The Noncommunicable (NCD) Roundtable submitted testimony to the House Committee on Appropriations, Subcommittee on State, Foreign Operations, and Related Programs, for fiscal year 2018 on April 3, 2017. Testimony focused on “Working to Reduce Mortality and Morbidity from Noncommunicable Diseases in the Developing World”.

Testimony document

On July 14, 2016, the Noncommunicable Disease (NCD) Roundtable in collaboration with the Congressional Global Health Caucus held the Congressional Briefing, “The Global Threat of Noncommunicable Diseases” at the Rayburn House Office Building.

A panel of experts discussed the global economic and public health impact of NCDs. Some major points of discussion included the strain NCDs put on health systems due to increased demand for high cost health services, which subsequently reduces international trade and development. The potential for NCDs to cause burdens on institutional capacity and the pressure of the population’s unmet needs for chronic-care services was also highlighted. Additionally, an emphasis was placed on the importance of public-private partnerships to strengthen health systems and expand access to health services. Speakers also stressed the need for funding for programs to reduce NCDs, as they are crucial for public health and the global economy.

Thomas J. Bollyky, Senior Fellow for Global Health, Economics, and Development at the Council on Foreign Relations (CFR), discussed the creation of the first CFR task force devoted to global health. He noted that though NCDs are typically viewed as a problem that mainly affects developed countries, they are also on the rise in low-and middle-income economies. He also pointed out that lower-income countries have the worst health outcomes. Bollyky emphasized that NCDs are not merely a byproduct of success and unhealthy lifestyles, noting that the rise of NCDs exceeds the decline of infectious diseases in developing countries. Bollyky also pointed to the need for a reallocation of global health funds toward NCDs, as the amount of funding they currently receive is disproportionate to the health burden they pose in US priority countries.

Bollyky described the array of consequences of NCDs for individuals and households, health systems, and national economies and governments. For individuals and households, NCDs can lead to impoverishment and high risk of children developing NCDs. For health systems, NCDs can lead increased demand for high cost health services and diminished capacity to address other health needs. For national economies and governments, reduced labor supply and lower tax revenue, both of which may cause political pressure because of unmet population needs can result from NCDs. All these combine to produce global and regional effects that include poorer global health, reduced international trade and development, and political instability.

Rachel Nugent, Vice President for Global Noncommunicable Diseases at RTI International, discussed the work RTI has done to prevent and reduce the health and economic burdens of chronic non-communicable diseases in low and middle income countries. She mentioned that this work aims to achieve a one-third reduction in premature mortality from NCDs by 2030 as part of Sustainable Development Goal (SDG) Target 3.4.

John F. Steele, Senior Director, International Government Affairs, for Eli Lilly, discussed NCDs through the lens of healthcare economics, addressing the impact of wellness on workforce productivity. A Victoria University study on the link between health and productivity estimates the impact absenteeism (sick and absent from work), presenteeism (present at work but not working at full capacity due to health), and early retirement due to ill health. Steele pointed out that some countries have a rapidly ageing workforce, so keeping those workers healthy becomes an issue for economic growth and development, especially as the burden of NCDs rises steeply with age. Steele also noted that presenteeism has a far greater cost to productivity than absenteeism and early retirement, averaging a 3.3% GDP loss, as opposed to 1.3% and 2.4%. respectively.

Steele called for the formation of public-private partnerships in order to address the problems posed by NCDs. He used the ongoing work of Lily as a case study in public-private partnerships for NCD intervention. Their activities include strengthening healthcare systems, finding community-based health solutions that can be adapted, replicated, and scaled, and expanding access to medicines. To do this, Lily partners with leading health organizations and focuses its efforts on 4 countries with high NCD burdens: Brazil, Mexico, India, and South Africa. In South Africa, Lily partners with organizations such as the Donald Woods Foundation and Project HOPE to combat the rising burden of Type 2 diabetes and obesity, address the shortage of qualified clinicians, and reduce socio-economic disparities that lead to setting-specific healthcare challenges. Steele called for government and business to work together in the areas of prevention and treatment, organizational innovation, financing, and healthcare infrastructure.

The NCD Roundtable will be hosting additional events at various locations and on different subsets of the NCD issue.

Panel slides

Panel bios