In December 2024, the International Research Network on Quality of Care for Chronic Conditions held its first meeting in Antwerp. The focus was the growing burden of chronic, non-communicable diseases (NCDs) and access to good quality care. While globally NCD attention is increasing alongside high-level political commitments, it’s fair to say UN High-Level meetings (HLMs) on NCDs have not always translated into national policy implementation or greater funding allocations.
After the United Nations General Assembly (UNGA) adopted its first political declaration on the prevention and care for NCDs in 2011, the United Nations Inter-Agency Task Force on the Prevention and Control of Non-communicable Diseases (UNIATF) was convened, spearheading the preparation of the Global Action Plan for the Prevention and Control of NCDs (NCD GAP) that was endorsed by the World Health Assembly in 2013. The NCD GAP aspired to raise the profile of NCDs, and tackle the growing public health burden of these chronic conditions. However, a mid-term evaluation of its implementation (published in 2020 ) demonstrated slow and incremental progress in all member states with limited adequate financial and human resources to provide technical support for the implementation of the NCD agenda, particularly at the country level.
Towards a person-centred, contextualized approach
We need more evidence to support implementation of interventions to tackle NCDs, determinants and risks, especially in low- and middle-income countries. Addressing the growing problem of NCDs requires a person-centred approach: at the centre should be the people with one or several NCDs, their lived experiences, the risks they are exposed to, and the inequities that they experience, which often go beyond the health sector. However, current research, largely driven by private interests, more often focuses on specific NCDs and pharmaceutical discoveries. The critical domains of NCD research, such as implementation science and health systems and policy research are frequently neglected, largely underfunded, or conducted at small scale.
Given the current status quo, how can we successfully address the growing NCD burden?
In a world where people living in poverty oftentimes have no choice but to subsist on rice and salt; where a bottle of sugar-rich drink is cheaper than safe drinking water; where single cigarettes can be bought on the streets; where a young child can buy liquor at the corner store; where access to basic health care services is a difficulty; where policymakers are over-dependent on international health directives and dictations of donors?
Taking responsibility
Let this not become a story about the four people named Everybody, Somebody, Anybody and Nobody. NCD prevention and care is an important job that had to be done, and Everybody was sure that Somebody would do it. Anybody could have done it, but Nobody did it. Somebody got angry about that, because it was Everybody’s job. Everybody thought Anybody could do it, but Nobody realized that Everybody wouldn’t do it. It ended up that Everybody blamed Somebody when Nobody did what Anybody could have done.
Within a span of seven years (2011-2018), the UNGA has held three HLMs on non-communicable diseases. A fourth one will be held in September.
We call for more concrete actions on implementation science and health systems and policy research for NCDs to support the successful implementation of the NCD agenda, particularly in low- and middle-income countries.
We should have acted decades ago.
Let nothing stop us from acting now.
With contributions from Carolyn Johnson (Global Alliance for Chronic Diseases), Daniel Boateng (Kwame Nkrumah University of Sciences and Technology, Ghana), Martin Heine (University Medical Centre Utrecht), Kerstin Klipstein-Grobusch (University Medical Centre Utrecht) and Pedro Orduñez, (PAHO (Advisor)), on behalf of the International Research Network on Quality of Care for Chronic Conditions (funded by the FWO Scientific Research Network support programme )
