Global Health Council Conference 2011 - Please, No Mega-Funds: Building Stronger Health Systems to Expand NCD Coverage

Global Health Council Conference 2011 - Please, No Mega-Funds: Building Stronger Health Systems to Expand NCD Coverage

Left to right: Jonathan D. Quick, MD, MPH, President and CEO, Management Sciences for Health; Felicia Knaul, MA, PhD. Director, Harvard Global Health Initiative; Herb Riband, JD, Vice President - External Affairs, MedTronic; Deborah Birx, MD, Director, Division of Global HIV/AIDS, Center for Global Health - Centers for Disease Control; Claudine Humure, Rwandan Cancer Survivor


On Tuesday, June 14 at the 38th annual Global Health Council Conference, MSH hosted a lively discussion about non-communicable diseases and harnessing health systems. The speakers included: Felicia Knaul, PhD, Director, Harvard Global Equity Initiative and Founder of Tómatelo a Pecho; Herb Riband, MedTronic, Vice President, External Affairs; Debbie Birx, MD, Centers for Disease Control, Director, Division of Global HIV/AIDS, Center for Global Health; and Claudine Humure, cancer survivor, Rwanda. Jonathan D. Quick, MD, MPH, President and CEO of MSH, moderated the session.

While continuing to battle the backlog of infectious illness and, in the face of shortages of health care workers and services, especially in rural areas, Low and Middle Income Countries must address a new threat to their health systems: non-communicable and chronic diseases. The panelists looked at how a health systems strengthening approach is essential for ensuring access to care for all and how investments must be made by both the countries themselves and the global community, but not necessarily through a new “mega-fund” for NCDs. Dr. Quick noted the growing movement toward universal health coverage in Mexico, Thailand, Ghana, and Kenya and how this approach is necessary to reach the bottom billion.

Dr. Knaul, a breast cancer survivor, shared experiences from Mexico where she saw from the inside how the health system addressed a non-communicable disease. She said there are many barriers to overcome to improve health systems around the world, but “We must bring treatment closer to home. We have to teach health workers how to properly diagnose and effectively supervise these illnesses; this will save lives and help women know that it is possible to manage this disease.” She also explained that, in Mexico, existing systems were utilized to increase access to treatment and care. “No mega-fund was used; Mexico just added three to four pages of information on breast cancer to its Basic Information package. Mammography information was also integrated into existing anti-poverty cash transfer programs," she said. “Even if we got a $13 billion mega-fund, we aren’t ready to manage it; we still need more understanding of the barriers and resources that already exist that can be utilized.”

Mr. Riband discussed how the private sector is delivering unique solutions to address NCDs around the world. “We can, should and must be part of the solution to NCDs,” he said. The panel discussed how the array of actors in the health sector---developing country leaders, Ministries of Health, NGOs, donors, and the private sector---can work together to design and implement programs to meet this challenge.

Dr. Birx reflected on the HIV & AIDS epidemic and encouraged the global health community to model its efforts to those that were successful in the HIV & AIDS movement. Ten years ago HIV wasn’t being treated, but the World Health Organization led the way to drastic change. “It was made possible by people who transformed passion into program.” Many people around the world are passionate about NCDs, and if we transform that passion into programmatic change, the impact will be huge. Dr. Birx also discussed the importance of health systems strengthening, in particular, national laboratory strategies that had been developed to address HIV that can now help diagnose other diseases. “Laboratory medicine has always been an afterthought in Low and Middle Income countries.” She noted that much can be achieved if labs are working on providing diagnostic tests across the spectrum of both infectious diseases and NCDs.

The last speaker on the panel was Claudine Humure. She is an 18-year-old Rwandan woman who survived the genocide and is also now a cancer survivor. Claudine shared her personal experience of how it took years for doctors in Rwanda, and eventually the Democratic Republic of Congo, to properly diagnose the cancer in her leg. It spread to other areas in her body, but her life was saved when she made it to Boston, MA for treatment at Massachusetts General Hospital, with the assistance of Partners In Health. Claudine was an inspirational speaker, who had the choice between life and death, which most people in her same situation may not have because health systems are not prepared to identify and treat NCD’s. Claudine concluded her story saying, “Having cancer can’t stop me from following my dreams.” After finishing high school, she hopes to go to medical school and become a pediatric oncologist---and return to Rwanda.

Dr. Quick closed the session re-iterating that the only way we will be able to save lives affected by NCD’s is to take a comprehensive, integrated approach to strengthening health system around the world. “I was struck by Claudine’s statement of ‘I had to choose between life and death.’ Many patients don’t have that choice. Some of the biggest barriers we will have to face regarding NCDs are stigma, training, knowledge, and weak labs.” He noted the growing movement to improve health financing toward the realization of universal health coverage in Mexico, Thailand, Ghana, and Kenya and how this approach will be pivotal to reach the millions who, otherwise, will die from chronic diseases.

Margaret Hartley is the Online Communications Associate at MSH.

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