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Can the Success of HIV Scale-Up Advance the Global Chronic NCD Agenda?

Authors:

Anton M. Palma ,

Department of Epidemiology, Columbia University, New York, NY; ICAP at Columbia University, New York, NY, US
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Miriam Rabkin,

Department of Epidemiology, Columbia University, New York, NY; ICAP at Columbia University, New York, NY; Department of Medicine, Columbia University, New York, NY, US
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Harriet Nuwagaba-Biribonwoha,

Department of Epidemiology, Columbia University, New York, NY; ICAP at Columbia University, New York, NY, US
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Pido Bongomin,

Department of Epidemiology, Columbia University, New York, NY; ICAP at Columbia University, New York, NY, US
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Nomthandazo Lukhele,

Swaziland Ministry of Health, Mbabane, SZ
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Xolisile Dlamini,

Swaziland Ministry of Health, Mbabane, SZ
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Altaye Kidane,

ICAP at Columbia University, New York, NY, US
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Wafaa M. El-Sadr

Department of Epidemiology, Columbia University, New York, NY; ICAP at Columbia University, New York, NY; Department of Medicine, Columbia University, New York, NY, US
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Abstract

Noncommunicable diseases (NCD) are the leading causes of death and disability worldwide but have received suboptimal attention and funding from the global health community. Although the first United Nations General Assembly Special Session (UNGASS) for NCD in 2011 aimed to stimulate donor funding and political action, only 1.3% of official development assistance for health was allocated to NCD in 2015, even less than in 2011. In stark contrast, the UNGASS on human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) in 2001 sparked billions of dollars in funding for HIV and enabled millions of HIV-infected individuals to access antiretroviral treatment. Using an existing analytic framework, we compare the global responses to the HIV and NCD epidemics and distill lessons from the HIV response that might be utilized to enhance the global NCD response. These include: 1) further educating and empowering communities and patients to increase demand for NCD services and to hold national governments accountable for establishing and achieving NCD targets; and 2) evidence to support the feasibility and effectiveness of large-scale NCD screening and treatment programs in low-resource settings. We conclude with a case study from Swaziland, a country that is making progress in confronting both HIV and NCD.

Highlights

  • Noncommunicable diseases (NCDs) are leading causes of global deaths but receive negligible global health funding, unlike HIV.
  • A political priority framework setting helps explain different global responses to NCDs and human immunodeficiency virus (HIV).
  • Successful scale-up of chronic HIV care can serve as a model to inform national-level NCD programs.
  • NCD prevention and management requires input and demand from affected communities and patients.
  • A Swaziland case study demonstrates early success in adapting HIV systems and tools for NCD care.
How to Cite: Palma AM, Rabkin M, Nuwagaba-Biribonwoha H, Bongomin P, Lukhele N, Dlamini X, et al.. Can the Success of HIV Scale-Up Advance the Global Chronic NCD Agenda?. Global Heart. 2016;11(4):403–8. DOI: http://doi.org/10.1016/j.gheart.2016.10.012
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Published on 01 Dec 2016.
Peer Reviewed

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