ancially, medical products and staff salaries comprise the largest portion of the health budget. Lastly, delivery of health services will express the effectiveness of the health system.
Development of health systems, responsive to the challenges of the prevention and control of NCDs, is the priority in almost all countries. Today, many developing countries face a double burden of communicable and non-communicable diseases, added with the economic and social burden of these conditions. Oftentimes, co-morbidities or combinations of several diseases disproportionately affect those most vulnerable. This will be particularly challenging in countries with weak health systems characterised by fragmentation of healthcare services, competing programmes, disproportionate focus on specialist curative care, health commercialisation in poorly regulated systems and so forth. As we see the complexity of the overall picture, what will be the solution?
It is obvious that countries faced with these challenges would want or need a rapid response in tackling NCDs. However, a long-term view with clear and logical steps is crucial for the sustainability of action going into the future. The first step is the inclusion of management of NCDs and co-morbidities in national health plans and strategies. This will ensure government’s commitment and relevant budget allocation. The second step is to find ways of integrating services across health system functions whenever possible, while using existing platforms or developing new ones. The third step is to strengthen community and primary care services through the gradual integration of all health programmes. Together, these actions will open a window of opportunity for universal coverage in regards to prevention and control of NCDs.
The role of donors is crucial in the journey of combatting NCDs, as this is otherwise a huge and daunting task for any single government in resource-limited settings. Needless to say, it is best to avoid fragmentation of health services and competing projects which do not guarantee sustainability. Therefore, governments should be in charge of coordinating all donor efforts in an organised and effective manner towards the common goal of securing the population’s health. Most importantly, it is crucial to understand that the sole commitment of outside funding or well-planned programmes is not enough in this battle unless governments are willing to cooperate and committed to act.