The Lancet has published Global Health 2035: A World Converging within a Generation (Global Health 2035), a major new report by the Commission on Investing in Health.

Released to coincide with the 20th anniversary of the 1993 World Development Report, Global Health 2035 revisits the case for investing in health, identifies three priority health challenges for governments in the next 20 years, and puts forth a bold new investment framework to achieve dramatic health gains by 2035 to reduce illness-related poverty.

The report emphasises the increasing significance of non-communicable diseases (NCDs) and their risk factors in low- and middle-income countries (LMICs) for health and development. NCDs are identified as one of the three priority health challenges for the next 20 years, posing challenges to human development and economic growth.

Global Health 2035 urges governments to implement an essential package of low-cost interventions for NCDs in LMICs, which in total would cost approximately US$2 billion annually. Two Commissioners particularly involved in guiding the NCD package were Dr Srinath Reddy, President of the World Heart Federation, and Sir George Alleyne, Director Emeritus of PAHO.

Cary Adams, Chair of the NCD Alliance, said “Global Health 2035 not only adds to the growing consensus that investing in NCDs and global health is crucial to secure sustainable development, but that NCD prevention and control measures are available at low-cost to governments, with high economic and social returns. There is no excuse to delay investing in NCDs.”

Global Health 2035 outlines a framework for investing in global health that will yield maximum social and economic returns, including interventions on NCDs, while also calling for a path for the progressive realisation of universal health coverage (UHC) to achieve and sustain global health progress.

“This report comes at an opportune time to influence the discourse around how global health is integrated into the post-2015 development agenda,” said Cary Adams.

Headline recommendations

To tackle the complex global health challenges faced by LMICs today, the report proposes an investment framework built around four key messages:

Return on investment: The report provides a comprehensive understanding of the economic value of health improvements, and recommends a country’s “full income” as an adequate measure, with “full income” defined as the income growth measured in national income plus the value of additional life-years (VLYs) gained in that period. That is, the growth that results when value is measured beyond economic growth to include increased health and wellbeing.

Towards a “grand convergence” in health: The commission calls for a “grand convergence” – an increase in health investment to capitalise on current unprecedented levels of health innovation, in order to see a reduction in the burden of infectious diseases and RMNCH in most high-mortality LMICs to the rates presently seen in the best performing MICs.  Such convergence would prevent 10 million deaths in LMICs by 2035.

Curbing NCDs and injuries:  The commission recommends national governments curb NCDs through a combination of inexpensive population-based and clinical interventions, drawing from the WHO Best Buys. These highly cost-effective measures include taxation, regulation or legislation and information, along with clinical interventions to increase the availability of essential medicines and technologies.  The report identifies fiscal policies as an especially promising lever for reducing the NCD burden, and highlights tobacco taxation as the single most important intervention in this package.

Progressive universalism: Focusing on financial risk protection, the report endorses two pro-poor pathways to achieving universal health coverage (UHC) within a generation and helps governments conceive a new fiscal architecture that will help mobilise funds to secure resources for health care and services. The first pathway to UHC covers essential healthcare interventions to achieve convergence and tackle NCDs and injuries, while the second provides a larger benefits package with poor people exempted from payments.

The Commission was co-chaired by Professors Lawrence H. Summers from the Harvard Kennedy School and Dean Jamison from the University of Washington, and included an international multi-disciplinary group of 25 Commissioners. To read more about the Commission, or read the background papers and editorial comments – including Global Fund Executive Director Mark Dybul, World Bank President Jim Yong Kim, WHO Director General Margaret Chan, UNDP Chief Administrator Helen Clark and Editor of The Lancet Richard Horton - click here.

To launch Global Health 2035, a symposium and a panel discussion led by Dr Richard Horton, Editor of The Lancet, is being held today in London. NCD Alliance Chair, Cary Adams, is a panellist on the NCD session.

Source: The Lancet