Opportunities for Prevention and Control(cont...)

For each country, the focus and prioritization of efforts depend on the disease burden, health and nonhealth sector capacity, government priorities and resources, and the policy environment. Policy makers need to consider the role of the public sector in the following (and see Chapters 6 and 7):

* Population-based NCD burden assessments and surveillance to monitor change and improve

policy decisions

* Strategy development and coordination within and outside the health sector

* Implementation of population-based health promotion laws and campaigns in the community,

to reduce modifiable risk factors

* Improvement in access to individual-based prevention and treatment within the clinical setting

* Implementation of activities including setting human resource and health facility standards;

assessing the quality of care, treatments, drugs, and technology; developing and enforcing a regulatory framework; and providing and/or regulating health financing, which should address

allocation of services, equity, risk sharing, and consumption smoothing.

Even though most of these functions apply to far wider diseases and health conditions than NCDs, they highlight the need to improve the health system infrastructure for addressing NCDs. Such improvement will also result in benefits for other disease prevention and control measures.

Some countries are already taking action. They have developed policies and are launching programs, but most of these moves are still in their very early stages, and implementation and scaling up are slow.

However, although few empirical data exist, as national budgets become stressed and health budgets shrink, low- and middle-income country governments are often encouraged to focus on addressing the Millennium Development Goals (MDGs), which still have many health challenges, but which as a set or international targets do not take into account the increasing impact of NCDs.

Development partners, in focusing their efforts on issues that will more readily elicit support from their constituents, have largely funded the MDGs. Another challenge is that NCD prevention policies (such as tobacco taxation) are largely implemented outside the health sector and require the health sector to develop new relationships both with non-health sector stakeholders and with public–private partnerships.