Report Proposes Solutions To Address Non-Communicable Diseases

An industry-backed group of experts has issued a report identifying significant obstacles to addressing non-communicable diseases (NCDs) and proposing solutions to reduce premature deaths caused by NCDs.

The most prominent actions put forward by the group range from the need for “intersectoral” action (between governments, private sector and civil society), to the amelioration of the supply chain of drugs as well as the restructuring of primary health care.

The report is available here.

On 4 February, a panel of experts, including some of the authors, gathered in an event organised by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) to present a report published by the John Hopkins University (US) that was commissioned by IFPMA. The study is a compilation of five policy briefs written by various academics.

Firstly, the panellists stressed the key role of cooperation. George Alleyne, former director of the Pan American Health Organization who contributed to the report, called attention to the importance of intersectoral cooperation for the prevention and control of NCDs.

Jeffrey Sturchio from Rabin Martin – an organisation whose clients include pharmaceutical companies like Johnson & Johnson, Merck, and, Pfizer- stressed the vital role that the World Health Organization must play in terms of surveillance and technical assistance. Sturchio emphasised how the industry can bring its expertise to reduce the burden of NCDs.

Cary Adams from the Union for International Cancer Control and NCD Alliance said that the WHO needs to adopt an inclusive philosophy by which it would work in cooperation with other stakeholders. He focussed on the role played by civil society and explained that in many low and middle income countries (LMICs) primary care services are provided by civil society organisations.

Adams also highlighted the challenges civil society faces. He described the difficulty for all involved actors – from civil society to the private sector and United Nations agencies – to work together, as they have heterogeneous interests and push different agendas. Along the same lines, Alleyne described civil society as a “multicoloured entity”. He reminded the audience that by its very nature the private sector aims at doing business and at making profit.

In addition, according to Margaret Kruk of Columbia University (US), a co-author of one of the policy briefs, what is needed is “a reset of primary care to realise its potential to tackle NCDs in low and middle income countries.”

Focussing on her experience in sub-Saharan Africa, she discussed how to ameliorate primary care as a prevention measure against NCDs. For her, this first level of intervention could cover 80 percent of the needs through diagnosis and immunisation. She said the problem in addressing NCDs is a lack of funding as well as a problem in health policy orientation. In Africa over the last 50 years, the focus has been on infectious diseases like HIV/AIDS, leaving NCDs outside the scope of many health policies in the global South, she said.

On the question of access to NCD medicines, the panellists tended to agree that there is a need to improve and strengthen the supply chain of drugs. Answering a question from the audience, Sturchio explained that most of the medicines to treat NCDs have been off patent for many years. For him, the challenge is more to bring medicines to people in need. Adams agreed with this idea and said that many drugs like morphine are cheap and easy to make available to a large audience of patients.

Studies have shown that this statement is true for a broad range of medicines. However, with respect to cancer drugs this assertion is more nuanced.

Treatments associated with cancer are often extremely costly. Academics recently agreed that these high costs pushed emerging countries like India to grant compulsory licenses on cancer drugs. For instance, in 2012, the Indian government announced granting a compulsory licence for Nexavar, a liver and kidney cancer treatment from Bayer.

Panellists also presented alternative cheap solutions for preventing NCDs, like sports policies or increased health measures targeting tobacco and alcohol. These policy measures can make a difference for many NCDs but may not be true for all NCDs. Many academics agree that with some diseases, prevention is not enough and treatment is needed. In some cases, as the Indian example demonstrates, the price of medicines can be a problem in addressing certain types of NCDs.

Held on World Cancer Day, this conference was also an opportunity to explain the global impact of NCDs today. Sturchio reminded the audience that NCDs are the leading cause of death worldwide. He explained that 8 million people died of cancer in 2012. Kruk explained that LMICs are disproportionally affected, as 80 percent of deaths caused by NCDs occur in such countries. Alleyne relied on the UN Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases from September 2011 to qualified NCDs as “a challenge of epidemic proportions” having “socio-economic and developmental impacts.”

Tiphaine Nunzia Caulier recently graduated with a Master in International Law from the Graduate Institute in Geneva and UCLA School of Law. Through her work experience and academic interests she has specialized in international trade, intellectual property, and public health.