Integration Science for universal health coverage and the noncommunicable diseases and injuries (NCDIs) of the poorest billion
Global public health strategies since World War II have traditionally focused on addressing the small number of diseases or risk factors that were thought to account for the vast majority of premature death among those living in extreme poverty: the poorest billion. More recent research is showing that the noncommunicable diseases and injuries (NCDIs) account for more than a third of the all-age burden in these populations. However, because of young age and different risk exposure pattern of the poorest billion as compared with other populations, there is not a limited number of “best buy” clinical interventions that could be scaled to achieve great health impact with equity. Instead, there is a long tail of attractive medical and surgical interventions addressing severe and heterogenous conditions such as, for example, rheumatic and congenital heart disease, Type 1 diabetes, sickle-cell disease, congenital hydrocephalus, epilepsy, psychotic disorders, and orthopaedic trauma. The supply-side constraints to delivering these interventions in low- and lower-middle income (LLMIC) countries are significant. The challenge for advocacy and delivery on the path to universal health coverage (UHC) in the poorest populations is to develop an “integration science” to relieve these supply-side constraints in an efficient fashion. This side meeting will bring leaders from LLMICs engaged in newly-established National NCDI Poverty Commissions (http://www.ncdipoverty.org/countries/) together with management researchers and global health policy experts to discuss how emerging theories of health system integration could be applied to the problem of the NCDIs of the poorest billion (NCDI Poverty).
"Integration Science" for universal health coverage and the noncommunicable diseases and injuries (NCDIs) of the poorest billion (Side Meetings - Prince Mahidol Award Conference 2019)