These conditions account for over a third of the burden of disease among the poorest, including almost 800,000 deaths annually among those aged under 40 years, and killing more people than HIV, tuberculosis and maternal deaths combined.

Forgotten diseases have hit the poorest billion the hardest during the Covid-19 pandemic, according to a new Lancet Commission report. It says that for the first time, non-communicable diseases and injuries (NCDIs) caused more deaths and disability at every age among the world’s poorest billion than in wealthy countries.

These conditions account for over a third of the burden of disease among the poorest, including almost 800,000 deaths annually among those aged under 40 years, and killing more people than HIV, tuberculosis and maternal deaths combined.

Among the poorest billion, people with a diverse set of severe NCDs – such as Type 1 diabetes, rheumatic and congenital heart disease, and paediatric cancers – live 20 fewer healthy years than in high-income countries. Yet less than $100 million – or just 0.3% of development assistance for health – is allocated to NCDIs among countries that are home to the poorest.

Progressive implementation of affordable, cost-effective, and equitable NCDI interventions between 2020 and 2030 could save the lives of over 4.6 million of the world’s poorest.

“No disease should be a death sentence in one country but treatable, preventable or curable in another. Universal health coverage is unobtainable unless the global health community broadens geographies and conditions covered by action on non-communicable diseases,” said Lancet NCDI Poverty Commission co-chair Ana Mocumbi, from Universidade Eduardo Mondlane and Instituto Nacional de Saúde in Mozambique.

“Even before the pandemic started, low-income countries did not have the resources to deliver a truly comprehensive set of public health services,” said Chelsea Clinton, commissioner, Clinton Foundation.

The commission has helped to establish National NCDI Poverty Commissions, groups, and consortia in 16 countries that are doing analyses and identifying pro-poor priorities based on the best locally available data. India is one of the 16 countries that have organized these national commissions as of August 2020, according to the report.

It says India spends only 1·1% of its gross domestic product (GDP) on health, putting it at the low end of countries ranked by public investment in health care. Estimates based on local and central government budgets indicate that slightly more than one-fourth of total health expenditure targets NCDIs, and about four-fifths of this expenditure takes place at the state level.

“Managing non-communicable diseases is on top of the government agenda… early detection and putting patients on treatment in time is crucial in reducing the overall economic burden in the long run,” said a health ministry official.

Courtesy Hindustan times