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.

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