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24/09/2012
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Learning from AIDS: Responding to non-communicable diseases
It is the chronic nature of AIDS that is giving governments and health experts a new opportunity -- to use health systems set up for HIV/AIDS care and treatment and strengthen them to address NCDs.
As executive director of UNAIDS from 1994 to 2008, I was privileged to have a front row seat at one of the great global health struggles of modern times. Although our work against AIDS is far from finished, we have stabilized the pandemic and started to imagine a world without AIDS. Unfortunately, the same is not true of non-communicable diseases (NCDs) like cancer, cardiovascular disease, chronic respiratory disease and diabetes, which cause nearly two out of three deaths in the world (80 percent of those in developing countries). Infectious diseases like AIDS continue to have a devastating impact on the health and development of many low- and middle-income countries, particularly in Africa. However, NCDs have slowly emerged, in the words of The Economist, as "the poor world's greatest health problem" and the major causes of premature deaths there. NCDs are a time bomb. If left unaddressed, they will lead to more death, disability and the implosion of already overburdened health systems in developing countries at huge cost to individuals, families, businesses and society. Like AIDS, NCDs are a problem for rich and poor countries alike, but the poor suffer the most. The 2011 U.N. High-Level Meeting on NCDs -- only the second time the UN had convened a major meeting on a health issue, following the U.N. AIDS Summit in June 2001 -- was a landmark event in the short history of the fight against NCDs but was not a tipping point. Much more remains to be done. I believe we have learned much from AIDS that can help leaders design effective and sustainable responses to NCDs:
The AIDS response taught us that efforts to address a pandemic are incremental and take time. We must have patience. And we need to be both opportunistic and strategic to design an NCD response that is commensurate with the scale of the problem. I am not suggesting that we should transpose mechanically the AIDS experience to the very complex realities of NCDs, but I believe that leaders of the NCD response can be inspired by, and learn from, the AIDS experience. With more people living for longer periods with AIDS, it is the chronic nature of AIDS that is giving governments and health experts a new opportunity -- to use health systems set up for HIV/AIDS care and treatment and strengthen them to address NCDs. It would be tragic to save a person from a disease like AIDS if that person then dies from one like cancer. By Peter Piot |
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