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Slowing the NCD “Epidemic”

Explore strategies to combat non-communicable diseases globally, emphasizing data gaps, interventions, and challenges. Learn about primary prevention methods, dietary impacts, and the importance of implementing proven interventions worldwide.

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Slowing the NCD “Epidemic”

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  1. Slowing the NCD “Epidemic” K.M.Venkat Narayan, Emory University Stakeholder’s Meeting Harvard School of Public Health 10 December, 2015

  2. Need cohort data in LMICs • Lack of data on “incidence” for NCDs in LMICs is problematic • Phenotypes may be different • Risk factor effect may differ, other risk factors may be relevant • Window for intervention not always clear • Huge opportunities for developing • Low-cost data systems • Imaginative methods to estimate incidence indirectly

  3. NCDs – Common Myths? • Due to • aging of populations • urbanization • macro-economic changes • socio-economic factors • Almost everything is due to “obesity” • Major opportunities to • Use demographic, econometric methods to understand macro-level influences on NCDs

  4. Slowing the “epidemic” versus slowing the impact of the epidemic • In high-income countries major improvements in • DM complications • CVD death rates • Cancer death rates • Disability rates • All of these require screening and early application & evaluation of effective interventions (pharmacology, technology, low-cost work-force, integrated care) at health system and policy levels • Methods • To measure quality of care at population level • To implement and test multi-pronged approaches to improve quality of health-care

  5. Primary Prevention • Tobacco control • Lifestyles (Diet & Activity) • Huge gap in data and methods on multi-level interventions • Single item dietary approaches are problematic and lack RCT evidence • Soda tax – reduces consumption of soda, may increase juice substitution, impact on health outcomes needed • Only diet intervention to show benefit is the Mediterranean diet • Weight-loss and lifestyle interventions among people with impaired glucose tolerance and diabetes have benefits • Few good data on how to change activity/sedentary behavior • Vaccines • We are not paying enough attention to these

  6. Closing thoughts • Stop thinking of HIC interventions as different from LMIC interventions • Stop “Exporting” failures • Stop offering “Simplistic” solutions to complex problems • Instead • Carefully implement proven interventions • Lower cost of interventions • Simplify delivery of interventions • Build research base and capacity in LMICs • Develop innovative methods for implementation science, borrowing from other disciplines (e.g., business, economics, demography)

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