That the UN Summit on AIDS ten years ago was already a success even
during its planning stages is just one of the glaring differences between
NCDs and AIDS, or almost any other health issues with existing programs
for that matter.
From a certain perspective, the care for NCDs is generally
unexciting. Aside from some forms of cancer, there is no race for cure;
only the long, arduous, unpredictable, and often costly trek of case
management to control the conditions, and people afflicted of NCDs will
eventually die of their disease. A utilitarian versus libertarian debate
may lead one to conclude that people with NCDs will only cause further
strain on already heavily-burdened health systems and economies, thus it
is better not to care for them anymore in the hope that they will die
sooner and ease some of the burdens that they impose.
Prevention of NCDs by addressing certain risk factors as was proposed
in the NCD Alliance outcome document
(http://www.ncdalliance.org/sites/default/files/resource_files/UN%20High-...) is equally unexciting. The maximum
benefits of the efforts - decreasing prevalences of NCDs - may no longer
be reaped during the lifetime of those who will advocate, initiate and/or
fund any NCD control or prevention programs. From a business point of
view, the seeming balance between the "hand that doles out the food" with
"the hand that takes away the food" becomes lost when dealing with the
care and prevention of chronic diseases. Donors will not get a good deal
of tangible returns from their investments on NCDs; what takings would one
expect if the main strategies would be increasing physical activity and
reducing use or intake of harmful or health risk products? Compared to
AIDS, TB, or malaria to cite a few, there will probably be less
involvement of (commercially-inclined) industries who are usually tapped
to deliver a number of goods related to these disease programs and to
embark on related researches which in turn may produce more marketable
goods. Conversely, commercial industries might suffer from profit losses
if the calls for reformulation, higher taxes and more strict regulations
are enforced. If this happens, they will reflect their losses on society.
This leads to the argument that donor countries will likely tend to lose
more than what they are willing to give if they support strategies such
as strict regulations and restrictions of health risk products. It seems
that the prevention and control of NCDs ask too much, and the word
"altruism" is yet to be personified.
Very sadly, the only conclusion that could be drawn now seems to be
that both control and prevention of NCDs are not lucrative for these
people; and inequities will always reverberate from inequalities that
arise within and between societies because of this.
Competing interests:
GMVKu is a member and one of the spokespersons of the Network 'Switching International Health Policies and Systems' (SWIHPS), an international network of individuals and institutions to disseminate and exchange information, expertise and practice to contribute to stronger health systems and improved policy making. The network has a strong thematic focus on the organization of care for chronic diseases in low income countries. The secretariat of the network is hosted by the Institute of Tropical Medicine Antwerp, Belgium.In addition, GMVKu was diagnosed with diabetes mellitus type 2 at the age of 30, She has been able to control her NCD for the past 11 years without any occurrences of life-threatening complications or co-morbidities; and has been a useful member of the society with a number of contributions especially in the field of Family & Community Medicine in the Philippines. Currently, she is involved in the organization of community-oriented primary care for diabetes in several sites in the Philippines.
25 August 2011
Grace Marie V. Ku
Family Physician
Veterans Memorial Medical Center, Philippines / Institute of Tropical Medicine, Belgium
Rapid Response:
Saying it like it is...
That the UN Summit on AIDS ten years ago was already a success even
during its planning stages is just one of the glaring differences between
NCDs and AIDS, or almost any other health issues with existing programs
for that matter.
From a certain perspective, the care for NCDs is generally
unexciting. Aside from some forms of cancer, there is no race for cure;
only the long, arduous, unpredictable, and often costly trek of case
management to control the conditions, and people afflicted of NCDs will
eventually die of their disease. A utilitarian versus libertarian debate
may lead one to conclude that people with NCDs will only cause further
strain on already heavily-burdened health systems and economies, thus it
is better not to care for them anymore in the hope that they will die
sooner and ease some of the burdens that they impose.
Prevention of NCDs by addressing certain risk factors as was proposed
in the NCD Alliance outcome document
(http://www.ncdalliance.org/sites/default/files/resource_files/UN%20High-...) is equally unexciting. The maximum
benefits of the efforts - decreasing prevalences of NCDs - may no longer
be reaped during the lifetime of those who will advocate, initiate and/or
fund any NCD control or prevention programs. From a business point of
view, the seeming balance between the "hand that doles out the food" with
"the hand that takes away the food" becomes lost when dealing with the
care and prevention of chronic diseases. Donors will not get a good deal
of tangible returns from their investments on NCDs; what takings would one
expect if the main strategies would be increasing physical activity and
reducing use or intake of harmful or health risk products? Compared to
AIDS, TB, or malaria to cite a few, there will probably be less
involvement of (commercially-inclined) industries who are usually tapped
to deliver a number of goods related to these disease programs and to
embark on related researches which in turn may produce more marketable
goods. Conversely, commercial industries might suffer from profit losses
if the calls for reformulation, higher taxes and more strict regulations
are enforced. If this happens, they will reflect their losses on society.
This leads to the argument that donor countries will likely tend to lose
more than what they are willing to give if they support strategies such
as strict regulations and restrictions of health risk products. It seems
that the prevention and control of NCDs ask too much, and the word
"altruism" is yet to be personified.
Very sadly, the only conclusion that could be drawn now seems to be
that both control and prevention of NCDs are not lucrative for these
people; and inequities will always reverberate from inequalities that
arise within and between societies because of this.
Competing interests: GMVKu is a member and one of the spokespersons of the Network 'Switching International Health Policies and Systems' (SWIHPS), an international network of individuals and institutions to disseminate and exchange information, expertise and practice to contribute to stronger health systems and improved policy making. The network has a strong thematic focus on the organization of care for chronic diseases in low income countries. The secretariat of the network is hosted by the Institute of Tropical Medicine Antwerp, Belgium.In addition, GMVKu was diagnosed with diabetes mellitus type 2 at the age of 30, She has been able to control her NCD for the past 11 years without any occurrences of life-threatening complications or co-morbidities; and has been a useful member of the society with a number of contributions especially in the field of Family & Community Medicine in the Philippines. Currently, she is involved in the organization of community-oriented primary care for diabetes in several sites in the Philippines.