Prevention and control of NCDs: a business case in Kyrgyzstan

Buying healthy food at the market

Both health and economy would benefit from investing in the prevention of NCDs

Almost 4% of Kyrgyzstan’s gross domestic product is lost due to noncommunicable diseases (NCDs) such as cancer, cardiovascular diseases, diabetes and chronic respiratory diseases. These diseases and their risk factors are an increasing public health and development challenge. Cardiovascular diseases, for example, cause half of all deaths in the country.

A new report from WHO and the Kyrgyz Government shows that implementing measures to prevent NCDs would not only bring health gains for the population, but would also have a return on investment of up to 12 times the cost of the intervention. This is one of a series of reports WHO/Europe is producing in collaboration with the United Nations Interagency Task Force on NCDs and the United Nations Development Programme.

The report was launched at a multistakeholder forum with United Nations partner agencies on 20 September 2017 in Bishkek. Analysing the economic burden of NCDs, the cost of interventions and the return on investment, it shows that the reduced cost of a healthier population often far outweighs the investment needed to lower the prevalence of NCDs.

Health care costs are just the tip of the iceberg

The premature death, morbidity and disability associated with NCDs have a negative impact on socioeconomic development. As in many parts of the world, NCDs in Kyrgyzstan are causing a surge in health-care expenditure. The Government is estimated to have spent US$ 54 million on treatment for the 4 main NCDs (cardiovascular diseases, diabetes, cancer and respiratory disease) in 2015.

However, the analysis of the economic burden of NCDs found that government expenditure on health care for NCDs is just the tip of the iceberg. The hidden additional costs from lost productivity are almost 4 times higher, at approximately US$ 213 million.

Altogether, the current economic cost of NCDs to Kyrgyzstan’s economy is approximately US$ 250 million per year, which is equivalent to 3.9% of the country’s annual gross domestic product.

Cost-effective interventions

Actions to prevent NCDs in Kyrgyzstan are relatively inexpensive and cost-effective. The analysis of intervention costs reviewed interventions in the areas of tobacco use, physical inactivity and unhealthy diet, as well as a package of clinical interventions for cardiovascular diseases and diabetes.

A benefit-to-cost ratio of 12:1 on investments

The economic modelling for the analysis of return on investment suggests that the most cost-effective intervention in Kyrgyzstan is the package of salt-reduction interventions. Reducing tobacco consumption – for example, through increased taxation – and increasing physical activity in the population would also be very cost-effective.

The economic benefits of these packages far exceed their costs, especially in the long term. The salt-reduction policy package achieved a benefit-to-cost ratio of 12:1 when considered across a 15-year period.

The economic burden of NCDs will grow

Cardiovascular diseases cause 50% of all deaths in Kyrgyzstan. Although almost half of the adult population (43%) has hypertension, the majority (79%) of these individuals are not taking antihypertensive medication. Further, 45% of men smoke tobacco, 1 in 5 people is obese, and Kyrgyzstan is estimated to have one of the highest salt intakes in the world.

The increasing and relatively young population of Kyrgyzstan, and the increasing prevalence of NCD risk factors, suggest that unless action is taken rapidly, the costs of NCDs will grow even further. This would act as a huge drag on the country’s economy.

WHO/Europe and the WHO Country Office in Kyrgyzstan coordinated the preparation of the report under the 2016–2017 biennial collaborative agreement between the Ministry of Health of Kyrgyzstan and WHO/Europe. This report, as well as the business case project in Kyrgyzstan, was made possible by funding from the Government of the Russian Federation.