This year’s Global Week for Action on NCDs shines a spotlight on the need for stronger investment in noncommunicable disease (NCD) prevention and care, as part of delivering Universal Health Coverage (UHC) to ensure no one is left behind.
People living with or at risk of NCDs face challenges at every step of their health journey. From navigating an often-fragmented healthcare system to coping with the daily struggles of a chronic disease, these challenges not only affect people living with NCDs but have a broader impact on communities and inhibit healthcare professionals from effectively providing care and support.
What is a people-centered approach?
The traditional approach to health program development and delivery of care has focused on the disease itself, overlooking the needs and concerns of individuals. However, there has been a growing shift towards a people-centered approach, which places the needs, priorities and expectations of people living with NCDs— patients and their families and carers as well as healthcare workers and the wider community—at the center. It recognizes that not only should individuals be empowered to influence their own health and care but that they are critical in shaping policy and planning programs to best serve people living with NCDs.
“Effectively addressing NCDs requires understanding how these diseases affect people and the challenges and needs that people face as they navigate healthcare systems and daily life. Learning from the lived experience and first-hand knowledge of NCDs is essential to improving policies, services, programs and social beliefs.” – “Meaningfully Involving People Living with NCDs”, Our Views, Our Voices. An NCD Alliance Initiative supported by Access Accelerated
Emphasizing experience and empowerment
At Access Accelerated, a whole-of-society approach is at the core of how we work. A significant part of this involves meaningful engagement with people living with NCDs as well as the healthcare professionals who support them. Access Accelerated partners are leaning into this approach, with partner projects serving both individuals and populations with an emphasis on patient experience and empowerment to advocate for stronger NCD policy.
“Taking a people-first approach in responding to NCDs is not a moral rhetoric—it simply makes sense. By bringing people living with NCDs into the decision-making process and listening and responding to their needs, this helps to shape NCD programs and inform policies that actually work.”
– Martin Bernhardt, Director of Access Accelerated
The growing NCD burden in Africa
Infectious diseases like HIV, tuberculosis and malaria have long been the biggest public health challenges in low- and middle-income countries (LMICs), but over the past decade NCDs have risen at an alarming rate. In Africa, the total number of people living with diabetes is predicted to more than double to 55 million by 2045. Deaths on the continent from tobacco-related diseases like lung cancer and cardiovascular diseases have increased by 70 percent in the past three decades.
The growing NCD burden in LMICs is largely due to increases in risk factors – urbanization, tobacco, alcohol, ultra-processed food, air pollution and a lack of physical activity – and is exacerbated by fragile health systems. Today, 70 percent of all deaths in LMICs are due to NCDs. Funding for NCDs has not reflected this drastic rise, and only 1-2 percent of global health funding supports NCD care. But many LMICs in Africa and around the world are taking domestic action or forming innovative partnerships to combat the world’s leading cause of death and disability.
Gaining a seat at the table in Kenya
The NCD Alliance, an Access Accelerated partner, provides examples of meaningfully involving people living with NCDs to facilitate change. It often starts with supporting individuals with the skills they need to be effective advocates and spokespeople. Following training opportunities in Kenya, exposure to advocacy experiences and leveraging the national NCD Alliance’s role as Co-Chair of the Kenyan Ministry of Health’s Intersectoral Coordination Committee on NCDs, representatives of people living with NCDs had the opportunity to share their experiences with decision-makers. As a result, they gained a permanent seat in the Technical Working Group for the development of the new National Strategic Plan for Prevention and Control of NCDs 2020/21– 2025/26, which explicitly considers patients’ experiences and priorities.
People Living with NCDs calls for Ghana’s leaders to respond
Ghana has its own Advocacy Agenda of People Living with NCDs, which gathered recommendations for better prevention and treatment from over 100 people living with NCDs, during a two-day workshop, supported by the partnership between the NCD Alliance and Access Accelerated.
“This Advocacy Agenda serves to strengthen the NCD response at national, regional and local levels,” says NCD Alliance CEO Katie Dain. “It is a compass for civil society and people living with NCDs to demand action from decision makers, urge them to meet global and national NCD commitments, and to put people first.”
Since the launch of the Ghana Advocacy Agenda in 2019 and with the voices of people living with NCDs as its very center, the Ghana NCD Alliance (GhNCDA) has leveraged it as a community mobilization and advocacy tool.
“The Ghana Advocacy Agenda has formed the foundation for the Ghana NCD Alliance’s call for stronger NCD prevention and control in the country, higher taxes on unhealthy commodities to fund the National Health Insurance Scheme and integration of NCDs in UHC frameworks,” says Mr. Christopher Agbega of the Ghana NCD Alliance.
Building off this previous work, Ghana recently launched its Policy & Strategic Plan for the Prevention and Control of NCDs (2022-2026), which presents a framework to guide the implementation of NCD prevention and control interventions in the country. Informed by its network of people living with NCDs, the GhNCDA provided civil society perspectives in the development of both key documents that were launched at a National Strategic Roundtable on Non-Communicable Diseases hosted by the Ghanaian Ministry of Health this past April.
Speaking at the launch, the World Health Organization’s Africa Regional Director, Dr. Matshidiso Moeti, stressed the requirements for successful implementation, including sustainable financing, addressing social determinants and NCD risk factors, multisectoral action and centering people and communities.
Such partner projects are helping to ensure that people living with NCDs have a place at the table and, importantly, that they are supported and have the skills to leverage their lived experiences. In 2021 alone, Access Accelerated partner projects documented close to 20 interactions between people living with NCDs and high-level decision-making authorities, and a total of 136 policy changes, highlighting that sustainable change starts with empowering people and patients.