NCD Alliance calls for govt action

__________

MUNICH - As the international AIDS conference convenes in Munich, the NCD Alliance is sounding the alarm on the slow progress in addressing non-communicable diseases (NCDs).

Statistics indicate that NCDs claim three out of four lives globally.

 "The NCD burden is a ticking time bomb, and we're running out of time to address it," Dr Prebo Barango of the World Health Organisation says.

"NCDs cause three out of four deaths globally, and 80% of premature mortality from NCDs - deaths before the age of 70 - take place in low- and middle-income countries, where HIV mortality is also disproportionately high."

The NCD Alliance is calling on HIV organisations to join forces in pressuring governments to take concrete actions to address the growing epidemic of NCDs. 

"We need to recognise that people living with HIV are not only at risk of HIV-related illnesses but also of NCDs and ensure they have access to integrated healthcare services," Katie Dain, the CEO of the NCD Alliance,  said on Tuesday, July 23, 2024, adding:  "This is a critical moment in the global HIV response and we must seize it to demand action on NCDs".

The alliance is urging governments to fulfill their commitments to reduce NCD deaths by 2030, as pledged in the Sustainable Development Goals. Specifically, they are demanding increased investment, accelerated policy implementation, and robust monitoring of progress.

NCD Alliance sounded the alarm on the slow progress in addressing non-communicable diseases. (Courtesy Photo)

"Governments must mobilise more resources to tackle NCDs, and ensure that policies are put into practice to reduce the burden of these diseases," Dain said.

 The NCD Alliance has issued an open letter to governments, calling on them to take action. 

"NCDs such as diabetes, cancer, cardiovascular diseases, chronic respiratory conditions, neurological conditions, and mental ill health, are the leading cause of death and disability worldwide," the letter states, adding: "We urge governments to fulfill their responsibility to protect current and future generations from the risk factors that cause NCDs and provide healthcare for those who need it."

 By joining forces, the NCD Alliance hopes to push governments to take bold action to address the growing NCD crisis, particularly in low- and middle-income countries where the burden is greatest.

Uganda is implementing a programme to integrate care for noncommunicable diseases into HIV services (Credit: WHO)

"We cannot afford to wait any longer to address NCDs," said Barango. "The time for action is now".

 Improving care for chronic diseases among people living with HIV in Uganda
In Uganda, more than 1.4 million people are living with HIV, 42% of these have NCDs and of these, 5.8% have diabetes.

Diabetes is common among people living with HIV and is one of the main causes of death in this population. Overall, non-communicable diseases account for 36% of annual deaths in the country. 

Diabetes occurs when the body does not produce enough insulin or is unable to use insulin, the hormone that regulates blood glucose.

To address this health threat, Uganda is implementing a programme to integrate care for NCDs into HIV services. Launched in 2019, the programme aims to improve the prevention, timely diagnosis and long-term management of chronic diseases among people living with HIV.

A strong collaboration between the Ugandan government, the World Health Organization (WHO), the United Nations Development Programme and the United States President's Emergency Plan for AIDS Relief (PEPFAR) has enabled the mobilisation of over $6m to scale up the implementation of the programme in 2022 and 2023. 

The programme aims to improve the prevention, timely diagnosis and long-term management of chronic diseases among people living with HIV. (Credit: WHO)

These efforts, along with better access to HIV treatment, have led to a decline in the number of deaths among people living with HIV, from 24 245 deaths in 2017 to 16 450 in 2023.

“Through our noncommunicable disease/HIV initiative, we are seeing a reduction in diabetes-related complications among clients, as the disease is detected early, facilitating timely client management,” Dr Noella Owarwo, a physician and Deputy Director of Infectious Diseases Institute (IDI), says.

A key aspect of the NCDs/HIV initiative is its focus on addressing the heightened risk of certain NCDs among individuals living with HIV. To this end, over 1,800 HIV centres nationwide have been empowered with trained healthcare providers who can detect and manage prevalent conditions such as cervical cancer, diabetes, and hypertension, ensuring comprehensive care for those affected.

"The management of NCDs among HIV-positive people, using WHO guidelines and tools, has led to remarkable results,”  Dr Franck Mugabe, the principal medical officer ‒ NCDs at the the health ministry, says. “The country has decreased deaths among people living with HIV by almost one-third since 2017 to date”.

Among the challenges in implementing the programme is the need to ensure access to medication and regular education on chronic diseases to encourage people to undergo screening, adhere to treatment, reduce stigma and adopt a healthy lifestyle.

“The lessons learned in the implementation of this intervention should be scaled up to include everyone and continued investments are critical. WHO is ready to support this process,” says Dr Hafisa Kasule, WHO technical officer in charge of noncommunicable diseases.