Over 1 in 3 people affected by neurological conditions, the leading cause of illness and disability worldwide

Over 1 in 3 people affected by neurological conditions, the leading cause of illness and disability worldwide

Geneva, 14 March 2024– A major new study released by The Lancet Neurology shows that, in 2021, more than 3 billion people worldwide were living with a neurological condition. The World Health Organization (WHO) contributed to the analysis of the Global Burden of Disease, Injuries, and Risk Factor Study (GBD) 2021 data.

Neurological conditions are now the leading cause of ill health and disability worldwide. The overall amount of disability, illness and premature death (known as disability-adjusted life years, DALYs) caused by neurological conditions has increased by 18% since 1990.

Over 80% of neurological deaths and health loss occur in low- and middle-income countries, and access to treatment varies widely: high-income countries have up to 70 times more neurological professionals per 100 000 people than low- and middle-income countries.

“Neurological conditions cause great suffering to the individuals and families they affect, and rob communities and economies of human capital,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This study should serve as an urgent call to action to scale up targeted interventions to allow the growing number of people living with neurological conditions to access the quality care, treatment and rehabilitation they need. It is more important than ever to ensure brain health is better understood, valued and protected, from early childhood to later life.”

The top ten neurological conditions contributing to loss of health in 2021 were stroke, neonatal encephalopathy (brain injury), migraine, dementia, diabetic neuropathy (nerve damage), meningitis, epilepsy, neurological complications from preterm birth, autism spectrum disorder, and nervous system cancers.

Overall, neurological conditions cause more disability and health loss in men compared to women, but there are some conditions like migraine or dementia where women are disproportionately affected.

Since 1990, the absolute number of individuals living with, or dying from, neurological conditions has increased, while age-standardized DALY rates have dropped. This means that increases in absolute numbers are mainly driven by demographic change and people living longer.

Diabetic neuropathy was the fastest growing neurological condition. The number of people with diabetic neuropathy has more than tripled globally since 1990, rising to 206 million cases in 2021. This increase is in line with the worldwide increase in diabetes. Other conditions such as neurological complications from COVID-19 (for example, cognitive impairment and Guillain-Barré syndrome) did previously not exist and now account for over 23 million cases.

At the same time, neurological burden and health loss due to other conditions decreased by 25% or more since 1990 as a result of improved prevention (including vaccines), care and research: tetanus, rabies, meningitis, neural tube defects, stroke, neurocysticercosis (parasitic infection that affects the central nervous system), encephalitis (inflammation of the brain), and neonatal encephalopathy (brain injury).

The study also examined 20 modifiable risk factors for potentially preventable neurological conditions such as stroke, dementia and idiopathic intellectual disability.

Eliminating key risk factors – most importantly, high systolic blood pressure and ambient and household air pollution – could prevent up to 84% of stroke DALYs. Similarly, preventing exposure to lead could reduce the burden of idiopathic intellectual disability by 63.1%, and reducing high fasting plasma glucose levels could reduce the burden of dementia by 14.6%. Smoking significantly contributed to stroke, dementia and multiple sclerosis risk.

More investments needed to improve treatment, care and quality of life

At the World Health Assembly in 2022, Member States adopted the Intersectoral global action plan on epilepsy and other neurological disorders 2022–2031 (IGAP) with ambitious scope to address the long standing neglect of neurological disorders.

“The Intersectoral Global Action Plan 2022–2031 sets out a roadmap for countries to improve prevention, early identification, treatment and rehabilitation of neurological disorders. To achieve equity and access to quality care, we also need to invest in more research on risks to brain health, improved support for the healthcare workforce and adequate services,” said Dévora Kestel, Director, WHO Department of Mental Health and Substance Use.

IGAP sets out strategic objectives and targets to improve access to treatment, care and support for people with neurological disorders; implement strategies for brain health promotion and disease prevention; strengthen research and data; and emphasize a public health approach to epilepsy and other neurological disorders.

? NCDs  outcomes NDoH March 2023?

? NCDs outcomes NDoH March 2023?

NCDs related outcomes for APP 202s/2023

NCDs are a neglected priority in the National Department of Health (NDoH) Annual Performance Plan 2022/23 (APP) which expires at the end of March. Only 4 /18 outcomes in programme 3 are NCD-related.

The bottom 2 rows in the table, require the re-development of national policies for mental health and obesity.  Transparency and an inclusive  process are problematic.
Our Constitution calls for the meaningfu involvement of civil society and people living with NCDs. Together these conditions impact millions of South Africans and place increasing burden on the health system.
It would also be great to see the reviews of the existing policies which should come before a new policy.

The NCDs+ National Strategic Plan 2022-2027, launched in May 2023, (see the top row in the table) Implying that the provinces will have be close to publishing the impemetion plans for obesity, diabetes and hypertension. I know there is lots hard work getting the plans ready. The Medium-Term Strategic Framework 2019-24 makes it clear that NCDs budgets and  implementation must happend in at the sumbnational or provinical level.

 

Comment on: WHO Zero Draft Framework for Meaningful Engagement people with NCDs & mental health

Comment on: WHO Zero Draft Framework for Meaningful Engagement people with NCDs & mental health

WHO has launched a web-based consultation on Zero Draft of the WHO Framework for Meaningful Engagement of People Living with Noncommunicable diseases (NCDs) and Mental Health conditions (hereby ‘The Framework’). The web-based consultation is open until the 14th of November, 2022.

The Framework will support WHO and Members States in the meaningful engagement of individuals with lived experience to co-create and enhance related policies, programmes, and services. The framework has been co-created with individuals with lived experience, WHO, Member States and other relevant partners. WHO has proactively prioritized and included individuals with lived experience across a range of evidence-generating activities and processes, which has informed the Zero Draft of the Framework

Member States, UN organizations, non-State actors and individuals with lived experience are invited to submit their comments through e-mail to [email protected]The response can be given in any of the six official UN languages: Arabic, Chinese, English, French, Russian or Spanish. We kindly note that the deadline for comments is 14th November 2022.

To submit your comments or to ask any queries on the Framework or the web-based consultation, please contact:  Mr Jack Fisher, Technical Officer, Global Coordination Mechanism on NCDs, Global NCD Platform, [email protected]

Please share this URL and attached social media tile widely across your networks to ensure all key stakeholders have the opportunity to provide inputs and feedback into the Zero Draft. We deeply appreciate all your inputs and support to date and look forward to hearing the response of the wider community.

WHO mental health report launch -Transforming mental health for all.

Mental health is critically important to everyone, everywhere. All over the world, mental health needs are high but responses are insufficient and inadequate.  This comprehensive report draws on the latest evidence available, showcasing examples of good practice from around the world, and voicing people’s lived experience of mental health conditions. It highlights why and where change is most needed and how it can best be achieved.

It calls on all stakeholders to work together to deepen the value and commitment given to mental health, reshape the environments that influence mental health and strengthen the systems that care for people’s mental health.

Register information coming soon here. hh WorldMentalHealthReport

2023 NDoH Annual Performance Plan presentation

2023 NDoH Annual Performance Plan presentation

Today is the health budget speech at 14:00, and in the interests of transparency and inclusivity, it would be great if we, the people, had a look at it beforehand. The budget speech is a version of the Annual Performance Plan (APP) for the financial year to 31 March 2023.

So we are already into the financial year, and the APP23 s already in progress. Having asked for said APP23 PDF, and scouring government and parliamentary websites, we are still in the dark. The closest we came to is a presentation from the health portfolio committee.


The most positive aspect for NCDs+ is that NCDs+ are still in stream, branch or programme 3 along with communicable diseases. At least it hasn’t be shoved back in Programme 4 Primary Health Care where it languished without food or water.

Mind you it is unlikely to change much since the Medium Term Strategic Framework 2019-2024 (MTSEF24) does not prioritise NCDs+ or allocate funding. Except in the most peripheral way. I call this the legacy of 3M era: MDGs, Motsoaledi and Mkhize. Too bad that we are in SDG times and need different action to achieve universal health coverage (UHC target 3.8) and there is more than the target 3.4to achieve action on NCDs.

The MTSF 2019-2024 – a lasting legacy courtesy of the 3M era, MDGs, Motsoaledi and Mkhize.
The absence of national budgets for NCDs+ is not the only issue. At the last count maybe one province had a sort-of-NCDs plan. Clear budget line items are awaited as an evolutionary step like the missing link. It would would great to have progress at the implementation level and within National Health Insurance budgets.

Joy there is a change to the number of outcomes and outputs covering NCDs+ in the APP23. That means a lot without a programme budget and an implementation plan.