Targeting non-communicable diseases

John C. Lechleiter Around the world, one of the major factors destroying lives and hampering economic growth is also one of the hardest to address. Non-communicable diseases (NCDs) – such as heart disease, diabetes, and cancer – now account for two-thirds of all deaths worldwide. In addition to cutting lives short, NCDs exact a massive economic toll on their victims, their families, and their communities, sapping economic productivity and driving up medical costs. Over the next two decades, the total economic losses from NCDs could top $30 trillion. Addressing the complex challenge posed by NCDs will require a coordinated international effort. Fortunately, there have been some important recent steps in that direction. In September, the United Nations adopted the Sustainable Development Goals, a set of 17 objectives that will guide the global development agenda for the next 15 years. Alongside targets like eliminating poverty and measures to protect the environment is a commitment to reducing mortality caused by NCDs – the first time the UN’s official development agenda has taken direct aim at the problem. This is a welcome milestone, but it is only the first of many on a long road. The physical and economic burdens associated with NCDs fall the hardest where they are least easily borne: low- and middle-income countries, where 80% of NCD-related deaths occur. Millions of people who have recently escaped poverty could be pushed back into it as a result. The attention and peer pressure generated by the SDGs can help drive progress. But achieving the targets will require sustained focus, drawing on the resources and expertise of governments, international non-profit organisations, and, crucially, the private sector. My experience in the health sector has led me to conclude that two important factors will prove crucial in addressing the challenges posed by NCDs. Progress will depend, first and foremost, on crafting effective local approaches that can be adapted, replicated, and scaled up. There are no one-size-fits-all solutions to problems like diabetes or heart disease. But, given that NCDs afflict communities in all parts of the world, there is much common ground that need not be continually rediscovered. In 2013, for example, the Carlos Slim Foundation conducted a rigorous baseline assessment at eight primary-care clinics to understand the state of diabetes prevention and treatment. Based on the data gathered during the study, the Foundation piloted what is known as the CASALUD model to improve screening, treatment, and prevention using low-cost, user-friendly devices that can measure a range of relevant vital signs, including blood glucose levels. Participating clinics have been equipped with an online system to track drug inventories and avoid shortages. The approach was so effective that Mexico’s health office is using the CASALUD model as the basis for its national campaign to fight obesity, which can fuel diabetes and other NCDs – a great example of scaling up based on local experience. The second key to success in the fight against NCDs is a commitment to tapping the resources of the private sector. This includes not only the mobilisation of private investment, but also the deployment of the vast amounts of technical, operational, and locally tailored expertise that private companies have gained in the course of doing business around the world. By forming partnerships with governments and international and local organisations, companies can help reduce the impact of devastating and costly diseases. I know this because my company is involved in just such an effort: the Lilly NCD Partnership, in which we are cooperating with partners and the governments of India, Mexico, South Africa, and Brazil to tackle NCDs. In Brazil, for example, we are working closely with key local organizations, including the Federal University of Rio Grande do Sul, to improve disease prevention – with a focus on helping mothers who were diagnosed with gestational diabetes while pregnant and are now at risk of developing type 2 diabetes. Programmes like ours demonstrate what can be achieved through substantive, locally driven public-private partnerships around the world. Ensuring the success of the SDGs – including the reduction of mortality from NCDs – will require companies to move beyond traditional philanthropy and forge creative solutions to socioeconomic problems. If we recognise that innovation stems from understanding local conditions and optimising the vast resources of the private sector, we can ensure better health – and more rapid economic growth – far into the future. John C. Lechleiter is the chairman, president, and chief executive officer of Eli Lilly and Company. Copyright: Project-Syndicate.

Opinions

Targeting non-communicable diseases