I chaired a session on nutrition with two excellent presenters, Venkat Narayan from the Rollins School at Emory University and Andres Mejia Acosta a Fellow at IDS.
NCDs are what they say they are--diseases that are not communicable. This is includes cardio vascular disease, some cancers, diabetes, some neurological conditions and mental health.
This is what we know (see slides from one of yesterday's speakers, Richard Smith, Director of United Health Chronic Disease Initiative):
- the fundamental drivers of NCDs are increasing: urbanisation, ageing, consumption of processed foods, inequality
- the global burden of disease will shift rapidly from infectious disease to NCDs in the next 10-15 years, even in the poorer countries (the above graphic on the website is from the Bangladesh Matlab nutrition surveillance sites -the red shows the % of deaths caused by non communicable disease--growing very rapidly)
- NCDs rates are not related to income levels, and for some NCDs are higher in the poorest groups
- we don't have effective interventions or policies and we don't have good evidence on what works
Why is this a development issue?
- Because it is a very bad byproduct of the dominant development pathway
- Because it threatens to close off future development pathways by overburdening health systems, workforce productivity, and taking away resources from communicable diseases.
- Because it profoundly affects wellbeing and the quality of life for very long periods of life.
The neglect is possibly because:
- the "narrative" around NCDs is fragmented (undernutrition has its 1000 days), what does over nutrition have?
- it is not seen as development, rather as a disease of affluence or lifestyle choice--but this is clearly not the case as the data presented by Richard Smith yesterday show
- the limited range of cost-effective interventions, backed up by rigorous evidence, is not reassuring enough for policymakers--we need more research
- civil society is not organised around these issues--on the one hand we have the MDG type NGOs and on the other hand the non-development NGOs concerned with single issue NCDs
- NCDs are not in the MDGs--will they get into the next round?