Package of Essential Non-Communicable Diseases Interventions for Humanitarian Settings (PEN-H) [EN/UK] – ReliefWeb

Report on the Escalating Challenge of Non-Communicable Diseases in Humanitarian Crises: A Sustainable Development Goals Perspective

Introduction: A Threat to Global Health and Sustainable Development

The increasing frequency and complexity of global humanitarian emergencies, including natural disasters, conflicts, and disease outbreaks, pose a significant threat to global health security and the achievement of the Sustainable Development Goals (SDGs). These crises critically weaken health service infrastructure, disrupt access to essential medicines, and deplete the health workforce. This systemic degradation presents a formidable barrier to delivering quality healthcare and directly undermines progress towards SDG 3 (Good Health and Well-being), particularly the target of achieving universal health coverage (Target 3.8).

The Nexus of NCDs, Humanitarian Settings, and SDG 3

Non-communicable Diseases (NCDs), including cardiovascular disease, diabetes, cancer, and chronic respiratory diseases, have emerged as a primary public health threat within humanitarian settings. NCDs are the leading global cause of mortality, responsible for nearly 70% of all deaths. The burden is disproportionately borne by low- and middle-income countries (LMICs), which account for 82% of these premature deaths. This reality is in direct opposition to SDG Target 3.4, which aims to reduce premature mortality from NCDs by one-third by 2030. Evidence indicates that humanitarian crises exacerbate NCD-related morbidity and mortality, making the management of these chronic conditions a critical development challenge.

Compounding Factors Undermining Multiple SDGs

In the aftermath of a crisis, individuals living with NCDs face heightened vulnerability due to a confluence of factors that impact several interconnected SDGs. Key contributing factors include:

• Disruption of Health Services: The interruption of medical treatment due to the destruction of healthcare facilities directly impedes SDG 3 and compromises community resilience under SDG 11 (Sustainable Cities and Communities).
• Deterioration of Living Conditions: Overcrowding, loss of shelter, and damage to essential infrastructure violate principles of SDG 11. The associated loss of livelihood pushes affected populations further into poverty, hindering SDG 1 (No Poverty).
• Food and Water Insecurity: Shortages of regular food supplies and clean water, coupled with reliance on unhealthy diets, directly challenge the attainment of SDG 2 (Zero Hunger) and worsen health outcomes related to SDG 3.
• Environmental and Psychological Stressors: Increased stress, anxiety, physical inactivity, and exposure to environmental toxins like smoke create a negative feedback loop that exacerbates NCDs, further distancing communities from the health and well-being targets of SDG 3.

A Strategic Response to Uphold the 2030 Agenda

To address this challenge, a dedicated resource package has been developed to strengthen the capacity of health systems to manage NCDs in crisis situations. This intervention is designed to advance the 2030 Agenda through several key actions:

1. Facilitate Quality Care Delivery: The package provides health workers with essential guidance to deliver quality NCD care, ensuring continuity of treatment and directly supporting the core mission of SDG 3.
2. Strengthen National Health Systems: By offering the PEN-H protocol as an adaptable framework, the initiative helps nations build robust NCD management into their emergency preparedness plans. This strengthens institutional capacity in line with SDG 16 (Peace, Justice and Strong Institutions) and enhances risk management capabilities as called for in SDG Target 3.d.
3. Complement National Guidance: The resources are designed to augment, not replace, national policies, fostering a cohesive and resilient approach to public health that is essential for making sustainable progress on the interconnected goals of the 2030 Agenda.

Analysis of SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 10: Reduced Inequalities
• SDG 16: Peace, Justice and Strong Institutions

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
     
     Explanation: The article’s primary focus is on Non-communicable Diseases (NCDs) like cardiovascular disease, diabetes, and cancer, which are described as the “leading causes of death and disability worldwide.” It explicitly mentions that these diseases cause “almost 70% of all deaths globally with 82% of these premature deaths happening in LMICs.” The text also highlights “severe situational stress and anxiety” in emergency contexts, which directly relates to promoting mental health and well-being.
   • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
     
     Explanation: The article describes how in humanitarian settings, “health service infrastructure, access to medicines and medical supplies and the health workforce is often weakened.” This directly points to a failure in providing universal health coverage and access to quality healthcare services and medicines for vulnerable populations. The introduction of the “resource package” aims to “facilitate the delivery of quality NCD care,” which is a core component of this target.
   • Target 3.d: Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.
     
     Explanation: The article discusses managing “humanitarian emergencies with health consequences from a range of crises including natural disasters, conflicts… and infectious disease outbreaks.” It proposes a resource package (PEN-H) to be used when “national guidance is not available,” directly addressing the need to strengthen the capacity of countries to manage health risks in crisis situations.

2. SDG 10: Reduced Inequalities

   • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
     
     Explanation: The article highlights a significant health inequality, stating that “82% of these premature deaths [from NCDs] happening in LMICs (low- and middle-income countries).” It also focuses on the specific vulnerability of people living with an NCD in the aftermath of a crisis, who are often excluded from continuous care due to the breakdown of services.

3. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.1: Significantly reduce all forms of violence and related death rates everywhere.
     
     Explanation: The article identifies “conflicts” as a primary cause of humanitarian emergencies. The resulting “increased NCD morbidity and mortality” can be considered a “related death rate” stemming from the violence and breakdown of societal infrastructure that conflicts cause.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Target 3.4

   • Indicator (Mentioned): Mortality rate from NCDs (cardiovascular disease, cancer, diabetes, or chronic respiratory disease).
     
     Explanation: The article directly states that “common NCDs include cardiovascular disease, diabetes, chronic respiratory diseases and cancer” and that they are “responsible for almost 70% of all deaths globally.” Tracking the mortality rate from these specific diseases is a direct way to measure progress.
   • Indicator (Implied): Prevalence of risk factors for NCDs.
     
     Explanation: The article lists several contributing factors to NCD vulnerability, such as “use of tobacco and harmful use of alcohol,” “unhealthy diets,” and “physical inactivity.” Measuring the prevalence of these risk factors in affected populations would serve as an indicator for prevention efforts.

2. Target 3.8

   • Indicator (Implied): Availability of essential NCD medicines and functioning health facilities.
     
     Explanation: The text points to the “interruption of regular medical treatment” and the “destruction of health care facilities” as key problems. Therefore, measuring the percentage of facilities that are operational and have a consistent supply of essential NCD medicines would be a relevant indicator of access to care.
   • Indicator (Implied): Density and capacity of the health workforce.
     
     Explanation: The article notes that the “health workforce is often weakened” in crisis settings. Progress towards universal health coverage could be measured by the number and training level of health workers available to provide NCD care in these contexts.

3. Target 3.d

   • Indicator (Implied): Adoption and implementation of national guidance for NCD management in emergencies.
     
     Explanation: The article introduces the PEN-H resource package as a tool to be used “When national guidance is not available.” This implies that a key measure of a country’s capacity is the existence and application of its own national protocols for managing health risks like NCDs during crises.

4. Table of SDGs, Targets, and Indicators

Source: reliefweb.int