Global action will stem silent killer

A health worker draws a blood sample from a resident to test for diabetes during a free medical camp at Kabiruini Catholic Church, Nyeri County, on February 25, 2018. PHOTO | FILE | NATION MEDIA GROUP

What you need to know:

  • The epidemic of non-communicable diseases and mental disorders are likely to escalate.
  • People with severe mental disorders are far more likely to smoke or have diabetes than the general population.

While the return of Ebola to the Democratic Republic of Congo (DRC) captured media attention around the world, a global epidemic responsible for 15 million premature deaths every year remains largely ignored.

Cancer, diabetes, heart disease and lung disease — the four main types of non-communicable diseases (NCDs) — the world’s top killers.

They are responsible for 41 million deaths every year, often after long hospitalisations and costly treatment, putting pressure on fragile health systems.

And since mental health problems increase the risk of these chronic diseases and vice versa; a comprehensive strategy must involve tackling both.

While an estimated 106,000 people die yearly from these chronic diseases in Kenya, the epidemic of NCDs and mental disorders are likely to escalate.


In response to the threat posed to both people and health systems, the World Health Organisation’s Independent High-Level Commission on NCDs has published its report outlining how to boost political leadership, increase financing and ensure accountability for progress in beating NCDs.

The commission — made up of political leaders, experts and civil society representatives — calls for national leaders and the WHO to prioritise these diseases politically, technically and financially.

To ensure the WHO can provide the needed technical support to countries, it is critical that they have the financing to respond to the growing epidemic of NCDs as well as continue to tackle infectious diseases such as tuberculosis (TB), HIV and malaria and respond to new disease outbreaks.

To facilitate the needed fundraising for the NCDs cause, the report explores establishing a Global Solidarity Tobacco and Alcohol Contribution and a multi-donor trust fund.


The commission also covers the root causes of NCDs, giving fresh emphasis to the escalating and largely unchecked challenges of tobacco use, harmful use of alcohol, obesity and air pollution.

For example, obesity has been one of the drivers behind the explosion of cancer, type 2 diabetes and heart disease in low- and middle-income countries over the past decade.

People with severe mental disorders are far more likely to smoke or have diabetes than the general population. Air pollution alone kills seven million people yearly.

Recognising that many of the drivers of the NCDs epidemic fall outside the remit of ministries of health, the commission calls for heads of state to lead whole-of-government responses to the diseases.

Concerned not just with examining the origins of the NCDs problem but also generating novel solutions, the commission has learned from successes in reducing maternal and child mortality, achieved in part through holding national governments accountable.


It recommends an annual scorecard for these killer diseases to monitor progress and allow for course-correction towards the Sustainable Development Goal (SDG) target of reducing premature NCD deaths by a third by 2030.

But plans and strategies mean little without the implementers. The commission recommends empowering health workforce, including nurses and community health workers, and strengthening primary health services to better incorporate prevention and treatment of chronic diseases and mental disorders.

Committed to rallying allies beyond healthcare professionals, the report encourages constructive engagement with the private sector, where appropriate, with vested interests managed and undue influence guarded against — amongst other precautions.

It also recommends that governments increase regulations — provided they are effective — and calls on the WHO to develop a code of conduct restricting marketing of unhealthy products that contain excessive sugar, sodium, saturated fats and trans fats.


These calls to action come at a key time. Since the turn of the Millennium, there has been nowhere near enough progress on stopping the global epidemic of NCDs and mental disorders.

An opportunity is coming up in the form of the High-Level Meeting on NCDs during the UN General Assembly in September, where all states are set to demonstrate their willingness to engage with the thorny, entrenched problems that have come to define the 21st Century.

The states will also align themselves with the view that human capital holds equal, if not greater, weight to economic growth.

Political and health leaders must firefight the slow-burning crisis of NCDs with the urgency of a global pandemic. We have an opportunity to save millions of lives; so, let’s stop talking and start delivering.

Ms Kariuki is the Cabinet secretary for Health. [email protected]