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NCD Alliance emphasizes the need of a person-centred, inclusive NCD agenda

It has been 10 years since the United Nation High-level Meeting on Non-communicable Diseases. Demand to evolve the NCD agenda is growing, with intention to accelerate action on the current agenda  based on the 5X5 approach, in another hand exploring the opportunity for a more inclusive approach that leaves no one behind. This vision brings a new challenge of the need for a person-centered in implementing NCDs programme globally.

The latest discussion paper from NCD Alliance (NCDA) shows that we should Strengthening the focus on younger and older people living with NCDs, instead of focusing on the current group of 30-70 years old only. It is estimated that by 2100, one quarter of the world’s population will be over 65 years old. If we maintain the current upper limit of 70 years, almost 25% of the world’s population in the future will face the risk of being excluded. This not only unethical, but  also result in substantial economic and social costs in sectors other than health 

“We lack programmes aimed at the elderly population, to not move them away from social and productive life.”
                               Our Views, Our Voices Advocacy Agenda consultation participant, Mexico

Recent study of NCD-VN in people living with NCDs (PLWNCDs), with 62% interviewee is older people, about 1/3 (33%) reported that they have difficulties in accessing available treatment care, while 30% reported difficulties accessing early detection and accessing affordable treatment (30%). NCDA Discussion paper also recommends broadening from mortality to morbidity and comorbidity, as well as recognizing a broader set of conditions and diseases. Moreover, responses to NCDs, and all healthcare services should include the older people, while ensuring equal access based on disease or medical evidence, rather than age. Ageism can create gaps in healthcare for the older people and PLWNCDs, leading to a huge burden as some NCD will not receive properly treatment.

“There’s no better NCD. We all feel the pain of inadequate policies. Misplaced budgets and fragmented health systems. All NCDs matter and we are all needed to shape the global response of NCDs.”
                                       Our Views, Our Voices Global Advisory Committee Member (2020-21)

A recent study found that 62% of healthcare providers worldwide think that dementia is part of normal aging as opposed to a disease, and 40% of the public think healthcare practitioners ignore people with dementia. However, there is demanded to access psychological care. According to NCD-VN study, most of PLWNCDs reported to have a challenge in obtaining integrated care (combined medical, psychological, and social support) (60%), followed by accessing psychological care (58%). 

“I have been treated with aerophagia cancer, in the stage 4 for two years. I went to hospitals many times. My doctor said that, the hospital follows provision by health insurance for the treatment. if any medicine is not covered by the health insurance, I need to buy those medicines from hospital’s pharmacy, and its restricted to buy those medicine from outside pharmacies due to the fake medicines for treating cancer are prevalent. The doctor recommended that, the poor farmers should try to request local authority to grant title of poor household suffered from severe diseases so that I can receive supporting allowance of 500, 000 VND per month. But I asked all PLWNCDs in Thanh Liem district, no one receives this support.                                                  One PLWNCDs in Thanh Nghi commune, Thanh Liem District, Ha Nam province

In the future, NCDs agenda will need to get closer to the need for person-centered to fill in the gaps facing in the current agenda. In particular, the most important thing is to emphasize the role of contribution and to encourage meaningful participation of PLWNCDs and communities in decision-making on NCDs at national and global level, including design, implementation, and evaluation of UHC services. “The integration of such direct information will promote policymakers' approach to addressing issues such as inclusive health system design, equitable access, and quality across the continuum of care, and will thereby organically strengthen the health and NCD agenda.”1 To facilitate this, establishing a community support group is a positive way to aim for diverse support from the whole society, thereby strengthening the voice of PLWNCDs in all age, including children, youth and the older.


Intergeneration Self-Help Club (ISHC) - an initiative community model of HelpAge International - has been implemented in Vietnam according to the Prime Minister's Decision 1533 / QD-TTg since 2016 -2020 and has achieved great success in increasing the participation of older people in addressing health and social issues. The model continues to be replicated throughout the territory of Vietnam in the next 2021-2025 period according to the Prime Minister's Decision No. 1336 / QD-TTg to continue promoting and replicating the model's achievements in locally older people care.  
 

 


*5x5 approach mentions 5 diseases (Diabetes, cancer, chronic respiratory diseases, mental and neurological condition and cardiovascular diseases) and 5 risk factors (Air pollution, tobacco use, harmful use of alcohol, unhealthy nutrition and physical inactivity)