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. 2024 Apr 10;9(4):e014784.
doi: 10.1136/bmjgh-2023-014784.

The reported impact of non-communicable disease investment cases in 13 countries

Giuseppe Troisi  1 , Roy Small  2 , Roman Chestnov  3 , Diana Andreasyan  4 , Henrik Khachatryan  5 , Erwin Arthur Phillips  6 , Taraleen Malcolm  7 , Hero Kol  8 , Nargiza Khodjaeva  9 , Mussie Gebremichael  10 , Addisu Worku Tessema  11 , Asmamaw Bezabeh Workneh  12 , Tamu Davidson  13 , Michelle Harris  7 , Nurgul Ibraeva  14 , Aigul Nurmatova  15 , Aliina Altymysheva  16 , John Juliard Go  17 , Anna Kontsevaya  18 , Krisada Hanbunjerd  19 , Sushera Bunluesin  20 , Olivia Nieveras  20 , Banu Ekinci  21 , Bekir Keskinkiliç  21 , Toker Erguder  22 , Oyoo Charles Akiya  23 , Hafisa Kasule  24 , Aidah Nakanjako  25 , Shukhrat Shukurov  26 , Nazokat Kasymova  27 , Patrick Banda  28 , Ernest Kakoma  28 , Nathan N Bakyaita  29 , Alexey Kulikov  30 , Dudley Tarlton  31 , Nadia Putoud  32 , Scott Chiossi  30 , Douglas Webb  33 , Nicholas Banatvala  30
Affiliations

The reported impact of non-communicable disease investment cases in 13 countries

Giuseppe Troisi et al. BMJ Glob Health. .

Abstract

Non-communicable diseases (NCDs) are a leading health and development challenge worldwide. Since 2015, WHO and the United Nations Development Programme have provided support to governments to develop national NCD investment cases to describe the socioeconomic dimensions of NCDs. To assess the impact of the investment cases, semistructured interviews and a structured process for gathering written feedback were conducted between July and October 2022 with key informants in 13 countries who had developed a national NCD investment case between 2015 and 2020. Investment cases describe: (1) the social and economic costs of NCDs, including their distribution and projections over time; (2) priority areas for scaled up action; (3) the cost and returns from investing in WHO-recommended measures to prevent and manage NCDs; and (4) the political dimensions of NCD responses. While no country had implemented all the recommendations set out in their investment case reports, actions and policy changes attributable to the investment cases were identified, across (1) governance; (2) financing; and (3) health service access and delivery. The pathways of these changes included: (1) stronger collaboration across government ministries and partners; (2) advocacy for NCD prevention and control; (3) grounding efforts in nationally owned data and evidence; (4) developing mutually embraced 'language' across health and finance; and (5) elevating the priority accorded to NCDs, by framing action as an investment rather than a cost. The assessment also identified barriers to progress on the investment case implementation, including the influence of some private sector entities on sectors other than health, the impact of the COVID-19 pandemic, and changes in senior political and technical government officials. The results suggest that national NCD investment cases can significantly contribute to catalysing the prevention and control of NCDs through strengthening governance, financing, and health service access and delivery.

Keywords: global health; health economics; health education and promotion; health policy; prevention strategies.

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Conflict of interest statement

Competing interests: None declared.

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