Giving Compass' Take:

• Vivekanand Jha discusses the fact that most improvements in global health have been made in the field of communicable diseases. When it comes to building a framework for long-term primary care, chronic noncommunicable diseases must be a priority, but they pose many challenges. 

• How can the challenges of noncommunicable diseases be addressed with existing assets? How can philanthropy help to create new assets for addressing noncommunicable diseases? 

• Learn about the World Health Organization's plan for noncommunicable diseases.

Most discussions about healthcare delivery start by celebrating the impressive gains made in tackling infections, and reductions in maternal and childhood mortality (even though we remain behind several countries with comparable economies). There is also a general agreement, reinforced by reports of the Global Burden of Disease Study, that future threats to population health and economy will come from the rapidly growing burden of chronic non-communicable disorders. We also agree that addressing the challenges presented by these conditions requires a qualitative change in the way healthcare is delivered.

Communicable diseases announce their presence by making an individual fall ill, which makes her want to seek medical care. In contrast, non-communicable disorders generally do not produce symptoms until major complications involving important organs – like heart attack, stroke, kidney failure or blindness – develop, which is generally too late. Non-communicable disorders like high blood pressure, diabetes, and kidney disease may be discovered either during a routine health check or when she undergoes evaluation for an unrelated condition.

Competing priorities force her to the demands of daily life more seriously, and a disease that is not bothersome is ignored. Further, the main providers of healthcare are doctors, who are relatively scarce and always expensive. The need to repeatedly visit a faraway doctor for management of conditions that are likely to be present for a person’s lifetime is not a recipe for optimal sustainable care.

All stakeholders now agree that increasing penetration in care delivery for chronic noncommunicable diseases in emerging countries will require us to move away from the West’s physician-based models of healthcare delivery, which favors the relatively privileged. The democratization of this process requires us to identify resources in the community and co-opt them to improve efficiency.

Read the full article about chronic noncommunicable diseases by Vivekanand Jha at India Development Review.