Amadou Diarra, IFPMA Council Chair, reflects on overcoming challenges to accessing non-communicable disease (NCD) care in low- and middle-income countries (LMICs).

The global pandemic has severely disrupted routine health services around the globe and increased the urgency for action on NCDs, adding complexities in delivery of medicines and additional burdens on access to treatment and care, and raising concerns about a longer-term upsurge in NCD morbidity and mortality. Last week, we observed the Global Action on NCDs, and see the opportunity to reimagine how we achieve greater equity and coverage in NCD care if we want to mitigate the impact of COVID-19 and bolster health systems to manage these often life-long conditions.

NCDs – comprising of mainly cardiovascular diseases, cancer, diabetes, chronic respiratory disease, mental health and neurological disorders – are currently the number one cause of death and disability, responsible for almost 70% of premature deaths worldwide. Forty percent of these deaths are during a person’s most productive years, and the burden is disproportionately severe in LMICs, where four out of five people with an NCD live. Thirty-eight million people die each year from NCDs, more than all other diseases combined, and the cost of inaction on NCDs in LMICs in the next 20 years is estimated at US$7 trillion. Investing in NCD control is essential if we want to achieve robust and sustainable development – it not only means lives saved, but also contributes to socioeconomic growth.

NCDs are diverse and complicated, and the private sector brings deep expertise in 1) the specificity of individual NCDs and their treatments; 2) bolstering delivery of care through a multitude of initiatives and investments in infrastructure and capacity building: and 3) research and development of innovative new treatments and care models.

Leading by example

IFPMA partners with a number of global health actors, such as the Coalition for Access to NCD Medicines & Products, to co-create an innovative access framework for low-resource settings.  This Coalition of government agencies, private-sector entities, non-governmental organizations, philanthropic foundations, and academic institutions is dedicated to increasing access to medicines and health products for NCDs.

Additionally, in 2017, IFPMA launched Access Accelerated, a unique cross-industry collaboration that seeks to reduce barriers to prevention, treatment and care for NCDs in LMICs through health systems strengthening and alignment with the World Health Organization’s Universal Health Coverage objectives and priorities.

This initiative actively seeks to improve access to care, build health system capacity, and strengthen and advocate for policies that promote health equity through cross-industry collaboration. Twenty-four biopharmaceutical companies have come together and, through various partnerships, have reached over 217 million patients worldwide.  The effort has resulted in hundreds of millions of dollars in investments in NCDs and policy changes in 14 countries and recognizes 107 public health and capability building programs across 136 LMICs. These collaborations bring together local health stakeholders and policymakers to explore ways to scale up and improve access to prevention, treatment, and care in NCDs.

Access Accelerated’s collaboration with the World Bank is also improving health outcomes for people living with NCDs by supporting projects that generate data on the impact of NCDs and scale up solutions, and by fostering investment in “evidence for policy” at country level. By seed funding several important projects driving NCDs care improvements at country level, this partnership has helped catalyze US$355mn in new LMIC investments in NCDs and national policy changes in 14 countries. The World Bank now has a US$5.5bn NCD portfolio.

One of the biggest needs in 2020 was addressing the pandemic’s impact on NCD care delivery and patients. Access Accelerated supported PATH to train more than 2,800 health care workers in Kenya on COVID-19 infection prevention and control for people living with NCDs, reaching almost 1 million people with improved care. Similarly, at the request of the Ghana Ministry of Health, PATH developed health awareness messaging for people living with NCDs. Using posters, flyers, and radio, the campaign reached 1.8 million people.

Access Accelerated is also a partner of City Cancer Challenge (C/Can), which engages cities with populations of over 1 million in LMICs to improve equitable access to and delivery of cancer treatment and care. By strengthening healthcare worker capacity, integrating medical care, and mobilizing community-based services to support patients and caregivers with resources and education, C/Can and partners enable improved access to cancer care in LMICs. Since launching in 2017, C/Can has reached 43.5 million people in nine cities. In 2020, COVID-19 partially or completely disrupted 42% of countries’ cancer services. However, through innovative solutions and digital health technologies, including interactive online learning, C/Can continues to support care provision and implement sustainable solutions for improved cancer care. Partnerships such as this strengthen localized efforts and deliver real results for patients.

In developed countries, 80% of pediatric cancers and blood disorders are cured, while in LMICs, only an estimated 15-45% are cured. This is largely due to a significant lack of healthcare workforce and treatment capacity. In an effort to address this disparity and improve outcomes for thousands of children in Africa, the Bristol Myers Squibb Foundation, in partnership with Texas Children’s Hospital and the governments of Malawi, Botswana, and Uganda, launched Global HOPE (Hematology Oncology Pediatric Excellence) in 2017. Global HOPE is a comprehensive initiative focused on building long-term capacity to treat and dramatically improve the prognosis of thousands of children with cancer and blood disorders in southern and eastern Africa. To date, 10,000 patients have been treated and 4,000 healthcare professionals have been trained.

Action for the future

At this time, we are right to acknowledge the vital role our industry has in contributing to global public health, but there is more to do. The industry is uniquely positioned not only to drive R&D innovation to support NCD treatment and to help strengthen capacity, but also to support the convening of multistakeholder collaboration for access to and the delivery of care, supporting robust primary healthcare to reach more patients.

We have witnessed how the pandemic affects those living with NCDs who are at higher risk of severe complications and death from COVID-19.  As we begin to reimagine health delivery in the wake of the pandemic, we must seize this unique chance to drive improved access to NCD prevention, care, and treatment. There is no time to waste.

Author

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  Amadou Diarra Senior Vice-President, Global Policy, Patient Advocacy and Government Affairs, Bristol Myers Squibb