Opportunities to Integrate NCDs into Existing Systems Lessons Learned from the HIV-Experience

Astrid Permin, Senior Technical Adviser, TAS

Learning from the HIV/AIDS experience

• Addressing NCDs is much more than providing the right treatment in the health facility!– Awareness raising globally and locally– More focus on Civil Society– HIV positive groups– Access to treatment and cheaper medicines– Strategic investment

Issues to consider

• How to provide affordable NCD interventions in a context where funds for health are limited?

• NCD is another new area - risk of developing new vertical programmes

• How can we work with prevention of NCDs • Which types of health interventions can be included into

essential health packages?• How to work with affordable and equitable interventions

for primary health care?• Who is going to pay?

Danidas Support

• UN organisations (WHO, UNICEF, UNFPA, UNAIDS)

• Global Funds: (GFATM, GAVI, IAVI)

• General Budget Support: Policy dialogue at national level (Governance, PRS etc)

• Sector Support: Policy dialogue with partners in the sectoro Sector Budget Support, Basket funds etc.o Earmarked Support

o Core fundingo Projectso TA

• Civil Society support (core funding, project)

Other Danida support

• Researcho Calls for research every year.

• Civil Society• Humanitarian Aid

o International NGOs (Red Cross, Dan Church Aid etc)

Levels of Engagement

• Global level:o Awareness raising: Conference on the emerging burden of

Chronic Diseases, April 2011o UN special session on Chronic Diseases in New York,

September 2011o Post MDG process – High Level meeting on health in Botswana

in February 2013

• Country level: o Support to incorporation of NCDs into health programmes

Points of entry for NCDs

• Political level o Awareness raisingo Financingo Where to focus

• Policy dialogue o Prioritizingo Making funds available

• Technical issueso Prevention

o Diet, exercise etc.o Health Markets

o Primary care – Universal Access to Health Careo Essential drugso Vaccineso Essential health packages

o Secondary (tertiary) care – levels of hospital care

How to start

• Civil society o Health promotion o Awareness raising on risk factorso Patients groupso Patient rights

• Health systemo How to finance, costing of serviceso Developing health education strategyo Deciding on levels of intervention

(project , mainstreaming)

• Other important sectorso Educationo Youth and sportso Gender etc.