Health economists from all corners of the world came to Geneva to be updated on the latest methodologies for conducting national investment cases on noncommunicable diseases (NCDs). The week-long meeting was financially supported by the government of the Russian Federation under the Task Force-led joint WHO-UNDP programme, Catalyzing Multisectoral Action for NCDs.
The meeting provided the opportunity for economists to master the OneHealth Tool, a web-based application that enables economists to calculate the burden of disease and understand the return on investment on a range of policy interventions. Melanie Bertram, responsible for the NCDs interventions in the OneHealth Tool and co-facilitating the training, said “Country demand for NCD economics is growing, and the capacity of the international community to respond is limited. Expanding the knowledge of health economists, and those who can use the OneHealth tool to support costing and strategic planning, to also support NCD analytics will benefit all countries in developing plans for Universal Health Coverage”.
The participants emerged themselves in the tool and other aspects of investment cases. Aashna Mehta, research associate at the Public Health Foundation of India reflects: “The training was extremely helpful in understanding the OneHealth tool as well as investment cases. The trainers were very supportive.”
“This meeting will result in an increase in the number of economists that can work with countries to develop these investment cases,” said Nick Banatvala, Head of the Task Force Secretariat, “At this point, we have multiple countries knocking on our door requesting an NCD investment case. Our capacity to respond has until now been very limited. This meeting will result in a new pool of health economists that will help us be more responsive to demands from countries.” he added.
“Just as important as the technical modelling,” said Dudley Tarlton of the UN Development Programme, “is making sure the economists know how to tailor the findings to each country’s political environment, so that the investment case recommendations have the best chance of actually being put into practice.”
Moving forward on the NCD agenda is vital – as reflected in their prominent inclusion in the 2030 Agenda for Sustainable Development. On top of the huge loss in quality of life related to NCDs, the exorbitant costs of these diseases, including often lengthy and expensive treatment and loss of breadwinners, forces millions of people into poverty annually, exacerbates inequalities and stifles development. Without progress on NCDs, the Sustainable Development Goals will not be achieved.
What are NCD investment cases?
NCD investment cases are economic and political analyses of current and potential future interventions to prevent and control noncommunicable diseases in a particular country. The aim is to identify priority areas of action, and quantify the benefits of action and the costs of inaction. A case for investment, in the sense employed here, incorporates both economic and political perspectives, thereby ensuring that the recommendations are made in the context of a country’s institutional capacities and political environment.
The purpose of the NCD investment case is to support governments to develop compelling arguments for scaled-up, prioritized and coherent investments in NCD prevention and control. There are two major components of the investment case, an economic and a political economy component; respectively, they are quantitative- and qualitative-based exercises.
A return on investment analysis constitutes the economic component. It quantitatively evaluates the potential returns to implementing a set of country-specific priority interventions, as well as defining the costs of inaction (baseline or business as usual). These interventions are either specified in a national plan of action on NCDs, or derived from the full set of 88 cost-effective actions defined in the WHO Global Action Plan on the Prevention and Control of NCDs.
The economic component is complemented by an institutional and context analysis (ICA) component to help understand the diverse range of institutions, actors and stakeholders that effect NCD-related policy in a given country. The ICA provides recommendations to help ensure that the numbers, narratives and policy options emerging from the economic modelling are heard, understood and acted upon.
National NCD investment cases are context-specific and rely on significant inputs from national experts and, where available, local data in order to ensure a tailored and compelling case is developed. Of course, not all countries have access to the same data, nor the same local capacities and expertise. The result is that the exact approach for undertaking each investment case will vary from country to country.
The reports written for the investment cases in Mongolia and Kyrgyzstan are examples of how the investment case work is tailored to country specific needs.