Op-ed Urges New Focus on ‘Crushing Burden’ for Poorest Billion

Posted on Feb 1, 2019

Partners In Health staff and video producer David Murdock (last in line) walk across a hillside in Mirebalais, Haiti, in February 2018, to the home of Adolphe Joseph, a 17-year-old Type 1 Diabetes patient enrolled in the pediatric NCDs program for Zanmi Lasante, as PIH is known in Haiti. The director of PIH's NCD Synergies program is calling for a heightened focus on care for children and young adults who are battling NCDs while also facing extreme poverty. Photo by Leslie Friday/Partners In Health

The director of Partners In Health’s NCD Synergies program is calling for a dramatically overhauled approach to cancer, heart disease, mental illness, and other non-communicable diseases, saying in a Bangkok Post op-ed that detection and treatment have “largely failed to reflect the experience” of the world’s poorest, jeopardizing efforts to achieve universal health coverage and leaving countless people without care. 

“NCDs have long been a crushing burden for children and young adults living in extreme poverty in rural Sub-Saharan Africa and South Asia: hundreds of thousands will die each year before the age of 40 from an NCD,” Dr. Gene Bukhman writes in the Wednesday op-ed, co-authored with Dr. Gina Agiostratidou of the Helmsley Charitable Trust. 

“In addition, the out-of-pocket expenses necessary for treatment can be catastrophic for families already living on next to nothing,” they continue. “And that's if these conditions are diagnosed at all, which is far from guaranteed.” 

Bukhman helped launch NCD Synergies in 2013, and in 2016 became a co-chair of the Lancet Commission on Reframing NCDs and Injuries for the Poorest Billion. Agiostratidou is the director of Helmsley’s Type 1 Diabetes Program. Their op-ed coincides with the 2019 Prince Mahidol Award Conference, held this week in Thailand’s capital and focusing on the political economy of NCDs, which kill an estimated 41 million people a year globally. 

Despite that alarming rate, they write, “NCDs among the poorest billion have gone under the radar of the global health community,” particularly regarding young patients.

“Childhood conditions among the poorest billion, such as type 1 diabetes, rheumatic heart disease, or sickle cell anemia, often have genetic, infectious, or environmental determinants,” they write. “Because these NCDs are diverse and relatively uncommon, they have so far failed to garner needed health policy attention: they don't easily fit into a traditional public health agenda, structured around highly standardized approaches to preventing disease or minimizing risks. 

“Now is the time for that to change.”

Bukhman and Agiostratidou lay out a three-pronged approach to revamping NCD policies, including: a greater focus on the world’s poorest, research on integrating health care delivery for non-communicable diseases and injuries, and partnerships to boost financing and integrated solutions. 

Read the full op-ed, here.
 

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