You're not speaking my language: reframing NCDs for politicians and policy makers
2017; Elsevier BV; Volume: 390; Issue: 10105 Linguagem: Inglês
10.1016/s0140-6736(17)32429-7
ISSN1474-547X
Autores Tópico(s)Healthcare Systems and Reforms
ResumoRichard Horton correctly identified inadequate framing as an important reason for why the world's leading causes of death and disability—non-communicable diseases (NCDs)—are not being seriously addressed by global leaders (July 22, p 346).1Horton R Offline: NCDs—why are we failing?.Lancet. 2017; 390: 346Summary Full Text Full Text PDF PubMed Scopus (30) Google Scholar The non-communicable misnomer wrong-foots the uninitiated and implicitly promotes individualistic above societal solutions.2Allen LN Feigl AB What's in a name? A call to reframe non-communicable diseases.Lancet Glob Health. 2017; 5: e129-e130Summary Full Text Full Text PDF PubMed Scopus (36) Google Scholar The most effective interventions are population-level multisectoral policies that are unpopular with libertarians and much more challenging to introduce than individualistic, health-only initiatives.3Allen L Non-communicable disease funding.Lancet Diabetes Endocrinol. 2017; 5: 92Summary Full Text Full Text PDF PubMed Scopus (10) Google Scholar There is some modelled evidence for the costs of action and inaction on NCDs,4WHO and World Economic ForumFrom burden to “best buys”: reducing the economic impact of non-communicable diseases in low- and middle-income countries.http://www.who.int/nmh/publications/best_buys_summary.pdfDate: Sept 18, 2011Google Scholar but it is written with little thought for the intended audience—more technical document than policy brief. Again, there has been a move towards curating personal stories (eg, NCDs & me) but these efforts haven't broken into the public consciousness yet. The average voter has no idea what an NCD is, nor do patients living with NCDs, nor the vast majority of health professionals. Why would politicians? Changing the name might help.2Allen LN Feigl AB What's in a name? A call to reframe non-communicable diseases.Lancet Glob Health. 2017; 5: e129-e130Summary Full Text Full Text PDF PubMed Scopus (36) Google Scholar So would presenting evidence in policy makers' own language with attention to returns on investment, trade-offs, and opportunity costs. Politicians need engaging narratives and ways of linking NCDs with priorities such as global warming, economic growth, and migration. President Trump's recent budget proposal used a security framing that could work well for NCDs,5Allen L Biosecurity and non-communicable diseases.J Bioterror Biodef. 2016; 7: 145Crossref Google Scholar especially since European leaders are being pushed to meet NATO spending commitments. A final, fruitful prism is pandemic preparedness, which is important to both President Trump and WHO Director-General Dr Tedros. The NCD community could do more to leverage global outbreak vernacular to mobilise additional resources for this neglected slow-motion disaster.6Allen L Are we facing a noncommunicable disease pandemic?.J Epidemiol Glob Health. 2017; 7: 5-9Crossref PubMed Scopus (26) Google Scholar I declare no competing interests. Offline: NCDs—why are we failing?Why is the global health community failing to respond effectively to the rising burden of non-communicable diseases (NCDs)? The answer can be summed up in one word—fear. Fear of a species-threatening pandemic. A pervasive fear that has displaced all other health concerns. Anxiety among political elites is causing a recalibration of priorities among global health leaders. In his first speech to staff in Geneva this month, WHO's new Director-General, Tedros Adhanom Ghebreyesus, named four urgent issues: health emergencies; universal health coverage; women's, children's, and adolescents’ health; and climate change. Full-Text PDF
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