In the midst of the global COVID-19 pandemic, it is hard to think of anything else. And yet, the burden of Non-Communicable Diseases (NCDs) — such as diabetes and hypertension — remains and continues to grow across low- and middle-income countries. Each year, NCDs kill 41 million people [13], equivalent to 71% of all deaths globally.

In Kenya, over half a million adults [14] were living with diabetes in 2019, and 40% of them were unaware of their condition. Nearly half of hospital admissions and an estimated 55% of deaths in Kenya are associated with an NCD.

Recently, a World Health Organization survey [15], completed by 155 countries in May 2020, confirmed serious disruptions in prevention and treatment services for NCDs due to the COVID-19 pandemic, noting that low-income countries are most affected. These trends raise great concern, as people living with an NCD are heavily represented among serious cases of the virus. 

Low- and middle-income countries (LMICs) struggle to reach and sustain universal health coverage (UHC) due to limited and inefficient allocation of resources. Their health systems are strained by a dual burden—continuing to manage infectious diseases, such as HIV, TB, and malaria, while responding to the prevalence growth of noncommunicable diseases, such as diabetes and cardiovascular conditions. COVID-19 is placing even more demands on already stretched resources. Systematic priority setting through the use of health technology assessment (HTA) is part of the policy ammunition at the disposal of those making such difficult distributional calls in these settings. 

Read this blog on the CSEM website [24]

As COVID-19 infiltrates the physical, mental, social, economic and geographical landscapes we all inhabit, citizens around the world are forced to obey new national laws and policies on social isolation, lockdowns, and movement restrictions.

For some groups of particularly vulnerable people - the elderly, disabled, those suffering from physical and mental ill-health or those at risk of violence and abuse - the restrictive measures have a significant and negative effect. These people’s health and wellbeing, in all senses, are being corroded. In some cases, people are in extremely threatening and deadly situations.

So who is making these decisions on isolation and lockdowns? How do their judgments take into consideration the wider impact on the population and the secondary effects of these restrictions, especially on vulnerable people? We, a group of colleagues working on universal health coverage, decided to do a rapid analysis of 24 national COVID-19 Taskforces to identify their composition and investigate their decision-making processes. What we found out was shocking.

This article was originally published in NextBillion [28].

What does scalable innovation in global health look like?

It could be a piece of software that provides faster access to blood supplies in Cameroon, an m-health platform that links virtual health coaches to people facing chronic illness in Nigeria, or an app that lets people use points to buy and exchange health products in Senegal, helping them save for out-of-pocket expenses. Or it might be a primary care service that reaches underserved people in India via telemedicine, or a microscope app that can diagnose breast and cervical cancers in remote areas in sub-Saharan Africa, where some 400,000 women die each year because they cannot access screening services.

This story was originally published by Global Health Now [32]

It was January of 1925, and Nome’s children were dying. Diphtheria had struck the Alaskan town, but the curative serum the local doctor needed was in Nenana, nearly 700 miles away.

Sub-zero temperatures meant that shipping the serum by air was not an option, so the governor turned to sled dog teams, which had delivered mail on that route. Over 5 and 1/2 days, 20 mush teams and their human drivers set up a relay and delivered the lifesaving medicine, a trek known as the “Great Race of Mercy”—now commemorated every year in an event called the Iditarod.

The moral: Get help when you need it, no matter how unorthodox.

We need to employ that strategy in global health development by integrating private sector organizations into our health system solutions more often. They operate where governments cannot and are a rich source of flexibility and innovation. When a country’s government is frozen by conflict, natural disasters, financial crisis, or another crippling event, its health care system is all too likely to follow. Health workers flee or fall victim themselves, and hospitals run out of medicine and go dark. Others must step in to fill the void.

When community health programs are well-designed, managed, and sufficiently funded, they can yield substantial health and economic benefits. In addition to contributing to a healthier, more productive population, they can reduce the risk of costly epidemics while generating substantial cost savings for families and health systems (1). On the other hand, when poorly designed or managed and insufficiently funded, community health programs can fail to improve poor health outcomes and advance national health priorities.

Recognizing their potential in strengthening primary care and advancing Universal Health Coverage [36], countries are increasingly formalizing the role of the community health worker within their health systems. In fact, many countries have passed national community health policies to ensure that community health workers (CHWs) are well trained, incentivized, and equipped to provide a basic package of life-saving services within their communities.

Related

Community Health Planning and Costing Tool [37]

By Amy Lieberman [44], Jenny Lei Ravelo [45]

This story was originally published by Devex [46]

The onus to help everyone — including the most marginalized — secure universal health care coverage will likely depend more on individual government spending than on new foreign assistance, experts say.

Funding will be a critical, but not guaranteed, element in the forthcoming universal health coverage agreement governments will sign in September during the opening of the U.N. General Assembly session.

“Aid is not going to help achieve the global health goals. It has to come from domestic spending. But aid is very important for purposes of equity and that the poor do not get left behind.”— Jacob Hughes, senior director of health systems, Management Sciences for Health

This article was originally published by Global Health Now [49].

Paid or volunteer?

Community health workers are on the frontlines in many countries—and vital to achieving universal health coverage. Yet the public health community has not reached a consensus on which model is the best.

Consensus is urgently needed, both at the global and country levels, to inform future policies and strategies for strengthening health systems and delivering on UHC.

Based on our experiences in rural Peru and Ethiopia, it’s not either-or. It’s both.

Full-time, paid CHWs form the backbone of family- and community-based services, but there aren’t enough to reach all families. We envision teams of government-paid, full-time CHWs providing comprehensive services to a given population, with a primary health center hub as the base of operations. Each CHW, in turn, would lead a team of part-time community health volunteers providing limited health education and referral services—such as maternal and newborn health, nutrition, hygiene, tuberculosis, malaria, and HIV/AIDS—to a small number of neighboring families.