Intended for healthcare professionals

Analysis Solutions for Prevention and Control of Non-communicable Diseases

Using economic evidence to support policy decisions to fund interventions for non-communicable diseases

BMJ 2019; 365 doi: (Published 20 May 2019) Cite this as: BMJ 2019;365:l1648

This article has a correction. Please see:

  1. Melanie Bertram, technical officer1,
  2. Nick Banatvala, head of secretariat1,
  3. Alexey Kulikov, external, relations officer1,
  4. Itziar Belausteguigoitia, NCD economist2,
  5. Rosa Sandoval, adviser, tobacco control2,
  6. Anselm Hennis, director2,
  7. Douglas Webb, team leader3,
  8. Dudley Tarlton, programme specialist3
  1. 1United Nations Inter-Agency Task Force on the Prevention and Control of Non-communicable Diseases,World Health Organization, Geneva, Switzerland
  2. 2Department of Non-CommunicableDiseases, Pan American Health Organization, Washington, DC, USA
  3. 3Health and Innovative Financing, HIV Health and Development Group, UN Development Programme, New York, USA
  1. Correspondence to: M Bertram Bertramm{at}

Economic analysis of interventions to reduce non-communicable diseases can encourage countries to increase investment, say Melanie Bertram and colleagues

The global burden of non-communicable diseases (NCDs) is rising, and financing needs in low and middle income countries are increasing rapidly. This has led to a growing global debate about the required response and how to finance it. Current levels of investment in preventing and controlling NCDs in almost all low and middle income countries are insufficient to meet health and development targets. Global estimates suggest that investing in a set of cost effective and feasible interventions would prevent 8.1 million premature deaths and generate $350bn (£270bn; €310bn) in economic growth between 2018 and 2030.

To support low and middle income countries to make the economic case for greater domestic and international financing for NCDs, the World Health Organization and UN Development Programme are supporting countries to develop NCD investment cases, providing economic arguments on the benefits of expanding their NCD responses. Eight countries have completed investment cases and another 10 are in progress. The case for investment incorporates both economic (return-on-investment analysis for interventions) and political perspectives to ensure that the recommendations are made in the context of institutional capacities and economic and political environments. We describe the investment case work in the broader context of NCD financing along with some examples of how the investment cases have been used to support policy change in the Americas.

NCDs in the global health financing agenda

Non-communicable diseases (NCD) are responsible for around 8.5 million premature deaths a year in low and lower middle income countries, with cardiovascular disease responsible for roughly 40% of these deaths and cancer 27%.1 The economic losses associated with untreated NCDs are predicted to be $47tr over the two decades from 2010.2 Lack of political prioritisation and action for NCD prevention and …

View Full Text