SYSTEMATICALLY REVIEWING NCD IMPLEMENTATION RESEARCH IN LMICs

While the evidence for the clinical effectiveness of most NCD prevention and treatment interventions is well established, care delivery models and means of scaling these up in a variety of resource-constrained health systems are not. 

A new systematic review from WHO staff and a global academic team has sought to synthesize evidence on the current state of implementation research on priority NCD prevention and control interventions provided by health systems in low- and middle-income countries (LMICs). 222 eligible studies were included, evaluating 265 priority NCD prevention and control interventions implemented in 62 countries. Nearly 40% of all the studies were on cervical cancer.

Despite a growth in implementation research on NCDs in LMICs, the review identified major gaps in the science. They recommend that future studies should prioritize implementation at scale, target higher-level health systems, test the sustainability of NCD programs, as well as using mixed methods analysis to understand mechanisms of impact. 

ASSESSING EAR AND HEARING CARE IN THE WHO AFRICAN REGION

Globally, more than 1.5 billion people are estimated to experience hearing loss. The prevalence of hearing loss varies across WHO regions, with the vast majority of people affected living in low- and middle-income countries of the world. Globally, unaddressed hearing loss poses an annual cost to WHO Member States of over $980 billion.

In the World Report on Hearing, Member States have been called on to strengthen health systems to deliver ear and hearing care at all levels. To assess the current status of ear and hearing care service provision and plan for strengthening of the same, WHO is undertaking a regional level situation assessment in the African region, using an ear and hearing care situation analysis tool. This aims to:

• assess available policies, services and human resources related to ear and hearing care; 
• determine the preparedness of the health care system in the country with respect to EHC and identify areas requiring attention; 
• identify opportunities for integrating ear and hearing care across the continuum of care at all levels of the health system.

This regional assessment is the first of its kind in the field of ear and hearing care. To date, 42 Member States in the regions have nominated focal points, and data collection is ongoing. WHO African regional office is coordinating the assessment. 

Once concluded, a regional level ear and hearing care assessment report will be launched with detailed analysis and recommendations for strengthening ear and hearing care services in the African region.

UPDATING THE WHO NCD BEST BUYS: CHANCE TO CONTRIBUTE TO OUR SECOND INFORMAL CONSULTATION

Last week, we published a second draft discussion paper on the update to Appendix 3 of the Global Action Plan for the Prevention and Control of NCDs 2013-2030 for public consultation.

The WHO 'best buys' are a priority set of effective, feasible and cost-effective interventions that WHO Member States can adopt to improve NCD outcomes for their populations, with a specific focus on accelerating progress in lower- and middle-income countries. They also inform how WHO monitors the world's progress and uptake of key NCD interventions.

They are crucial for countries around the world investing in NCDs, unlocking sustainable development, and save tens of millions of lives in this decade.

Please ensure you provide comments on the updated Appendix by 28 August at the link below. As other notable dates for your diary:

16 September 2022: The Secretariat will convene a second informal consultation with Member States and UN organizations.
19 September 2022: The Secretariat will convene a second informal consultation with non-State actors in official relations with WHO.

NEW TRAINING ON NOMA FOR HEALTH WORKERS

Noma (cancrum oris) is a serious gangrenous disease of the mouth and face, mainly affecting children aged 2 to 6 years in sub-Saharan Africa. Despite substantial knowledge gaps, it is reported to be linked with malnutrition, poor oral hygiene, immunosuppression, and living in extreme poverty situations.

Since 2013, the WHO Regional Office for Africa has supported ten noma priority countries - Benin, Burkina Faso, Cote d'Ivoire, the Democratic Republic of the Congo, Guinea Bissau, Mali, Niger, Nigeria, Senegal and Togo - to develop an implement the national noma control programme, based on a step by step guide. This work also falls within a regional noma programme, focused on integrating noma prevention and control interventions into national health care plans, strengthening primary health care, capacity building of health workers, and alignment of noma efforts with universal health coverage.

A new course from WHO aims to provide information about noma, and to increase the knowledge and skills of national and front-line health workers to help them prevent, identify and treat this disease. 

It will describe the epidemiology and pathogenesis of noma, clinical aspects, how a diagnosis is made, treatment, and public health considerations including the socioeconomic impact, including the human rights perspective, and the appropriate public health interventions.

Join almost 700 participants already, and sign up!

NEW NATIONAL NCD STRATEGY IN THE GAMBIA

His Excellency President Adama Barrow has launched The Gambia’s National Multi-Sectoral Strategy and Costed Action Plan for the Prevention and Control of NCDs, 2022-2027. The five-year action plan – developed in partnership with WHO, Defeat NCD Partnership and other health sector partners in the country – provides a roadmap for how the country seeks to tackle the increasing burden of NCDs to the public health care system of The Gambia.

President Barrow highlighted the toll NCDs were playing domestically: “In the Gambia, NCDs alone accounted for nearly 34% of all deaths registered in the country.”WHO Gambia has also helped customize the WHO Package of Essential Noncommunicable Disease interventions (also known as the WHO PEN package) to improve the coverage of services for people with NCDs in primary health care within the country. 

With the support of WHO, Defeat-NCD and other health parteners, The Gambia has launched a new National Multi Sectoral Strategy and Costed Action Plan for Non-Communicable Disease Prevention and Control in The Gambia 2022-2027. You can watch the launch the report here!

ADVANCING RESEARCH AND INNOVATION ON NCDs

The 150th session of the Executive Board recently highlighted the need to accelerate national NCD responses, including research and innovation. The Implementation Roadmap 2023-2030 for the Global action plan for the prevention and control of NCDs 2013-2030 will guide and support Member States to take measures to progress towards the nine voluntary global NCD targets and SDG target 3.4.

Implementation research is key to scaling up proven interventions, to determine feasibility in settings with different populations and resources, and to provide context-specific answers on how to implement policies and interventions for maximum impact. Implementation science leads to improved data, and helps to understand different approaches to integrating NCDs into primary health care across countries.

Helping to drive innovation within WHO, the WHO Technical Advisory Group for NCD-related Research and Innovation (TAG-NCD R&I) was established in July 2021. TAG-NCD R&I members have strong links to leading organizations in implementation research, including the Special Programme for Research and Training in Tropical Diseases, the Global Alliance for Chronic Diseases, and WHO Collaborating Centres. A subgroup of the TAG-NCD R&I has also been established to provide coordinated country support for NCD-related research.

We are looking for an academic institution to support the work of our WHO Technical Advisory Group on NCD-related Research and Innovation, bringing implementation research expertise and strong research networks in lower- and middle-income countries. By supporting NCD-related implementation research at global, regional and country level, you could help us accelerate NCD outcomes.

You have until 24 August to apply.

NEW REPORT ON TOBACCO CONTROL IN THE AMERICAS

A new Report on Tobacco Control of the Region of the Americas 2022 presents the progress of the implementation of the MPOWER technical package during the period of 2018-2021. 

While there has been significant progress noted, the report also highlights the gaps in the acceleration of the tobacco control agenda both at the global and regional levels. Collectively, 26 of the 35 Member States within the region are implementing at least one measure of the MPOWER technical package at the highest level of application, accounting for 96% of the region's population being protected from the harms of tobacco. Nine Member States still still have not implemented any of the six measures. 

More countries (24) are protecting people from tobacco smoke (smoke-free environments) than any other measure, following by warnings about the dangers of tobacco (22). 

The report also details how the global COVID-19 pandemic is seen as being the most important threat to the tobacco control agenda, while the development and accessibility of new and emerging tobacco and nicotine products is adding to the challenge of accelerating tobacco control. 

Amidst all of the challenges outlined, in 2020 South America became the first subregion within the Region of the Americas to become 100% smokefree. The Region also saw a decline in the prevalence of tobacco consumption, and now ranks the second lowest prevalence of current tobacco consumption in the world. As such, it is likely that the Region of the Americas is on track to achieve a 30% relative reduction in the prevalence of tobacco use among individuals aged 15 years and older by 2025, in line with Goal 5 of the WHO Global Action Plan for the prevention and control of noncommunicable diseases 2013-2030. 

On Monday, 15 August 2022, join PAHO/AMRO staff for the Launch of the Report on Tobacco Control for the Region of the Americas 2022. You can attend in person, or register below!

HOUSEKEEPING AND COUNTRY IMPACT

As part of efforts to improve WHO communications, we always want your feedback of what you like, and what you would like to see more of! Send me your feedback below.

We are also piloting a new On The Pulse feature series, working with WHO Regional and Country Offices to explore our country impact on NCDs! If you would like to be kept in the loop about this, please also let me know by writing.

THE TWEETS WE RETWEET

• Learn more about @EU_Health's #HealthierTogether Initiative, supporting EU countries on health promotion, prevention and control of NCDs. (August 2022)
• Get prepared for @NCDAlliance's Global Week for Action on NCDs - join the campaign and follow #ActOnNCDs on social media! (August 2022)
• Work from @MSF on community health volunteer engagement during COVID-19 to reduce NCD risk in low-resource urban settings in Malaysia (August 2022)