Tackling the deadly burden of non-communicable disease
Chronic diseases disproportionately affect low- and middle-income countries. What can be done to reduce their toll?
In May, global health experts, UN member state delegates and civil society representatives gathered in Geneva for the first meeting of the World Health Assembly since the onset of the Covid-19 pandemic.
While the focus of the assembly’s 75th meeting was primarily the theme of Health for Peace and Peace for Health, the attention of delegates was also drawn to the continuing challenges posed by non-communicable diseases (NCDs). Also known as chronic diseases, NCDs affect patients in low- and middle-income countries (LMICs) disproportionately. NCDs include diabetes, cardiovascular disease such as heart attacks and stroke, cancers and chronic respiratory diseases including asthma and chronic obstructive pulmonary disease. Each year, around 41million people are killed by NCDs – 71 per cent of all deaths globally1.
As a result, in 2015, when the UN adopted its 2030 Agenda for Sustainable Development, it recognised health as both a precondition for and an outcome of the agenda, and NCDs were included as a sustainable development priority for all countries for the first time.
“The adoption of the 2030 Agenda marks a momentous achievement for the NCD community,” said Katie Dain, Executive Director, NCD Alliance, at the time. “We can be more optimistic about the future of prevention and control of NCDs than perhaps at any stage of recent history. As we celebrate the new agenda, we also encourage immediate action to realise the ambitious SDGs by their 2030 end date.”
As part of the global effort to tackle the scourge of NCDs, pharmaceutical companies are being encouraged to support the UN’s Sustainable Development Goals (SDGs) and, as a result, the French pharmaceutical and vaccine giant Sanofi established a new global non-profit, Sanofi Global Health (GHU), in 2021.
As Jon Fairest, head of the GHU, explains, after early pilots focusing on 10–12 treatments, the initiative will eventually sell 30 essential medicines on a not-for profit basis to 40 LMICs while supporting local capacity-building. Sanofi Global Health’s initial list of therapies includes treatments for cardiovascular diseases, diabetes, cancer, malaria and tuberculosis.
“We’re looking at the unmet needs of patients who have very little access to healthcare, in countries where the healthcare infrastructure is minimal, where there’s very little training in disease management, and where there’s insufficient money in healthcare systems to fund enough people to manage them,” says Fairest, who has worked for Sanofi for 20 years.
Recognising that the issue is too large a challenge to be tackled single-handed, the GHU is focused on creating partnerships and empowering start-ups. The aim is to create a legacy that can assist LMICs at a strategic level, says Rebecca Stevens Alder, head of global partnerships at the GHU.
“We want to build partnerships, not just with governments but also with NGOs and communities: partnerships that will become entrenched, and programmes that are sustainable and that people can own. It’s also about partnering with organisations that are already working in communities, and providing them with the support they need to access patients with chronic diseases.”
In the face of such a multifaceted problem, trying to ensure that the GHU delivers measurable and meaningful change is one of the greatest challenges, Fairest and Stevens Alder admit, as is the fact that the new organisation is attempting to do something for which there is no playbook.
“We’re not about sales or bottom line here. We’re about changing mindsets and increasing patient reach, and supporting local entrepreneurs and sustainable private initiatives with equity investments through the innovative fund on inclusive business that we are deploying,” says Fairest. “That’s why we’re working with ministries of health, local start-ups and NGOs or faith-based organisations involved in local delivery of healthcare to work out where funding is coming from, which patients we are going after and how we are going to collect data that will enable us to measure outcomes.”
Alongside data collection, the GHU aims to create patient education programmes to assist with disease management and prevention of complications, achieving vital cost savings that can be reinvested into health systems and the needs of patients with acute conditions.
“The end point is that, in five years’ time, our partners can have health systems that manage themselves,” Stevens Alder explains. “That’s measurable, and we’ll be able to provide outcome data to show that, for example, overall blood glucose levels or hospitalisations have dropped. If you’re a bank or a ministry of health or a big NGO you want to know that, because you’ll want a return on your investment.”
The team behind Sanofi’s GHU hope that their approach will be tested and proven in measurable pilot projects that can then be rolled out internationally and at scale, and that the GHU will also help to test different approaches to health financing and patient monitoring that use technology to monitor their impact and effectiveness.
“We’re trying to move beyond the blanket of corporate and social responsibility activities,” Stevens Alder insists. “We want to be able to say that we have contributed to ‘X number’ of people’s lives, and that those people are now productive, living full lives.”
