Addressing the double burden of the COVID-19 and noncommunicable disease pandemics: a new global governance challenge

Abstract

PurposeAs the coronavirus disease 2019 (COVID-19) continues to spread across countries, it is becoming increasingly clear that the presence of pre-existing noncommunicable diseases (NCDs) dramatically increases the risk of aggravation in persons who contract the virus. The neglect in managing NCDs during emergencies may result in fatal consequences for individuals living with comorbidities. This paper aims to highlight the need for a paradigm shift in the governance of public health emergencies to simultaneously address NCD and noncommunicable disease (CD) pandemics while taking into account the needs of high-risk populations, underlying etiological factors, and the social, economic, and environmental determinants that are relevant for both CDs and NCDs.Design/methodology/approachThe paper reviews the available global frameworks for pandemic preparedness to highlight the governance challenges of addressing the dual agenda of NCDs and CDs during a public health emergency. It proposes key strategies to strengthen multilevel governance in support of countries to better prepare for public health emergencies through the engagement of a wide range of stakeholders across sectors.FindingsAddressing both CD and NCD pandemics during public health emergencies requires (1) a new framework that unites the narratives and overcomes service and system fragmentations; (2) a multisectoral and multistakeholder governance mechanism empowered and resourced to include stakeholders across sectors and (3) a prioritized research agenda to understand the political economy of pandemics, the role played by different political systems and actors and implementation challenges, and to identify combined strategies to address the converging agendas of CDs and NCDs.Research limitations/implicationsThe article is based on the review of available published evidence.Practical implicationsThe uptake of the strategies proposed will better prepare countries to respond to NCD and CD pandemics during public health emergencies.Originality/valueThe article is the first of its kind addressing the governance challenges of the dual pandemic of NCDs and CDs in emergencies.

Aging and hypertension among the global poor—Panel data evidence from Malawi

“…Addressing the implications of this shifting disease burden, which occurs together with a rapid aging of SSA populations, is critical for achieving the "grand convergence" in health that has been proposed as an achievable global health goal by 2035 [37]. Importantly, a renewed focus on NCDs-including hypertension as a top priority-will be critical as the Covid-19 pandemic has further revealed the incredible challenges of addressing a dual burden of communicable and non-communicable diseases in LICs [38], as well as the health and social vulnerabilities in LIC population that are caused by an often inadequately treated burden of noncommunicable diseases [39]. The rural subsistence agriculture population that is the focus of this study has low levels of modernization, very limited exposure to "classic" hypertension risk factors such as fast food consumption/unhealthy life styles, and is characterized by high levels of physical activity.…”

Lessons from the frontline: The COVID-19 pandemic emergency care experience from a human resource perspective in the Pacific region

“…When COVID-19 hit they would be forced to face the double burden of the COVID-19 and NCD (or “twin”) pandemics. 52 , 53 …”

“When all else fails you have to come to the emergency department”: Overarching lessons about emergency care resilience from frontline clinicians in Pacific Island countries and territories during the COVID-19 pandemic

“…Further, planning for future public health emergencies requires consideration of the potential impacts on morbidity, mortality and healthcare services of synergistic non-communicable and communicable diseases and new frameworks and governance mechanisms to overcome system fragmentation. 37…”