NCD Alliance Launches New Fund With Pharma To Bolster Prevention & Treatment Of Chronic Illnesses – That Exacerbate Risks From COVD-19
Chronic diseases claim up to 50 million lives a year

On Monday, the Geneva-based NCD Alliance launched the first-ever fund to bolster the efforts of NGOs worldwide fighting chronic diseases alongside the COVID-19 pandemic with some $US 300,000 in initial seed capital. 

The effort is unique in that it links major pharma interests that develop and produce drugs for non-communicable diseases (NCDs) to the support of NGOs in some 20 low- and middle-income countries (LMICs) and regions that are focused on prevention and access to affordable treatment. 

The new fund, the Civil Society Solidarity Fund on NCDs And COVID-19, also tackles a neglected aspect of the COVID-19 pandemic. 

Cardiovascular and lung diseases, as well as cancer and diabetes, make people much more vulnerable to serious COVID-19 illness and death. And mental illness can actually be triggered by the disease itself.

Even so, while donors have responded with billions of dollars to support the pandemic response, funding to NCD groups addressing root causes of those diseases has become all the more volatile. The new fund addresses that gap by supporting NGOs at the grassroots where action can make the biggest difference.   

“This is a first-of-its-kind fund to support NCD civil society organisations respond to COVID-19”, said Katie Dain, CEO of NCD Alliance. “During pandemics, momentum in several health and sustainable development issues, notably HIV/AIDS, Ebola and climate change, have repeatedly reinforced the critical role of civil society organizations and community-led efforts in accelerating action from local to global levels. Civil society are proven campaigners, change agents, experts, implementers, and watchdogs.”

Every year, chronic diseases cause over 50 million premature deaths and affect 1.7 billion people around the world, added Todd Harper, President of the NCD Alliance, at a virtual launch of the fund on Monday.

WHO Director General Dr. Tedros

But a “deadly interplay”’ between chronic diseases and COVID-19 is taking even more lives than before, as underlying conditions increase vulnerability to COVID-19, said WHO’s Director-General Dr Tedros Adhanon Ghebreyesus, who also spoke at Monday’s event.

“We cannot go back to the same health systems model, which has failed the majority of people living with NCDs…We need a paradigm shift to include the prevention, screening, early diagnosis and appropriate treatment of NCDs as a part of primary healthcare for universal health coverage….We need to build back better”.

“In Italy, 68% of the people who died from COVID-19 had high blood pressure, and 31% had diabetes”, said Norway’s Minister of International Development Dag Inge Ulstein.

Even before COVID-19, there was a “huge need” to fund NCDs, Ulstein said, especially in low and middle income countries (LMICs).

Currently, 86% of NCD-related premature deaths (before the age of 70) occur in LMICs, but NCDs still only receive about 1-2% of all global health related development aid.

Massive Disruptions Being Seen in NCD Treatments

The Fund comes as NGOs on the ground scramble to maintain their operations and to secure funding in the midst of the pandemic and a global economic crisis, according to an internal survey conducted by the NCD Alliance in late May.

“In the survey from late May of 40 national and regional NCD alliance groups, some 87-90% of respondents said that disruption of NCD treatment and care operations for people living with non-communicable diseases, less access to healthy food and physical activity; and more increased alcohol and tobacco use, were key issues they face during the pandemic”, said Dain to Health Policy Watch. Also, 70% of organizations experienced difficulties in securing future funding as a result of the pandemic.

Ilona Kickbush, Founding Director The Graduate institute’s  Global Health Centre in Geneva

Massive disruptions in essential services – combined with a “long-time global under-investment in NCD prevention and control” – are contributing to an uptick in chronic diseases around the globe, said Ilona Kickbush, Founding Director and Chair of the the Global Health Centre at Geneva’s Graduate institute, who moderated the launch event. 

“This is not a crisis that’s going to stop tomorrow, and even if COVID-19 stops tomorrow, the impact is going to be with us for years to come”, she added.

“The fund, totalling $300,000, will competitively award grants of up to US$15,000 to national and regional NCD alliances to support them in addressing the critical needs of people living with NCDs during the COVID-19 pandemic”, said the NCD Alliance. “The funds will support: advocacy and communication efforts for the continuity of essential NCD health services; inclusion of NCDs in national COVID-19 response and recovery plans;  and community-led awareness-raising campaigns on the linkages between NCDs and COVID-19”.

The Fund will amplify the voices of people living with chronic diseases, promote advocacy and communications strategies, and spearhead health policy reform through the grants, awarded on a competitive basis, to 20 national and regional NCD alliances around the world – including Brazil, Uruguay, Togo, Benin, Bangladesh, Cambodia, among other countries, said the NCD Alliance.

While the pandemic has created stiff new obstacles to NCD treatment, it also creates a political moment where policymakers are more aware of the need to address underlying conditions that make people more vulnerable to COVID-19.  

“You can’t underestimate the importance of a political moment, and you have to do the work to translate that political moment into an ongoing dividend”, added Jennifer Cohn from Resolve To Save Lives, an initiative launched by New-York based Vital Strategies.

The pharma companies that contributed to the Fund include: Takeda, AstraZeneca, Upjohn (Pfizer), and Access Accelerated – a partnership of some 20 biopharmaceutical companies working on NCD treatments and cures. The US-based Leona M. and Harry B. Helmsley Charitable Trust also contributed.

We Already Know How To Fight NCDs – But Governments Need To Pull Their Weight

While the new fund represents an alliance between the private sector and civil society, it is governments, ultimately, that need to act more assertively on the NCD challenge, said Cohn. 

Jennifer Cohn, Senior Vice President of Resolve To Save Lives

“Who will pay? It will be governments, it will not be an industry…we must use the opportunity to get commitments [and] ensure there’s transparency on these budgets, so that we can hold decision makers accountable”, she said. 

In past decades, public health professionals have tried and tested strategies that can effectively prevent and treat chronic diseases.

“We know very well that the majority of non-communicable diseases can be prevented or treated with smart policy measures and sound investment in universal health coverage”, said Harper.

However, governments needs to make core NCD investments, and adopt smarter policies and regulations. 

“Just like any other epidemics, the costs from NCDs will only grow if we don’t activate [proven] interventions to prevent and treat these diseases”, said Cohn.

Measures that can nudge people towards healthier lifestyles include higher taxes and plain packaging on tobacco products, as well as other policies recommended by the WHO Framework Convention on Tobacco Control, which 181 countries worldwide have ratified.

Processed foods have excess salt, leading to hypertension

As for hypertension, some 100 million lives could be saved over the next 30 years from the deadly effects of high blood pressure – including strokes and heart diseases – mainly by eliminating artificial trans fats in food supplies, reducing dietary sodium intake, and better front-of-package labeling for healthy and unhealthy foods, added Cohn.  

“We can successfully reduce [salt intake] through…policies and legislations that reduce sodium in packaged or institutionally prepared foods,” she said.

Governments also need to invest “a lot more” to prevent children and adolescents from developing NCDs like obesity, added Sir George Alleyne, PAHO’s Director Emeritus, and former UN Special Envoy for HIV/AIDS in the Caribbean:

“It is almost criminally negligent to [let children] become fat. Governments can stop children from becoming fast [by investing] progressively and more aggressively”. 

Last But Not Least – Community Engagement To Synergize With Policy 

Bente Mikkelsen, WHO Director for NCDs

Policy reforms offer a useful starting point to improve chronic disease management, but people with underlying conditions must not be left out of decision-making processes and interventions, added panelists.

“We need to do better…and secure seats at the table for people [with NCDs] because there are big decisions that need to be made”, said Bente Mikkelsen, WHO’s Director for NCDs.

People with chronic illness need to move from passive participation to “active collaboration and action”, added Nupur Lalani, a diabetic and founder of the India-based Blue Circle Diabetes Foundation

Sometimes, community engagement can address chronic diseases in ‘relatively simple and ‘relatively cheap’ ways, said Kickbush. 

In a hallmark initiative to slash cervical cancer – the largest killer of women in sub-saharan Africa – groups of young women with HIV were mobilized to support widespread screening for cervical cancer and to fight stigma associated with the disease. 

As a result, in only two years, over one million women with HIV were screened and treated for cervical cancer in 8 sub-Saharan African countries.

UNAIDS Executive Deputy Director Shannon Hadder

“Our lessons from HIV are that it needs to be community-led, community-led, community-led”, said UNAIDS Executive Deputy Director Shannon Hadder. 

Multi-disease screening can also be a game-changer, noted Hadder, describing a UNAIDS supported programme called Project Search – which monitors for diabetes, high blood pressure, eyesight and HIV all at one time: 

“We have seen [these initiatives] deliver sustainability, creativity and agility in ways that continue to serve.”

“Telemedicine is being scaled up in India as a really important intervention that can allow for treatment modifications from a patient’s home”, especially for chronic diseases, said Cohn, adding:

“Telemedicine can actually help us maintain lifesaving and sustainable pathways of care for those with NCDs. And these models can help us scale rational and sustainable and affordable models of care into the future, even when there’s not a global pandemic raging.”

Image Credits: WHO, Resolve To Save Lives.