were provided by Pfizer to the external experts for their attendance at the meeting No author received an honorarium for the preparation of the article. Dr Amrit Ray, Dr Anurita Majumdar, Dr Barrett W Jeffers, Dr Kannan Subramaniam and Dr Shekhar Potkar are employees of Pfizer. The authors report no other conflicts of interest in this work. The views and opinions expressed in this article are those of the authors and do not represent or reflect in any way the official policy or position of their current or previous employers. Editorial and medical writing support was provided by Transform Medical Communications, which was funded by Pfizer.

Mr Mathew Guilford reports personal fees from Common Health, Inc., during the conduct of the study; personal fees from Pfizer Upjohn, outside the submitted work. Dr Raghib Ali reports personal fees from Pfizer Upjohn, grants from Pfizer Upjohn, outside the submitted work. Dr Rayaz A Malik has attended advisory board to discuss NCD’s by pfizer, during the conduct of the study; and received grants from Pfizer, grants to support a consensus meeting on neurodegenerative disease from Biogen, personal fees from Novo Nordisk, personal fees from Aventis, outside the submitted work.