Dennis Odai Laryea and Thomas B Cueni argue that, with proper safeguards, pharmaceutical companies can make an important contribution. This article is part of the Solutions for Prevention and Control of Non-communicable Diseases collection by the WHO Global Coordination Mechanism on NCDs and The BMJ

Non-communicable diseases (NCDs) are responsible for 72% of global mortality, and 78% of NCD related deaths occur in low and middle income countries. Yet less than 1.3% of development assistance is channelled to tackle this major global health and development challenge.¹

NCDs are diverse and complicated, cut across all income levels, and require a variety of skills, creative ideas, and resources to transform health systems. Although governments have a primary role in responding to the challenge of NCDs, a whole-of-government, whole-of-society approach, based on multistakeholder partnerships, is needed. We understand that there is an ongoing debate about the role of the private sector in health, especially in prevention and control of NCDs. However, distinctions should be made, as some industries promote products that contribute to the NCD epidemic whereas others contribute to the solution. We believe that working with the private sector offers one way forward, but there must be clear rules of engagement and sensitivity to avoid potential conflicts of interest.

In our view, the biopharmaceutical industry is a key partner in the fight against NCDs since treatments for cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes require access to essential medical products, vaccines, and technologies. These are recognised as some of the main building blocks of a well functioning health system.²

Beyond being seen as a supplier of products and treatments, the biopharmaceutical industry also has a role across other health system functions, developing innovations and fostering their adoption. This touches on not only the traditional supply chain but also human resources for health and the quality of health services delivered, with effects on patients, their families, and caregivers.

Multistakeholder initiatives on NCDs are gaining traction as a mechanism to not only effect change but to leverage each partner’s respective strengths.³ One example of a partnership for preventing and treating NCDs is Access Accelerated, a platform that includes over 20 biopharmaceutical companies as well as civil society organisations such as the Union for International Cancer Control, the World Heart Federation, NCD Alliance, City Cancer Challenge, PATH, and the World Bank. Together they are creating solutions to scale up national NCD responses in low and middle income countries.⁴ For example, in Ghana, Access Accelerated has engaged with people living with NCDs and worked with the national health system to conduct the WHO stepwise approach to surveillance (STEPS) survey, a standardised tool to generate country data on the prevalence of NCDs and their risk factors, to inform the national NCD policy and strategic plan.

As NCDs tend to be long term, the challenge for health systems is how to empower individuals, families, and their communities to better manage these conditions and prevent progression, instead of relying on costly hospital based services.⁵ While supporting this shift in the locus of care and the increasing focus on outcomes, the biopharmaceutical industry has been involved in several value based initiatives and new mechanisms to look beyond pricing and align incentives for both the private and the public sectors.

It is critical that the international community continues to find meaningful and innovative ways to encourage collaboration among multiple stakeholders, including governments, WHO, other UN agencies, civil society, and the private sector. The biopharmaceutical industry is essential for achieving universal health coverage and improved health outcomes. NCDs are one of the most pressing global health challenges, and working with the research based pharmaceutical industry for sustainable solutions is the way forward.

 

Dennis Odai Laryea is a senior specialist with Ghana Health Service focusing on NCD control.

 

 

 

 

Thomas B Cueni is director general of the International Federation of Pharmaceutical Manufacturers and Associations (IFMPA), which represents research based biopharmaceutical companies and regional and national associations globally. Access Accelerated is an initiative of the IFPMA.

 

 

Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

 

References

1. World Health Organization Factsheet on noncommunicable diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
2. Everybody’s business: strengthening health systems to improve health outcomes. World Health Organization. 2007. https://www.who.int/healthsystems/strategy/everybodys_business.pdf
3. Collins T, Mikkelsen B, Axelrod S. Interact, engage or partner? Working with the private sector for the prevention and control of noncommunicable diseases. Cardiovasc Diagn Ther 2019;9:158-64. doi:10.21037/cdt.2018.08.04
4. 22 biopharma companies partner and launch first-of-its-kind global initiative to address rise of non-communicable diseases. Access Accelerated. Press release, 18 Jan 2017. https://accessaccelerated.org/wp-content/uploads/2017/09/Access-Accelerated-Press-Release.pdf
5. Subramanian S, Kibachio J, Hoover S, et al. Research for actionable policies: Implementation science priorities to scale up non-communicable disease interventions in Kenya. J Glob Health 2017;7:2. doi:10.7189/jogh.07.010204