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Addressing noncommunicable
diseases in emergencies:
a regional framework for action
Dr Hicham El Berri
Medical Officer, Noncommunicable Diseases Management
11 October 2023
I am deeply saddened to convey
distressing news: we’ve lost two
patients due to the renal dialysis
centre being out of service. I did
my best to reach out to donors
and associations to support the
provision of medical supplies,
but unfortunately, I failed.
May the souls of those who passed
away due to the unavailability of
medications rest in peace.
Almost half the Region’s countries are facing
emergencies  Fragile, conflict-affected and vulnerable (FCV)
Conflicts and displacements
Natural disasters
Financial crises
Home to 38% of those
who need humanitarian
assistance globally
People living with noncommunicable diseases (NCDs)
are more vulnerable during emergencies
Source: Global Health Observatory; NCD Data Portal; WHO regional diabetes costing study; Hayman KG, Sharma D, Wardlow RD, Singh S. Burden of
cardiovascular morbidity and mortality following humanitarian emergencies: a systematic literature review.
Probability of dying before 70 of an NCD
Heart attacks, strokes and asthma
attacks are up to 2–3 times more
common in emergency settings
25.1%
FCV settings
17.8 %
Non-FCV
NCD challenges in emergencies
Emergency
context
Competing priorities,
insecurity, and disruption of
services and infrastructure
Health system
capacity
Underinvestment, weak
government support, supply
chain issues, workforce
shortages
Increased risk
of excess
mortality and
long-term
complications
COVID-19: 82% of countries/territories in the Region
reported disruption of NCD services
11.10%
42%
47%
42% 42%
26%
0%
10%
20%
30%
40%
50%
60%
Hypertension
management
Asthma services Cancer treatment Diabetes and
diabetic
complications
managemen
Cardiovascular
emergencies
(including
myocardial
infarction, stroke
and cardiac
arrhythmias)
Completely disrupted Partially disrupted
Source: Hammerich A, Fouad H, Elrayah EE, Slama S, El-Awa F, El-Berri H, et al. The impact of the COVID-19 pandemic on service delivery for
noncommunicable diseases in the Eastern Mediterranean Region. East Mediterr Health J. 2022;28(7):469–477. doi:10.26719/emhj.22.053.
o Builds on WHO NCD packages
o Established in 2016
o 6 modules covering NCDs
o Covers 10 000 people for 3
months
o Rapidly integrated in the basic
package during crisis
Continuity of services:
NCD emergency kits
Since 2017, WHO has
distributed more than 6500
kits in the Region
May 2022
World Health
Assembly 75.
Recommendations
of Annex 4
May 2023
June 2023
Consultative
meeting with
Member States
Information
and Data,
Digital Health
& Research
Leadership,
Collaboration &
Advocacy
Resource
Mobilization
and Finance
Service Delivery, Human
Resources, Medications and
Technologies
Community
engagement,
Communication
and Trust
Building
Addressing
NCDs in
Emergencies
October 2023
RC70
endorsement December 2022
Cairo global and
regional meetings on
NCDs in emergencies
Expert meeting
Addressing
NCDs in
emergencies
Draft Framework for action on
addressing NCDs in emergencies
Life-threatening conditions
Specialized care
Continuity of services
Service delivery, human
resources, medications and
technologies
Leadership,
collaboration &
advocacy
Resource
mobilization
and finance
Community
engagement,
communication
and trust
building
Information
and data,
digital health
and research
Addressing
NCDs in
emergencies
Risk reduction &
preparedness phase
Stable or at risk of emergency
Reduce risk
Enhance resilience
Response phase
Acute emergency
Ensure timely and appropriate
health services for NCDs
Recovery phase
Protracted crisis or after acute
crisis resolved
Restore and improve the health system
response to NCDs and quality of life
Adapt NCD service delivery
models; include NCDs in benefits
packages
Invest in NCDs and mobilize
sustainable financial resources
Enhance NCD surveillance and data
collection
Strengthen collaboration with all
relevant actors
Key asks
for
Member
States
WHO support
Support NCD integration in
emergency preparedness,
response and recovery strategies
and actions
Strengthen partnerships and
collaboration
Report on the progress made by
Member States to the 72nd, 74th
and 76th sessions of the Regional
Committee
We can change the
narrative!
Balance priorities
Integrate NCDs as a vital piece
of the health care puzzle in
emergencies

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Addressing noncommunicable diseases in emergencies: a regional framework for action

  • 1. Addressing noncommunicable diseases in emergencies: a regional framework for action Dr Hicham El Berri Medical Officer, Noncommunicable Diseases Management 11 October 2023
  • 2. I am deeply saddened to convey distressing news: we’ve lost two patients due to the renal dialysis centre being out of service. I did my best to reach out to donors and associations to support the provision of medical supplies, but unfortunately, I failed. May the souls of those who passed away due to the unavailability of medications rest in peace.
  • 3.
  • 4. Almost half the Region’s countries are facing emergencies  Fragile, conflict-affected and vulnerable (FCV) Conflicts and displacements Natural disasters Financial crises Home to 38% of those who need humanitarian assistance globally
  • 5. People living with noncommunicable diseases (NCDs) are more vulnerable during emergencies Source: Global Health Observatory; NCD Data Portal; WHO regional diabetes costing study; Hayman KG, Sharma D, Wardlow RD, Singh S. Burden of cardiovascular morbidity and mortality following humanitarian emergencies: a systematic literature review. Probability of dying before 70 of an NCD Heart attacks, strokes and asthma attacks are up to 2–3 times more common in emergency settings 25.1% FCV settings 17.8 % Non-FCV
  • 6. NCD challenges in emergencies Emergency context Competing priorities, insecurity, and disruption of services and infrastructure Health system capacity Underinvestment, weak government support, supply chain issues, workforce shortages Increased risk of excess mortality and long-term complications
  • 7. COVID-19: 82% of countries/territories in the Region reported disruption of NCD services 11.10% 42% 47% 42% 42% 26% 0% 10% 20% 30% 40% 50% 60% Hypertension management Asthma services Cancer treatment Diabetes and diabetic complications managemen Cardiovascular emergencies (including myocardial infarction, stroke and cardiac arrhythmias) Completely disrupted Partially disrupted Source: Hammerich A, Fouad H, Elrayah EE, Slama S, El-Awa F, El-Berri H, et al. The impact of the COVID-19 pandemic on service delivery for noncommunicable diseases in the Eastern Mediterranean Region. East Mediterr Health J. 2022;28(7):469–477. doi:10.26719/emhj.22.053.
  • 8. o Builds on WHO NCD packages o Established in 2016 o 6 modules covering NCDs o Covers 10 000 people for 3 months o Rapidly integrated in the basic package during crisis Continuity of services: NCD emergency kits Since 2017, WHO has distributed more than 6500 kits in the Region
  • 9. May 2022 World Health Assembly 75. Recommendations of Annex 4 May 2023 June 2023 Consultative meeting with Member States Information and Data, Digital Health & Research Leadership, Collaboration & Advocacy Resource Mobilization and Finance Service Delivery, Human Resources, Medications and Technologies Community engagement, Communication and Trust Building Addressing NCDs in Emergencies October 2023 RC70 endorsement December 2022 Cairo global and regional meetings on NCDs in emergencies Expert meeting
  • 10. Addressing NCDs in emergencies Draft Framework for action on addressing NCDs in emergencies Life-threatening conditions Specialized care Continuity of services
  • 11. Service delivery, human resources, medications and technologies Leadership, collaboration & advocacy Resource mobilization and finance Community engagement, communication and trust building Information and data, digital health and research Addressing NCDs in emergencies Risk reduction & preparedness phase Stable or at risk of emergency Reduce risk Enhance resilience Response phase Acute emergency Ensure timely and appropriate health services for NCDs Recovery phase Protracted crisis or after acute crisis resolved Restore and improve the health system response to NCDs and quality of life
  • 12. Adapt NCD service delivery models; include NCDs in benefits packages Invest in NCDs and mobilize sustainable financial resources Enhance NCD surveillance and data collection Strengthen collaboration with all relevant actors Key asks for Member States
  • 13. WHO support Support NCD integration in emergency preparedness, response and recovery strategies and actions Strengthen partnerships and collaboration Report on the progress made by Member States to the 72nd, 74th and 76th sessions of the Regional Committee
  • 14. We can change the narrative! Balance priorities Integrate NCDs as a vital piece of the health care puzzle in emergencies

Editor's Notes

  1. Please help animate the pictures in a nice flow
  2. For designer: Make the circles bigger
  3. For designer: please make this into two slide (but should give the impression of one) to allow for readable print-outs. Please be mindful about the animation of the wheel. Please also add suitable icons for the three bullets that now have arrows. Let me know if unclear
  4. For designer: please make this into two slide (but should give the impression of one) to allow for readable print-outs. Please be mindful about the animation of the wheel. Please also add suitable icons for the three bullets that now have arrows. Let me know if unclear