After major progress achieved globally in the control of communicable diseases, noncommunicable diseases (NCDs) are today the world’s largest killers. NCDs (namely cardiovascular diseases, cancers, chronic respiratory diseases and diabetes) cause an estimated 38 million deaths every year, with a large part of these deaths being premature (i.e. before the age of 70 years).
NCDs not only affect people’s health but they also negatively impact the socioeconomic development of countries by increasing the financial burden on the health system and through the loss of productivity of people who get ill or die too early. Sadly, 85% of premature deaths due to NCDs occur in low- and middle-income countries, where resources are already scarce. Premature deaths from NCDs are largely caused by modifiable risk factors including tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. In Uganda, 33% of total deaths are due to NCDs and for every Ugandan citizen, the probability of dying prematurely from one of the four main NCDs is 22%.
We have to streamline our support to NCDs with clear targets in the next UN Sustainable Development Framework 2020–2025 El Khidir Daloum, UN acting Resident Coordinator Uganda | Although tobacco smoking has been declining in Uganda, 15% of men and 3% of women still use tobacco products. Alcohol use is another NCD risk factor with relatively high prevalence in Uganda. Unhealthy diet and insufficient physical activity are all increasing problems in Uganda and the prevalence of overweight and obesity has been on the rise over recent years. Nearly one fifth of adults have raised blood pressure, and about 3% have diabetes. Furthermore, Uganda is one of the countries with the highest rates of fatalities due to road traffic accidents, with an estimated 29 deaths per 100 000 population in 2016. |
NCDs and their risk factors are closely tied to social, economic, environmental, legal and commercial factors, and must therefore be tackled by multiple sectors. Ministries of education, health, finance, trade, industry, agriculture and communication all have their say in building up a national whole-of-Government and whole-of society response to NCDs.
The UN Joint Programming Mission was carried out in Uganda in the week commening 2 December 2019 by seven UN Agencies – UNDP, FAO, UNAIDS, WFP, IDLO, World Bank and WHO – and coordinated by the UN Interagency Task Force on NCDs (UNIATF), in close collaboration with the WHO Uganda Country Office.
The mission identified entry points for scaling up action on the NCD-related Sustainable Development Goals (SDGs) across the Government, the UN system, national and international development partners, the civil society and academia. Preliminary results from the consultations with key ministries – health, finance, education, gender, labour and social development – as well as with civil society organizations and representatives from the academia, showed the state of national response to the challenge of NCDs in Uganda.
Uganda is already demonstrating significant commitment for action on prevention and control of NCDs. Examples include the 2015 Tobacco Control Act, which fulfils Uganda’s obligations to the WHO Framework Convention on Tobacco Control (FCTC). Prohibition of smoking in public places, total ban on tobacco advertising and promotion, and prohibition of interactions with the tobacco industry, are some of the key elements that will most likely impact the consumption of tobacco products in the country. Another example of Uganda’s strong commitment in tackling NCDs is the recent launch of the Presidential Initiative on Healthy Eating and Healthy Lifestyle. Earlier this year, His Excellency President Yoweri Kaguta Museveni called on all Ugandans to take responsibility for their health by adopting healthy lifestyles and launched a set of recommendations specifically addressing the food environment and choices of the Ugandan population.
However, the Mission identified the need to push forward the establishment and operationalization of the NCD National Coordination Mechanism, to overcome challenges in the implementation of the NCD agenda through whole-of-Government and whole-of-society approaches.
The mission also collected data for the development of an NCD investment case. NCD investment cases are designed to help countries understand the real cost of NCDs and the need to invest in their prevention and control. Implementation of a set of highly cost-effective interventions (WHO “best buys”) has significant positive impact on the economy and health of the population in all countries. The analysis for the investment case is performed through the WHO OneHealth Tool, an epidemiology-based population model developed by United Nations partners to enable strategic planning and costing of interventions and projection of the health benefits expected from their implementation. | We need to know how much is being spent on NCDs and what the burden is, in order to advocate to more effective actions Honourable Dr Jane Ruth Acheng Minister of Health |
Preliminary results from the investment case identified the need for developing sustainable financing mechanisms for the health system response to NCDs, including the adoption of health taxes. Taxes on unhealthy products have the double result of reducing consumption of alcohol, tobacco and sugar sweetened beverages, for instance, and of raising additional revenues, which can be used for health promotion initiatives. The investment case explores this and other innovative and sustainable financing mechanisms to accelerate progress towards the achievement of the SDG target 3.4.
Investing in prevention and control of NCDs will contribute to both the population's wellbeing and the country's economic development through decreasing the social and economic losses associated with NCDs.