Why are NCDs underfunded?

By Luke Allen | 18 Oct, 2016

70% of global deaths and <2% of overseas health funding. What gives?

This new article in the Journal of Global Health perspectives (http://tinyurl.com/hgeokp7) explores ten reasons why NCDs are chronically overlooked.

Lack of data, weak evidence for interventions, fragmentation of the NCD community, ineffective framing, vested commercial interests, inopportune timing, and the sheer scale and complexity of the problem all contribute. What is your experience? Do these factors resonate?

Attached resource:



Justin Zaman Replied at 2:56 PM, 18 Oct 2016

Well I didn't get any grants in Global NCD research at associate professor level so have gone back to being a full time clinician. In the UK most funding in Global health seems to still go to diseases that kill within days (infectious) and if you're are an NCD researcher, your work better be UK based. Look at my alma maters UCL and LSHTM and even there not much NCD work goes on now five years after I left. But this is a personal perception so it will be interesting to hear others.

nohemie mawaka Replied at 4:09 PM, 18 Oct 2016

The topic of funding is always tricky. Within global health, I find that high income countries are constantly favoured, while the voices of scholars in the intended beneficiaries countries, they constantly struggle to qualify for these funds. With NCD, NIH, Wellcome Trust, etc., the funding often goes to an 'insider' who works closely with the grant committee (or is a committee member) or a past winner who continues to receive the funds. Its unfortunate, and I strongly believe that funding in global health has become a promotion of unequally shared power dynamics. It really makes you question who benefits from global health efforts?

paul johnson Replied at 7:05 AM, 1 Dec 2016

Thank you Nohemie,

Couldn't agree more; and this is not just from an equality point of view but a squandering of opportunity and resource which is ultimately of global health benefit. In the health sector it is a sheer arrogance for high income societies to assume that developing societies require a modified (cheaper) form of their health systems when these systems have by and large exported the extraordinary detrimental impact of so-called democratic consumer life-style to cause a global pandemic of avoidable diseases by health systems that attempt to treat them and not prevent them in the first place.

Clearly this is a societal responsibility; but one way, as you suggest, is for the target countries to be properly represented on the advisory boards of the NGOs, funding agencies and charities and re-align the priorities and expenditure based on science and social-based need.

Yet another clear example are the plethora of global health departments replicated across universities of most high income countries (rather like peace corps endeavors of the past) competing for funds to provide what one calls ‘frugal’ solutions for low income countries. This from countries with near-bankrupt health systems demonstrating cyclical man-made austerity cycles that predictably widen poverty and digital divide gaps as the rich get richer and the poor poorer globally.

A major hurdle for global medicine is to move into the 21st century by making a way for the latest clinical science to be made available to population care in the community and not be held back by multiple limitations, not least needing to be evidence-based on lengthy costly multiple RCTs, then systematic reviews, then approval ‘silo’ specialist guidelines, that are often barely efficacious in developed societies.

Another clear example are digital mobile technologies (so-called mHealth) being restricted to serve outdated high-income health systems being 'pasted' over societies where entirely different systems are required. The latest medical science screams out for individualized-care world needs made possible by the state-of-art of intelligent wearable wireless sensors (not to be confused with largely unvalidated expensive consumer wrist health bands). Indeed the overpriced profiteering technology available to the affluent 24/7 consumer in these devices and smartphones could ethically be ‘’locked in’’ to global health needs.

However, this democratization of population health requires innovation outside the box – or disruptive innovation- and thus for inclusive participatory community–wide national beacon sites (250,000) for evaluation before any scale-up or roll-out. Education is a ’key part of this ‘bundle’-hence a mobile personal digital educational and health system (mPDEHS) for all citizens is being described as the core.

To make this happen I would suggest that Nohemie’s ‘’low income clinical champions’’ have preferential access to the latest science and technology and to global funds in the interests of global health, likely to ‘reverse’ the direction of clinical innovation from low to high income environments once given an equal opportunity.

This is a discussion topic in its own right –anyone ready?

Paul Johnson MD - 'real-world' clinical scientist

Mei Lin Fung Replied at 10:07 AM, 1 Dec 2016

Bravo - I fully support what Paul Johnson has said

Paul - I am ready to engage in the topic on its own.

Mei Lin Fung
Organizer, People Centered Internet <http://www.peoplecentered.net>,
co-founded with Vint Cerf
External advisor to the Stanford Center for Population Health Science
Member of the Global Future Council on Digital Economy and Society,

Justin Zaman Replied at 8:10 AM, 2 Dec 2016

Wow Paul what a reply and exactly what I feel. I however never got to be a clinician scientist and so I'm afraid I'm now back to being a humble doctor serving my deprived UK rural coastal community and looking after my family whilst the world continues to mess up around me. I still teach on global NCD to those who still want to know what could have been..

Prosper Bashaka Replied at 2:08 AM, 3 Dec 2016

The main reason I can point out in my country Tanzania as to why NCDS are
underfunded will be lack of studies on the burden of different diseases.
As Paul J. did note in this discussion we need to change to evidence based
medicine. I believe that eveything in medicine starts with rearch work.
It's right time for us to use the little resource we have to build our
foundation from studies it is when if we ask for funds from other
stakeholders will support NCDS programs.

On Dec 2, 2016 8:20 AM, "Justin Zaman via GHDonline" <>
> Justin Zaman replied to a discussion in Non-Communicable Diseases:
> Wow Paul what a reply and exactly what I feel. I however never got to be
a clinician scientist and so I'm afraid I'm now back to being a humble
doctor serving my deprived UK rural coastal community and looking after my
family whilst the world continues to mess up around me. I still teach on
global NCD to those who still want to know what could have been..
> --
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MYCHELLE FARMER Replied at 3:24 PM, 3 Dec 2016

Like many of you, I am frustrated by the inability to secure funding for NCDs interventions and research. We need support to take on a systems approach, that will encourage investment into NCDs throughout the spectrum of the health care continuum, from the community level to the facilities and into national level programs. If everyone is not invested, then systemic change will be difficult, and in some countries, it will not happen. I certainly like the idea of investing in frontline workers to promote both clinical interventions and research. I agree with Paul! I also want more investments throughout the health care system for sustained change and success.
One idea to start the effort will be to support online education and discussion for all members of the health system. We can create a community of learners to familiarize ourselves with gaps in data and knowledge then collectively work on solutions. We can start with this forum. What are your priorities? In my organization, we are concerned about hyperglycemia in pregnancy (gestational diabetes). In my opinion, universal screening and management of hyperglycemia in pregnancy can be one of the World Health Organization's "Best Buys" because it can save both the mother and the newborn. What do you think about this? Can we consider ways to discuss NCDs in this forum, then collectively advocate for research and clinical change? I look forward to hearing from some of you!