By bringing together health policy and financing, we can create a sustainable future for NCD and mental health responses. The ambition – improving outcomes for people around the world.

Last week, the World Health Organization (WHO) and the World Bank brought together health policy and finance stakeholders, including IFPMA and its members, for an International dialogue on sustainable financing for NCDs and mental health. It was encouraging to see these stakeholders come together to discuss how we include non-communicable diseases (NCDs) and mental health responses within health and financing plans.

With the UN High-Level Meeting on NCDs and Mental Health (UNHLM) taking place next year, now is the time to ensure that the global health community establishes innovative and sustainable ambitions for NCD funding at both global and national levels.

Case for change

We urgently need to come together to address the global burden of NCDs and mental health. NCDs, such as cancer, cardiovascular disease, diabetes, and respiratory disease, lead to 41 million deaths per year, equivalent to 74% of all global deaths. Mental health conditions account for 1 in 6 years lived with disability, and people with severe mental health conditions die 10 to 20 years earlier than the general population. Even more, the global burden of NCDs is growing, with 77% of deaths from NCDs occurring in low- and middle-income countries (LMICs).

Thankfully, we know there are solutions available, which have the potential to improve outcomes for people around the world. These include integrating basic NCD treatment and care into universal health coverage (UHC) benefit packages, tackling social and commercial determinants of health, addressing key modifiable risk factors, implementing the WHO Best Buys, improving access to early screening and diagnosis, and bettering access to innovative and generic pharmaceutical products targeting NCDs.

The challenge we now face is to deliver these solutions to those who need them most while managing the cost of NCDs and mental health care, which has been estimated to cost US$47 trillion between 2010-2030. Addressing this NCDs burden to societies and economies will require prompt, effective, and ongoing diagnosis, treatment, and support, as well as adequate and innovative approaches to funding. As the innovative life sciences sector, we are ready to lend our support to tackling this growing global emergency.

As a global community, when we set health policy targets without a clear understanding of how they will be funded, we often find reality lags behind our ambitions.

Time to talk funding

As a global community, when we set health policy targets without a clear understanding of how they will be funded, we often find reality lags behind our ambitions. The latest data suggests that only somewhere between 6 to 14 countries are likely to achieve SDG 3.4 on NCDs and mental health by 2030. We need to accelerate progress against our commitments, which requires getting the funding we need for NCDs.

Three key-takeaways stood out for IFPMA following last week’s NCD financing dialogue.

First, we must look beyond traditional financing models for NCDs, and bring in new expertise to help us do this. While much of the attention during the recent financing dialogue was on reducing out-of-pocket spending and domestic resource mobilization, the harsh reality is that many LMICs will continue to struggle with unlocking sufficient resourcing for NCD prevention and control. The fiscal constraints countries face is further exacerbated by infectious diseases, conflict, climate change, rapid aging, and urbanization.

A diversified financing expertise – between government departments and across stakeholders – can strengthen our ideation and execution of sustainable financing models to overcome the NCD burden. Local insights, evidence, and best practices can also encourage cross-border learning between countries and within regions.

Second, innovative funding approaches to NCD interventions do exist and can be drawn from. Pharmaceutical companies producing products for complex NCDs like cancer have been exploring new financing mechanisms, such as value-based pricing and public-private insurance schemes, for many years.

One example is the Nigeria Cancer Health Fund, which Roche supports with other private sector partners and public authorities to provide access to funding for breast, cervical, and prostate cancer treatment when health insurance coverage is lacking. Another collective effort is Access Accelerated, which brings together leading private sector life science companies to address the NCDs burden in LMICs in partnership with the World Bank. In six years, Access Accelerated has supported over 40 projects in 36 countries, helping to catalyze more than US$4 billion in health systems investment for NCDs.

Other tools that are more common in the infectious disease space, such as debt swaps, social impact bonds (SIBs), and advanced market commitments (AMCs), are also gaining traction in the NCD financing dialogue.

Third, while last week’s high-level dialogue signified an important next step for NCD financing, there is still more to be done to bolster multilateral and multistakeholder collaboration. The private sector brings a wealth of capabilities and resources to the table when it comes to developing financing solutions that go beyond the classic references to “sin taxes,” domestic resources, and overseas development assistance (ODA).

Health-enhancing stakeholders, such as the pharmaceutical industry, can play a critical role in working with others to find new ways to unlock financing from less traditional sources. Indeed, the NCD Alliance’s recent policy brief on financing solutions for NCDs acknowledged the role of private sector to help bridge the NCDs and mental health funding gap, and that the WHO and World Bank have a hand to play in creating an enabling environment for private sector contributions and initiatives.

Working toward sustainable investment in NCDs

Last week’s international dialogue allowed the global community to show up and articulate the importance of NCD financing for global health and development – and, most importantly, for people’s lives. But it was another reminder that our efforts make a more meaningful impact when we work together.

Health leaders need to be ready to support through international and domestic funding, leveraging innovative financing mechanisms and setting realistic short- to mid-term, time-bound global financing targets for NCDs and mental health. By enabling best practice sharing and facilitating a whole-of-society and cross-sectoral approach, the global health community can support local implementation that addresses the barriers to care and enables the best outcomes for people living with NCDs and their communities.

Author

• 
  Tamara Schudel Global Health and Access Chair, IFPMA and VP & Head of Global Policy, Roche