WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
United Nations Development Programme, New York, New York, USA.
BMJ Glob Health. 2024 Apr 10;9(4):e014784. doi: 10.1136/bmjgh-2023-014784.
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.
非传染性疾病（NCDs）是全球主要的健康和发展挑战。自 2015 年以来，世界卫生组织（世卫组织）和联合国开发计划署（开发计划署）一直支持各国政府制定国家非传染性疾病投资计划，以说明非传染性疾病的社会经济层面。为评估投资计划的影响，于 2022 年 7 月至 10 月期间，与世卫组织建议预防和管理非传染性疾病措施的投资回报以及非传染性疾病应对的政治层面相关的信息。虽然没有一个国家实施了其投资计划报告中提出的所有建议，但已确定了投资计划所产生的行动和政策变化，这些变化涉及以下方面：(1) 治理；(2) 融资；以及 (3) 卫生服务获取和提供。这些变化的途径包括：(1) 政府各部和合作伙伴之间更紧密的协作；(2) 倡导预防和控制非传染性疾病；(3) 在国家拥有的数据和证据基础上开展工作；(4) 在卫生和财政部门之间发展相互接受的“语言”；以及 (5) 通过将行动框定为投资而不是成本，提高对非传染性疾病的重视程度。评估还确定了投资计划实施方面的障碍，包括一些私营部门实体对卫生部门以外部门的影响、COVID-19 大流行的影响以及高级政治和技术政府官员的变动。结果表明，国家非传染性疾病投资计划可通过加强治理、融资以及卫生服务获取和提供，有力推动非传染性疾病的预防和控制工作。
