Dr Samer Jabbour pursues a dual career path in medicine as a cardiologist and in public health as an associate professor at the American University of Beirut. He has worked as Director of the Department of Non-communicable Diseases and Mental Health at WHO Regional Office for the Eastern Mediterranean (EMRO) in Egypt.
In a previous blog, I discussed three challenges we face when addressing NCDs in the Eastern Mediterranean. I now take a look at the possible approaches that are needed to improve our responses to NCDs.
Tackling the key challenges
Forming an adequate response to NCDs in the Eastern Mediterranean will require health systems to be adapted so that they prioritise large-scale population prevention. We must also face the inescapable reality that doing this will require us to provide more health resources despite increasing costs.
Eastern Mediterranean countries need to get serious about implementing the regional agenda on NCDs. Where there is a will, there is a way, but implementation must be done in its entirety not in a piecemeal fashion that may render any progress slow, inadequate and, sometimes, meaningless. It is vital that we bring various Health Ministers, partners, stakeholders, and crucially the public, into the fight in meaningful and lasting ways, and monitor progress with transparency and accountability.
Mastering the tools
Every single action on NCDs will require technical competence; countries have no alternative but to master the tools of prevention and control - and these are numerous - in order for planning and implementation efforts to be successful.
Countries will face the question of “how do we do this here?” in every step, whether it’s formulating a coherent strategy or developing a realistic action plan, costing interventions, conducting essential NCD research, or reconfiguring primary care to deliver NCD interventions. Fortunately, tools for most of these interventions are available and countries can get help with these.
However, some countries grossly and consistently under-appreciate the amount of investment they must make in developing the technical competence and the mechanisms to monitor it.
Countries need not go at it alone
Forming an adequate response to NCDs can be overwhelming for any country. A major advantage of the progress in tackling NCDs is that tremendous experiences have accumulated in tackling NCDs upon which countries can readily draw. While a country’s response to NCDs needs to be unique, it can still learn immensely from what other countries have done. Innovations and evidence-based solutions are now documented in countries big and small, high, middle- and low-income. Countries can access these experiences and get help, which is cheap compared to the cost of inaction or going blindly, to adopt or adapt what might work or reject what seems unworthy. The World Health Organization (WHO), has been leading the global work on NCDs since the adoption of the WHO global strategy on NCDs in 2000 and they provide a useful platform for countries seriously interested in moving forward to get help.
But not going at it alone is more than getting technical help. For some low- and low-middle income countries, especially those ravaged by war, instability or economic downturn, health spending is inadequate to meet the demand for NCD prevention and control. With television adverts promoting fast foods reaching almost all countries in the region and low tobacco taxes in one country undermining tobacco efforts in a neighbouring country, all countries across the Eastern Mediterranean region will benefit from standing together in solidarity.
Our policy framework – called NOURISHING - includes almost 300 policy actions from 100 countries, including within the Eastern Mediterranean region, to help governments worldwide create healthier food environments and reduce obesity.