What’s the US Government doing to combat the global tsunami of chronic disease?

Noncommunicable diseases (NCDs), conditions like heart disease, cancers, and type 2 diabetes, aren’t confined to wealthy countries. Fueling this tsunami, which now accounts for roughly 6 times as many deaths—or 38 million—globally as major infectious diseases such as HIV/AIDS, malaria, and tuberculosis combined, is (in part) the widespread adoption of unhealthy behaviors, such as smoking, physical inactivity, and poor diets.

Aside from the overwhelming health burden, these conditions and risk factors (which often includes overweight and obesity) pose a monumental economic challenge, both from direct health care costs, as well as lost productivity and stymied economic output. A well-known, often-cited 2011 study by Harvard and the World Economic Forum puts the global price tag at $47 trillion.

The question is now what are governments, companies, NGOs and other stakeholders doing about it?

The 2011 UN High Level Meeting on NCDs sparked an elevated interest by governments around the world to address the issue. They also committed to take action, mostly because there is broad recognition that current public and private investments in NCDs is hugely mismatched with the burden of the challenge (i.e. the global burden of NCDs).

To be fair, the private sector has stepped up to the plate in many ways. Many have instituted wellness policies and programs, and are taking employee health and well-being more seriously, as something inextricably linked to their own health as a company.

Then there’s the public sector. As a starting point, many low- and middle-income countries are allocating more domestic resources for health. However, for those countries who contribute vast sums of money into the global health system, such as the US Government, there’s a question of how they are incorporating NCDs into its portfolio, if at all.

The US Government contributes billions of dollars each year to improve global health. It’s been a recognized leader in improving child health and curbing the burden of killer infections like HIV/AIDS, TB and malaria.

But like other governments at the 2011 UN High Level Meeting on NCDs, the US Government committed to doing its part as well. The consensus Political Declaration acknowledged, “resources devoted to combating the challenges posed by non-communicable diseases…are not commensurate with the magnitude of the problem.”

Almost 4 years since that landmark meeting, what’s the status of the US Government’s realization of this commitment?

Over the course of several months, I led an investigation for the NCD Roundtable, a coalition of organizations and companies committed to addressing global NCDs, into this exact question. Thanks to the support of the American Heart Association and LIVESTRONG Foundation, both of which sponsored the project. (You can access the full report and summary here.)

Admittedly, putting a price tag on the depth and breadth of US Government engagements and investments in global NCDs is difficult. Many of its contributions, such as policy expertise and normative leadership, is hard to monetize. Others have tried as well, which I wrote about in this previous blog, but there are always going to be limitations.

The study includes a set of 5 main findings accompanied by a series of recommendations for each. Some are broader, others are more specific and practical. But if there’s a major take-away from the study it’s this: actually, it’s a two-part take-away.

First, the USG is already doing a lot, much of which goes unnoticed because it’s difficult to quantify. But, just because something is difficult to quantify doesn’t mean it’s not important or impactful.

And second, there are several areas where the USG can do more, and it doesn’t necessarily mean spending more money. The example included in the report about the Treasury Department’s technical assistance capacity on tobacco control policy development and implementation is a case in point. These are good places to start.

This was an enlightening and fascinating project for me personally. Thank you to the people who helped shape it and contributing valuable insights. Specific names are mentioned in the report. I hope this is a helpful contribution to the community. And, as always, please feel free to leave a comment. I’d love any thoughts or feedback.


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