Significant Impacts to Health Services for Noncommunicable Diseases
- World Health Organization -
Prevention and treatment services for
noncommunicable diseases (NCDs) have been severely disrupted since the
COVID-19 pandemic began, according to a WHO survey released today [June 1]. The
survey, which was completed by 155 countries during a 3-week period in
May, confirmed that the impact is global, but that low-income countries
are most affected.
This situation is of significant concern because
people living with NCDs are at higher risk of severe COVID-19-related
illness and death.
"The results of this survey confirm what we have
been hearing from countries for a number of weeks now," said Dr Tedros
Adhanom Ghebreyesus, Director-General of the World Health Organization.
"Many people who need treatment for diseases like cancer,
cardiovascular disease and diabetes have not been receiving the health
services and medicines they need since the COVID-19 pandemic began.
It's vital that countries find innovative ways to ensure that essential
services for NCDs continue, even as they fight COVID-19."
Service Disruptions Are Widespread
The main finding is that health services have been
partially or completely disrupted in many countries. More than half (53
per cent) of the countries surveyed have partially or completely
disrupted services for hypertension treatment; 49 per cent for
treatment for diabetes and diabetes-related complications; 42 per cent
for cancer treatment, and 31 per cent for cardiovascular emergencies.
Rehabilitation services have been disrupted in
almost two-thirds (63 per cent) of countries, even though
rehabilitation is key to a healthy recovery following severe illness
from COVID-19.
Reassignment of Staff and
Postponing of Screening
In the majority (94 per cent) of
countries responding, ministry of health staff working in the area of
NCDs were partially or fully reassigned to support COVID-19.
The postponement of public screening programmes
(for example for breast and cervical cancer) was also widespread,
reported by more than 50 per cent of countries. This was consistent
with initial WHO recommendations to minimize non-urgent facility-based
care whilst tackling the pandemic.
But the most common reasons for discontinuing or
reducing services were cancellations of planned treatments, a decrease
in public transport available and a lack of staff because health
workers had been reassigned to support COVID19 services. In one in five
countries (20 per cent) reporting disruptions, one of the main reasons
for discontinuing services was a shortage of medicines, diagnostics and
other technologies.
Unsurprisingly, there appears to be a correlation
between levels of disruption to services for treating NCDs and the
evolution of the COVID-19 outbreak in a country. Services become
increasingly disrupted as a country moves from sporadic cases to
community transmission of the coronavirus.
Globally, two-thirds of countries reported that
they had included NCD services in their national COVID-19 preparedness
and response plans; 72 per cent of high-income countries reported
inclusion compared to 42 per cent of low-income countries. Services to
address cardiovascular disease, cancer, diabetes and chronic
respiratory disease were the most frequently included. Dental services,
rehabilitation and tobacco cessation activities were not as widely
included in response plans according to country reports.
Seventeen per cent of countries reporting have
started to allocate additional funding from the government budget to
include the provision of NCD services in their national COVID-19 plan.
Alternative Strategies for Continuing Care Being
Implemented
Encouraging findings of the survey were that
alternative strategies have been established in most countries to
support the people at highest risk to continue receiving treatment for
NCDs. Among the countries reporting service disruptions, globally 58
per cent of countries are now using telemedicine (advice by telephone
or online means) to replace in-person consultations; in low-income
countries this figure is 42 per cent. Triaging to determine priorities
has also been widely used, in two-thirds of countries reporting.
Also encouraging is that more than 70 per cent of
countries reported collecting data on the number of COVID-19 patients
who also have an NCD.
"It will be some time before we know the full
extent of the impact of disruptions to health care during COVID-19 on
people with noncommunicable diseases," said Dr Bente Mikkelsen,
Director of the Department of Noncommunicable Diseases at WHO. "What we
know now, however, is that not only are people with NCDs more
vulnerable to becoming seriously ill with the virus, but many are
unable to access the treatment they need to manage their illnesses. It
is very important not only that care for people living with NCDs is
included in national response and preparedness plans for COVID-19 --
but that innovative ways are found to implement those plans. We must be
ready to "build back better" strengthening health services so that they
are better equipped to prevent, diagnose and provide care for NCDs in
the future, in any circumstances."
Note
Noncommunicable diseases kill 41 million people
each year, equivalent to 71 per cent of all deaths globally. Each year,
15 million people die from an NCD between the ages of 30 and 69 years;
more than 85 per cent of these "premature" deaths occur in low and
middle-income countries.
This article was published in
Volume 50 Number 20 - June 6, 2020
Article Link:
Significant Impacts to Health Services for Noncommunicable Diseases - World Health Organization
Website: www.cpcml.ca
Email: editor@cpcml.ca
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