New Perspective from "NEJM": Linking HIV Global Health Efforts to those for Noncommunicable Disease

A recent article in the New England Journal of Medicine (see link below) provides a new perspective on noncommunicable diseases in the field of global health. Such diseases like cancer, cardiovascular disease, diabetes, physical disability, and psychological disorder are ubiquitous and costly, and affect populations and public administrations across the world. There is a clear public health threat presented by noncommunicable diseases, and something must be done to prevent and control them among the world’s population.

The authors suggest that the lessons learned from the multi-national effort to prevent and treat HIV/AIDS (initiated in 2001 during the United Nations General Assembly) could be applied to similar efforts to reduce the prevalence and prevent noncommunicable diseases throughout the world. They cite the increase in HIV surveillance from government organizations, the influx of research findings that supported biologically-based therapeutic and prevention efforts, the rising pressure to deliver programs in a short amount of time, and the large donations and vocal advocacy campaigns that came from powerful activist groups. The authors suggest that a similar approach could be used to approach noncommunicable disease treatment and prevention from a global perspective.

Like HIV, many noncommunicable diseases are rooted in behavioral risk factors. Therefore, like HIV, surveillance systems for these risk factors can be used to measure the problem’s scale, categorize the vulnerable populations, and evaluate interventions. The authors highlight the need to approach noncommunicable disease prevention and treatment from both a behavioral and biomedical standpoint, just as was done in past HIV efforts. They make the point that like HIV, many behavioral interventions for noncommunicable diseases are effective exclusively to people who are motivated to make significant lifestyle changes. “Therefore…,” the authors suggest, “it is critical to welcome and integrate the use of low-cost biomedical interventions into prevention efforts for noncommunicable diseases, viewing them as complementary and part of a holistic approach.”

Considering that the biology of an infection is totally different than that of many chronic, noninfectious diseases, it is interesting to see a possible linkage in the global health efforts for HIV/AIDS and diseases like cancer, diabetes, and physical disability. Indeed, attempting to implement the efforts used and lessons learned from HIV/AIDS global efforts is a daunting task, which would require international (political) support, billions of dollars from governments and private agencies, quick delivery of available resources, competitive environments to produce research supporting effective biolomedical therapies, as well as public awareness and enthusiasm for the problem at hand. Due to its infectivity and mortality, HIV/AIDS came into the world demanding immediate cooperation and use of resources. As a global community, we must recognize the need for similar cooperation and resources to be applied to prevention and treatment efforts for chronic, noncommunicable illness, which is quickly proving to be a serious public health issue throughout the world.

Narayan, K. V., M.D., Ali, M. K., M.B, Ch.B., del Rio, C., M.D., Koplan, J. P.,M.D., & Curran, J., M.D. (2011, September 8). Global Noncommunicable Diseases--Lessons from the HIV-AIDS Experience. The New England Journal of Medicine, 365, 876-878. Retrieved from http://healthpolicyandreform.nejm.org/?p=15249&query=TOC