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Of the 54.7 million deaths globally in 2016, over 70% were attributable to NCDs. i
Why do countries need to focus on NCDs?
Non-communicable diseases (NCDs), principally cardiovascular disease, diabetes, cancers and chronic respiratory disease, are the world’s leading source of premature death, illness and disability. Each year 15 million people die prematurely (between the ages of 30 and 69) from NCDs. Three quarters of NCD deaths, and over 85% of premature deaths from NCDs, are in low- and middle-income countries (LMICs).
NCDs place a growing and unsustainable burden on health systems, jeopardizing achievement of universal health coverage and other sustainable development goal (SDG) targets. NCDs also sap national economies. Without urgent and accelerated action, NCDs will remain on course to cost LMICs US$21.3 trillion between 2010 and 2030, due to medical costs and lost productive capacities. NCDs can also be socially and economically catastrophic to households. Treatment costs and/or the death of a family breadwinner can worsen poverty for vulnerable households. School dropout, to care for a sick relative or to make up for lost wages, is common. Women and girls are usually first to sacrifice time and opportunity.
The 2030 Agenda for Sustainable Development, through SDG 3, includes a specific target to reduce premature mortality from NCDs. Other SDG 3 targets are important for NCDs, for example targets to strengthen implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC), strengthen the prevention and treatment of harmful use of alcohol, halve global deaths and injuries from road traffic accidents, achieve universal health coverage, reduce deaths and illnesses from hazardous chemicals and pollution, and provide access to affordable medicines and vaccines.
Achieving these targets would deliver gains across Agenda 2030, given the relationship between NCDs and priorities such as poverty and inequality reduction, economic growth, climate action and financing for development. For example, reducing the 9 million deaths from NCDs caused annually by air pollution would benefit health while protecting the planet. Likewise, price and tax measures on tobacco, alcohol and sugar-sweetened beverages would generate significant domestic revenue, in addition to strong health impacts. The Addis Ababa Action Agenda of the Third International Conference on Financing for Development underscores this power of tobacco taxes.
The need for multi-sectoral action
Premature NCD death, illness and disability is largely preventable by taking cost-effective action to tackle the four main behavioural risk factors—tobacco use, harmful use of alcohol, physical inactivity and unhealthy diet. Ensuring access to prevention and treatment services, and addressing environmental risks such as air pollution, are also key.
Tackling NCDs and their risk factors requires a response from government sectors beyond health. Population exposure to NCD risk factors, and access to services, are determined largely by policies in finance, agriculture, environment, urban planning, trade, labour, education and other “non-health” sectors. This means that early death, illness and disability from NCDs are largely avoidable through improved policy coherence across sectors, and careful conflicts of interest management in public policy. Tackling the commercial determinants of health is of growing concern to policy makers and legislators.
In line with its Strategic Plan 2018-2021 and HIV, Health and Development Strategy 2016-2021, UNDP’s work on NCDs contributes to its broader commitment to eradicate poverty, reduce inequalities, strengthen effective and inclusive governance, and build resilient and sustainable systems for health. UNDP, in cooperation with WHO, the Secretariat of the WHO FCTC and other partners, supports governments in all regions to implement or strengthen whole-of-government NCD responses.
- UNDP fosters coordination within and beyond the health sector to ensure NCD responses are effectively integrated with broader efforts to improve health and achieve the SDGs
- UNDP has extensive expertise in implementing large health programmes, for example through its partnership with the Global Fund to Fight AIDS, TB and Malaria
- UNDP has strong core competencies across areas critical to NCDs, including access to affordable basic services, poverty and inequity reduction, environment and energy, governance and peacebuilding, sustainable financing, gender, and South-South and triangular cooperation
- UNDP has a strong track record of leveraging and strengthening partnerships for health and sustainable development, including with other global health organizations, civil society, academia, the private sector, and affected communities
UNDP and WHO have developed a joint programme on Activating National Responses to NCDs. With the Framework Convention Secretariat and WHO, UNDP is supporting the FCTC 2030 project, which aims to strengthen WHO FCTC implementation to achieve the SDGs.
This work includes support to ministries of health to develop national investment cases for scaled up action. The cases calculate the direct and indirect economic costs of NCDs/tobacco to a country, the costs of scaling up ‘best buy’ interventions/stronger WHO FCTC implementation, and the returns on those investments, in terms of lives saved and economic costs averted.
Together with the economic analyses, UNDP-led institutional and context analyses identify opportunities to strengthen policy coherence and multisectoral planning and coordination.
NCD investment cases
FCTC investment cases
UNDP and WHO have produced a set of sectoral briefs which provide policy and decision makers across government with information on how NCDs impact their sector, and the proactive steps they can take to respond to the challenges.
Discussion paper on tobacco control and sustainable development
UNDP and the Framework Convention Secretariat produced this paper to support Parties to the Convention, development partners, civil society, academia and other stakeholders to accelerate tobacco control and sustainable development in an integrated manner.