ZIMBABWE is currently meeting other African countries in Harare for the Global Fund Regional workshop to support countries with integrating NCDs and mental health into their funding request proposals to the Global Fund.
By Michael Gwarisa
The three day meeting is being attended by delegates from Ministries of Health from the African region, partners, and People Living with HIV/AIDS (PLWHIV) from Ghana, Mozambique, Tanzania, Zambia and Zimbabwe. Various speakers who during the official opening day concured that while there have been huge investments towards HIV, TB and malaria response through the Global Fund, little resources have been dedicated to address non-communicable diseases NCDs.
Speaking during the official opening of, Ministry of Health and Child, Dr Simon Nyadundu, Chief Director for Human Resources and Administration in the Ministry of Health and Child Care said the workshop had come at a time the treat of NCDs was increasingly becoming a burden in the HIV and TB fight.
The burden of NCDs on the Zimbabwean health care system is huge. Addressing NCDs is one of the Government of Zimbabwe’s key priorities, which is being spearheaded by the NCD department within the Ministry of Health and Child Health Care (MoHCC).
“The Government of Zimbabwe is committed to investing in NCDs and Mental health. We are happy to see that Global Fund is emphasizing on strong investment cases and it is my pleasure to announce that we have recently completed an investment case for Mental health, a vital step towards increasing resources for mental health,” said Dr Nyadundu.
He added that treatments and care for NCDs and mental health are often not integrated into HIV and TB essential care packages despite evidence showing the need to tackle NCDs to end HIV or TB. He also said government acknowledges the bidirectional relationship between HIV/TB and NCDs and these departments have been collaborating to address this burden.
“As the countries work on the Global Fund proposals, lets ensure we integrate NCDs and Mental Health. According to data, NCDs are the leading cause of death globally, with 15 million people dying globally every year between the age of 30 and 70. Almost half of these deaths are in low to middle income countries. This is despite the fact that most of these NCDs are preventable and are now well studied and understood. With the right policies for NCD prevention and treatment, this increasing trend can be reversed.”
The Global Fund Strategy 2023-2028 recognizes that to end AIDS, TB and Malaria, investments will have to include support to prevention and management of the NCDs and mental health co-morbidities that negatively impact achievement of the Global Fund outcomes. The new Global Fund Strategy 2023-2028 further recognizes the need for resilient and sustainable systems for health (RSSH) to deliver HIV, TB and malaria outcomes, to meet people’s and communities’ broader health needs, to build pandemic preparedness and response (PPR) capacities and to achieve SDG 3.
“It is important to prioritize early detection for NCDs within existing HIV platforms supported by the Global Fund and ensure proposed interventions reflect integrated people-centered services and approaches,” notes Global Fund Senior HIV Advisor Dr Lee Abdelfadil.
Meanwhile, WHO Representative to Zimbabwe, Professor Jean-Marie Dangou said the workshop being held in Harare was an opportunity for the respective countries to review and integrate NCDs and mental health strategic investments in your draft Global Fund funding requests.
“It is a fact that NCD burden continues to grow and is increasingly becoming the main cause of mortality in the WHO African Region where they were responsible for 37% of deaths in 2019, rising from 24% in 2000,” he said.
“Despite several high-level political meetings on NCDs with ambitious targets which are aimed at reducing the rising burden of NCDs, progress towards meeting these agreed goals and targets has been slow, according to the NCDs Progress Monitor 2020. The premature mortality from NCDs (death before the age of 70) accounted for more than 50% of deaths in some Member States such as Algeria (76%), Cabo Verde (70%), Mauritius (89%), Sao Tome and Principe (55%), Seychelles (81%), and South Africa (51%). In Zimbabwe, NCDs accounted for 39% of all-cause mortality in 2019 in both sexes (34% in males and 45% in females).”
He added that NCDs affect lives of millions of people, their families and communities.
“Many people are unable to access the care they need, and many are being pushed into poverty when health care is unaffordable. NCDs are an enormous drain on global and national economies – according to one estimate, they will cost US$ 30 trillion in the years 2011 to 2030.
“In addition, NCDs have a negative impact on health, and they leave people vulnerable to other health conditions, and lead to severe outcomes from other diseases such as HIV, TB or COVID-19. The bidirectional relationship between these HIV, malaria and TB and NCDs including diabetes, CVDs, cancer, chronic obstructive pulmonary disease, sickle cell disease and mental health as well as with NCD risk factors such as tobacco and alcohol use, has been established.”
According to the World Health Organisation, in 2021, up to 490,000 Tuberculosis cases were attributed to diabetes. People living with HIV and TB experience higher rates of depression and other common mental health conditions.
Mental and neurological and substance use disorders account for more than 10% of the global disease burden. In low-middle income countries, more than 75% of people with mental health disorders receive no treatment at all for their disorder.
At 24%, depression is higher among people living with HIV in sub-Saharan Africa compared with less than 3% for the general population. Depression is also associated with delays in TB diagnosis, treatment, poor treatment outcomes, disability, poor quality of life, treatment failure and death.
Meanwhile, Cardiovascular diseases constitute one of the leading causes of non-AIDS-related morbidity and mortality among PLWHIV. Women with HIV are more likely than non-HIV positive women to develop cervical cancer with the fraction of cervical cancer attributable to HIV of 40% or more in nine countries in the region being significantly higher that the less than 5% in 122 countries with lower HIV prevalence (Global average 5%).