The United Nations Interagency Task Force (UNIATF) on Noncommunicable Diseases (NCDs) held a multistakeholder forum in Bishkek, Kyrgyzstan, today to present the results of the business case on investing in the prevention and control of NCDs.
Economic analysis of the NCD epidemic
In 2016, the joint programming mission of the UNIATF to Kyrgyzstan recommended that there was a strong need to undertake an analysis of the level and benefits of investing in NCDs prevention and control in the country.
The result of this decision, a report providing an economic analysis of the NCD epidemic in Kyrgyzstan, was launched today at the forum organized by UNIATF, UNDP and WHO/Europe with the support of the Government of the Russian Federation and hosted by the Ministry of Health of Kyrgyz Republic.
The report detailed how NCDs cause almost 4% of the country’s Gross Domestic Product to be lost each year, equivalent to US$250 million, and how premature death, illness and disability from NCDs impact Kyrgyzstan’s socioeconomic development.
The findings suggest that government expenditure on health care for NCDs (US$54 million) is just the direct costs. The indirect (hidden) costs from lost productivity (absenteeism, presentism) are almost four times higher.
Multisector involvement is critical
NCDs, such as cancer, cardiovascular disease, diabetes and chronic respiratory disease, and their risk factors (tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity), are an increasing public health and development challenge in Kyrgyzstan. These diseases are responsible for 80% of all deaths in the country. Most worryingly, there is a 28% probability of dying prematurely (i.e. between age of 30 and 70 years) from NCDs in Kyrgyzstan.
The forum agreed that it is critical that sectors beyond health are involved in the national NCD response if Kyrgyzstan is to achieve the NCD-related SDG targets. Critical too, is the engagement of civil society organizations and the private sector.
“We need to create an encouraging environment for physical activity and healthy behaviours for the Kyrgyz population,” said Dr Talantbek Batiraliev, Minister of Health of Kyrgyzstan. “This requires engagement across sectors and increasing awareness about NCD risk factors among the population.”
The investment case report
“NCDs prevention and control is the key priority for the Government of Kyrgyzstan. Levels of cardio-vascular diseases keep quite high with more than 40% of population being hypertensive, each second male using tobacco, and each second drinking alcohol. Also we witness that our population doesn't care much of the levels of physical activity and healthy diets,” said Sanjar Isaev from the Social Development Department of the Government of Kyrgyzstan.
“Findings of the investment case will now be presented to the Head of State and Head of the Government of Kyrgyzstan. The results will input into the national development strategy through the 40 steps programme where we hope that two of these steps will support the NCDs agenda.”
The investment case report also estimates the return on investment in certain NCD preventive measures and the expected effect from the implementation of these cost-effective interventions in country. This investment case was developed through the One Health Tool, which utilises a model of economic damage assessment.
Mayram Mambetalieva, Head of Social Policy Department in the Minister of Finance said, “The Ministry of Finance is committed to a year-on-year increase in the rates of excise taxes on alcohol and tobacco products. This will generate additional revenue for the national budget of up to US$ 6 million a year. Accordingly, we believe that this will have a positive effect on national NCD programme financing.”
“The work of the UN Inter-Agency Task Force was instrumental in incorporating NCDs into the next cycle of UN Development Assistance Framework and into the country’s uptake on SDGs. The investment case shows what we need to focus on as we strengthen our approach to health, especially in the area of NCD control,” said Yukee Mokuo, UN Resident Coordinator a.i. and UNICEF Country Director. “Having UN agencies work together to support Kyrgyzstan is important. And I think we are on the right track. We look forward to presenting the progress we are making in Kyrgyzstan at the High level meeting on NCDs of the UN General Assembly next year.”
The Kyrgyzstan investment case was conducted thanks to financial support to WHO from the Government of the Russian Federation within the context of the WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office) as well as the joint WHO-UNDP Global Program.
“Realizing the importance of interrelating political and practical solutions at the national, regional and global levels, the Government of the Russian Federation has allocated more than US$ 1 million for the joint WHO-UNDP Global Program to intensify the multisectoral national response to NCDs, in particular helping governments quantifying the costs of NCDs.” said Vadim Chekmazov, Counsellor of the Embassy of the Russian Federation in the Kyrgyz Republic.
Scaling up national efforts on the prevention and control of NCDs
The report prioritised salt consumption, tobacco control and physical activity as most cost-effective areas to invest that in 15 years’ time will lead to a significant economic effect.
“All NCD risk factors are present in schools and among youth these days. We see pupils smoking cigarettes, drinking alcohol, consuming fast food and sugary sweetened beverages that they consider their favourite meals. The absolute majority of children are exposed to sedentary life and don't exercise much," said Abdimanap Muratov, Deputy Minister of Education. “The investment case provides an important tool to advocate for scaling up national efforts on the prevention and control of NCDs in order to make sure that we help every inhabitant of this country consume less salt and move more.”
Actions to prevent NCDs in Kyrgyzstan are relatively cheap and cost-effective. Jarno Habicht, WHO Representative in Kyrgyzstan, has emphasised that investments need to be borne across the whole of government. “This is a unique moment to learn from other regions and countries to make the right decisions,” he said.
Aliona Nickulita, UNDP Representative in Kyrgyzstan, said NCDs are not only a health problem, but a threat to the country’s socio-economic development, affecting industry, labour, cities and municipalities, environment and other sectors. She highlighted that UNDP is working closely with Parliament and a number of non-health ministries to support policy and legal frameworks that contribute to improving a healthy environment for Kyrgyzstan.
The forum was attended by the representatives of the government, minister of health, ministries of finance, economy, education, agriculture, state agencies on environment, youth and sports, representatives of civil society and academia and development partners, by the UN Resident coordinator and representatives from the seven agencies also joined the forum: Food and Agriculture Organization (FAO), United Nations Programme on HIV/AIDS (UNAIDS), United Nations Development Programme (UNDP), United Nations Children's Fund (UNICEF), United Nations Industrial Development Organization (UNIDO), the World Food Programme (WFP), and the World Health Organization (WHO) at all levels (global, European Regional Office and Country Office).