Launching the survey report on Assessing National Capacity for the Prevention and Control of Non-communicable Diseases, the World Health Organization (WHO) states that while some countries are making remarkable progress towards achieving global commitments on Non-communicable diseases (NCDs), the overall progress is insufficient and uneven particularly in low and middle income countries.
NCDs, including cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, and their key risk factors – tobacco, harmful use of alcohol, unhealthy diet and physical inactivity – remain the leading causes of death globally. NCDs are currently responsible for almost 70 per cent of global deaths, the majority occurring in low and middle-income countries.
In recent years, NCDs have been increasingly in the spotlight of the global public health community and national leaders. The 2030 Agenda for Sustainable Development Goals, adopted at the United Nations Summit on Sustainable Development in September 2015, recognized the critical public health importance of addressing NCDs, and included a goal to reduce, by one third, the premature mortality from NCDs, along with targets to address risk factors such as alcohol and tobacco, and achievement of universal health coverage by 2030.
WHO carries out periodic global country capacity surveys to assess the capacity of countries to respond to NCDs. Data has been collected from NCD focal points or designated colleagues within the ministry of health, national institute, or agency responsible for NCDs in all WHO Member States, 194 countries.
In all, 91 percent of countries 177 responded to the survey. Trends in national capacity for NCDs were derived from comparing the results of the 2015 survey with those from the capacity surveys conducted in 2013 and 2010.
For the comparison of responses across these three surveys, analyses were limited to the 160 WHO Member States that completed all three surveys and were focused only on the questions which appeared in all three surveys.
Analysis of results revealed that in 2015, 93 per cent of countries reported having a unit, branch or department responsible for NCDs within their ministry of health, with 91 per cent having at least one full-time technical or professional staff member working within the unit, branch or department.
The most prevalent form of funding was for health care and treatment, (94 per cent of countries) followed by primary prevention of NCDs (88 per cent), health promotion activities (87 per cent), early detection and screening (85 per cent), surveillance, monitoring and evaluation (81 per cent), and palliative care (64 per cent). Major sources of funding included government revenues (94 per cent of countries), international donors (64 per cent), health insurance (62 per cent), and earmarked taxes (34 per cent).
The 2015 NCD CCS revealed ongoing challenges in addressing NCDs at the national level including: a lack of resourcing of key initiatives; weak multispectral coordination; disparities between the existence of policies and operational plans to address NCDs and their implementation, particularly in the area of unhealthy diet; lack of routine population-based surveillance; inadequate provision of NCD treatment and management for some NCDs; poor targeting of screening programmes; and very weak provision of palliative care for those suffering from existing NCDs.
In general the survey revealed worrying disparities between high and low-income countries, with very weak capacity and policy and service delivery in low income countries. Opportunities revealed in the survey included increased recognition of the importance of addressing NCDs; improved infrastructure and staffing; existence of policies, plans and strategies to address NCDs; target and indicator setting to track overall progress at country level; and improvements in country capacity across the board.