If anything great or lasting is going to be achieved, cooperation is needed.
– A quote overheard at this conference and attributed to Sir George Alleyene
The Global Health Conference 2011, “Securing a Healthier Future for a Changing World,” which started yesterday in Washington D.C., deserves kudos for choosing to focus on non-communicable diseases (NCD), serving an important role in the lead-up to the UN Summit on NCDs on September 19 and 20, 2011. The first full day of the conference was rich with knowledge, insight, and highly engaging discussions on NCDs. The session that most stood out for us at Arogya World was the evening session on the global economic burden of NCDs and opportunities for action.
Many excellent points were made throughout the day.
Health is a Human Right
It’s energizing to hear so many people talk about health as a human right. This is so important and the dialogue is moving in the right direction. Srinath Reddy, who serves on Arogya World’s Indo-US Scientific Steering Committee, articulated something most important: He emphasized that while there is a need for both policy changes and a need for individual behavior change, it is policy changes that would have the most impact in a shorter time frame.
- Felicia Knaul: “The opportunity to survive should not be defined by income, yet it is.” Knaul spoke about a 10-90 gap in cancer mortality. In a developed country like Canada, 10% of those diagnosed with a particular cancer would die, but in the poorest countries, 90% with the same disease would die.
- Jeffrey Sturchio: “Global health is about social justice, everybody should have a right to health.”
- Francis Omaswa: “Poor people score health as the number one reason for their poverty.” And “Poor people are weak politically, they lack the necessary influence.”
- Srinath Reddy: “Science is sterile without social relevance, but policy will fall on clay feet without a strong science foundation… India’s public spending on health is just 1% with 75-80% being out of pocket. 40 million people slip into poverty each year in India from NCDs.”
By far, the most memorable remarks of the day were from a session on multisectoral partnerships in response to a question from Ann Keeling of the NCD Alliance on why there is no moral outrage against NCDs. Sir George Alleyene said that NCDs are an egregious manifestation of social injustice because there is no access in poor countries to early diagnosis, essential medicines and that people who get NCDs die painfully. These are perceived as lifestyle diseases and diseases of the rich, and we have failed to sufficiently emphasize the critical importance of the first 1000 days of life in determining health trajectories.
The Enormous Cost of Inaction
The evening session on economic costs of NCDs was particularly enlightening. David Bloom from the Harvard School of Public Health shared some explosive facts from preliminary analysis of a study funded by the World Economic Forum. Bloom said that “NCDs are a colossal impediment to poverty alleviation,” noting that the medical costs of treating five is in the range of 31 trillion dollars over 25 years from 2005 to 2030. While the exact cost of inaction is being calculated, it is likely to be formidable. The cost of action – implementing a package of public health interventions – is likely to be several orders of magnitude less. We are wrapping our heads around these numbers, but these analyses are timely and we congratulate the WEF and WHO for investing in these studies, which will inform the UN Outcomes document.
In addition, Julio Frenk, who said “We are grossly underinvesting in health today,” had some thoughtful reactions to these cost revelations, and suggested that options for action must not only be cost-effective, but should also have social and personal benefit. For example, pain medicines are important to those living with NCDs, even though they may not be technically cost-effective interventions.