Multidisciplinary, sustainable solutions to address the global burden of noncommunicable diseases

Non-communicable diseases, which include diabetes, cancer, cardiovascular and respiratory diseases have emerged as the biggest challenge to health – accounting for 71% of deaths globally. The Global Burden of Disease Study in 2019 noted that non-communicable diseases (NCDs) are responsible for 63% of deaths in India. 

Apart from the health impact, NCDs also lead to immense financial loss. A World Economic Study estimates that India stands to lose up to $4.58 trillion between 2012-2030 due to NCDs. Poor families are especially vulnerable as NCDs require long-term management, and the catastrophic health expenditure pushes them further into poverty. 

NCDs pose a challenge because of their multi-factorial nature. They are a result of complex interconnected factors including individual behaviours and environment along with social determinants of health such as poverty and education. Thus, they require a nuanced, multidisciplinary approach extending beyond the health sector. 

There are successful examples of how an intersectoral approach has been leveraged in this space. India’s National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) is focussed on prevention and management of NCDs and is managed by the Ministry of health and Family Welfare (MoHFW). The Eat Right India Initiative by FSSAI promotes healthy and sustainable eating along with improving food safety practices. They partnered where The Eat Right India Initiative trained frontline health workers under the NPCDCS to create awareness on healthy eating and nutrition. Thus, the two programs run by different departments achieved success by collaborating for their common goal of healthy living. 

Tobacco consumption is a key risk for chronic diseases, and multiple government bodies collaborate by leveraging their individual strengths to create a sustainable solution. The National Tobacco Control Programme promotes tobacco-free living through awareness generation, monitoring and providing cessation services. It works closely with the Income Tax department for taxation on tobacco products as a deterrent to consumption, along with working with the Information and Broadcasting Ministry to regulate tobacco-related advertisements.

Another successful example is the Swachh Bharat Abhiyan, or the Clean India Mission, that involves participation of multiple sectors including urban development, environment, health and education. Stakeholders from diverse sectors including corporates, media, government and nonprofits collaborated to work towards a shared goal of cleanliness and sanitation through behaviour change campaigns, along with strengthening infrastructure and services. 

While a multi-sectoral approach is acknowledged as a critical component of a sustainable strategy to address the burden of NCDs, there are multiple challenges. India’s federal government system means that while health is a state subject, the central government provides technical expertise, along with financial support. This makes it challenging to coordinate between various state and central teams. Further, a multi-sectoral approach requires coordination with not just health, but also sectors including education, environment, livelihoods, climate change and so on. There is a significant cost to this, which is difficult in a resource-constrained environment like India. 

India is also a very vast country with a high-level of diversity across geographical areas and population, which adds another layer of complexity. NCDs disproportionately affect the lower socio-economic classes, who face deep-rooted and interconnected structural issues such as poor education, low income levels and unhygienic living environments. Thus, a solution for NCDs must address these issues in addition to health-related factors.

Further, NCD is an underfunded space. One requires strong support and philanthropic capital from Corporates, Institutions and Individuals to support non-profits like Arogya World who have been working in this space. 

While problems are many, there are also solutions available to address them. Technology is a great enabler, allowing information sharing and communication across multiple sectors. It can also be used to track progress and provide feedback using real-time data for improved decision making. Joint creation of policies across departments is another effective strategy to ensure alignment. Similarly, coordinated planning and implementation across sectors will improve efficiencies by maximising resources. 

There is an urgency to address the problem of NCDs and it requires an inter-sectoral approach. Thus, it is imperative that an enabling environment is created to foster these collaborations and partnerships. The successful collaboration between the Eat Right India Initiative and NDCDCS or the Swachh Bharat Abhiyan shows what is possible when we come together.