When it comes to the mounting challenge of noncommunicable diseases (NCDs), no country or region is spared, but it is felt particularly keenly in Europe and Central Asia (ECA). This region has one of the world’s highest NCD burdens, fueled by the prevalence of tobacco smoking and alcohol consumption, among other factors. In 2019, the region reported 8.4 million deaths due to an NCD, representing 90% of all deaths in the region.^[1] It’s a situation that has forced governments to sit up and take notice.

That’s why the World Bank, in conjunction with Uppsala University and Karolinska Institute and with the support of Access Accelerated, is kicking off a two-day conference in Stockholm today, 29 November, called Smart investment in NCDs: the key to address future health challenges. The event convenes high-level policy makers from across Europe to share knowledge on realistic ways countries can ramp up efforts to meet, and ultimately solve, the rising NCD challenge.

“The COVID-19 pandemic adversely affected ECA because of its NCD burden and as we seek to strengthen health systems going forward, addressing NCDs is a priority” says Dr. Rupasinghe, Senior Health Specialist at the World Bank and Task Team Leader for Regional NCD program in ECA. “Countries within and outside of the ECA have had successful experiences addressing aspects of NCDs, which offers an important toolbox of experiences.”

As our populations age, an NCD tsunami looms

The conference’s first day will see the presentation of a new regional report by the World Bank and supported by Access Accelerated, titled Addressing Noncommunicable Diseases in Europe and Central Asia. The report provides guidance for countries with aging populations in assessing their readiness to confront NCDs (described in the report as three archetypes: early stage, progressing stage or advanced stage) as they work to identify and mobilize investments.

In addition to ECA’s high NCD burden, a defining feature of the region is its aging population.

“We’re living longer. That’s the good news,” says Michael Fredrich, Lead Access to Medicine Non-Communicable Diseases at Bayer Pharmaceuticals and Chair of the Access Accelerated Steering Committee. “However, it is critical that we ensure that a longer life translates into a healthier, longer life. As demographics shift, we need to shift our perspectives along with them and make sure that countries’ health systems are designed to best address NCDs and ultimately improve quality of life for their populations.”

Real-world solutions for real-world problems

Age can only partially explain NCD mortality in ECA as premature NCD mortality rates (deaths before the age of 70) in the region are among the highest in the world.

“Successfully addressing the needs of patients requires shifting towards patient-centered care, facilitating integration between health and other sectors and developing local solutions to patient needs” explains Dr. Koziel, Senior Health Specialist and co-Task Team Leader for the Regional NCD program in ECA. “We hope that by bringing together experts and practitioners that ministries across the region will be inspired by the innovations and ideas that they can adopt to support their populations.”

To that end, the report includes five case studies, each exploring examples of governments in countries around the world implementing reforms to tackle NCDs. One of these case studies features Brazil’s tobacco reform, which offers strong lessons and practical takeaways, including the value of unifying the government’s position against tobacco. More insight comes from Portugal, a country that has confronted a challenge plaguing many ECA countries: salt consumption and the hypertension that can result.

“Drawing on the experiences of other countries enables ECA countries to assess how these solutions can be adapted to their needs and replicated on their home soil,” says Mr. Fredrich. “When countries can learn from each other, to understand what worked and what didn’t, and importantly what solutions are realistically achievable, this helps to reduce the learning curve and accelerate actions. That’s critical to dealing with NCDs.”

A looming economic crisis in Europe will no doubt cause more uncertainty for health budgets. Yet, despite this and other obstacles, there remains not only an awareness by ECA governments that action is urgently needed but an appetite to make those changes happen soon. Drs. Koziel and Rupasinghe note that there has been strong interest across ministries within the region to address NCDs and that for many counterparts, it is often driven by personal experience and a deep commitment on the part of health ministers. It is the hope that ministries will feel empowered to act, based on the recognition that improving the management of NCDs in ECA is truly possible.

^[1] 2022. Rupasinghe, N. et al. Addressing noncommunicable diseases (NCDs) in Europe and Central Asia (ECA). World Bank Group.