Case study: How ready are countries to address NCDs among aging populations? Lessons from the World Bank’s work in Europe and Central Asia

Slowing growth of the global population of more than 8 billion people brings a new focus on aging. Aging populations accelerate the shift from communicable diseases to NCDs, particularly in Europe and Central Asia (ECA) which is home to the world’s fastest-growing aging populations. Ninety-four percent of elders over age 70 die from NCDs in the ECA region. The implications of large aging populations extend beyond the economy and health system readiness. They demand a re-imagined approach to NCD care.

Access Accelerated support enables the World Bank to reimagine care in two distinct ways. Leveraging the World Bank’s ability to collate actionable evidence and conduct advanced analytical work, the regional ECA project produced a report that guides countries with aging populations to assess their readiness to respond to NCDs. The report presents three stages of readiness — early, progressing, and advanced — depicting country archetypes based on NCD risk factors and disease burdens, levels of political commitment, implementation capacity for effective and accessible service delivery, and capacity to collect and utilize data to inform policy. Countries are invited to use these archetypes to assess their current state of readiness to address NCDs and determine the most effective levers to move forward. Actions include establishing a more enabling environment, enhancing monitoring and evaluation, or building implementation capacity. The archetypes offer a starting point for countries to think about what to do next, highlighting that a step in the right direction is always possible, irrespective of current stage.

The analysis presented in the ECA report informed discussion of upcoming frontiers in NCD care during a two-day conference held in late 2022 in Sweden, organized by World Bank, Karolinska Institutet, and Uppsala University. Identified frontiers include the role of digital technologies in supporting older populations and addressing shortages in medical devices and life-saving tools. In addition to the lively discussions, the event welcomed ministerial representatives from multiple countries, highlighting the high-level passion and attention that NCDs receive across the region.

The World Bank’s ECA effort operates at the regional and national level, and in addition to the regional work on readiness, five countries in the region conduct analyses to identify ways to prevent the erosion of human capital by addressing NCDs. For example, in Bosnia and Herzegovina, the World Bank is assessing the involvement of private providers in NCD care. The focus in Croatia is to mobilize evidence to facilitate investments in NCDs.

The ECA project exemplifies the World Bank’s commitment to supporting countries, demonstrating a focus on emerging challenges and solution-oriented dialogue. The project reveals that success is possible through the power of collaboration and participating countries’ passion for NCD action. Together, these components enable the creation of trust and connective tissue — with growing attention and changes in demand for NCD action, the World Bank works hand in hand to identify locally-relevant and systems-wide ways to address NCDs, facilitating knowledge exchange and enhancing social capital.