Non-communicable diseases and disability

Non-communicable diseases (NCDs) are conditions which are not infectious, such as heart disease, diabetes and mental health. Although this broad classification includes conditions such as musculo-skeletal problems and some dermatological conditions, four main NCDs have been focused upon - chronic heart diseases, chronic respiratory diseases, diabetes and cancer. These four priority conditions are often, although not always, linked with lifestyle.

NCDs are no longer a subgroup of diseases that can be classified as exclusive to developed nations which has previously been a common misconception. They are being seen in the global south in epidemic and ever growing proportions, where 80% of NCD deaths occur. Moreover, the four priority NCDs are estimated to account for 66.5% of all years lived with disability in low and middle-income countries. Given this growing need for the international community to recognise and address the scale of this problem, a UN High Level Meeting (HLM) on NCDs was held in September 2011 which gave rise to a political declaration on NCDs agreed by all nations. This meeting was the first High Level Meeting focusing upon a health issue since HIV and AIDS in 2001.

The overwhelming focus on NCDs has been on prevention, largely by targeting the four main risk factors - smoking, alcohol consumption, poor diet and reduced physical activity amongst populations. When treatment for NCDs is considered, this is often presented in terms of preventing mortality, rather than focusing on morbidity and the potentially disabling implications of living with an NCD. Additionally, people with disabilities can be a particularly vulnerable high risk group for NCDs. There is a need for enhanced collaboration among actors who advocate for disability issues within NCDs. It is essential that rehabilitation is included in the continuum of care for people living with NCDs, and that NCD programming and policy developments are inclusive. This is supported by article 25 of the Convention on the Rights of Persons with Disabilities (CRPD).

This keylist aims to raise awareness on the issue of NCDs and disability, providing access to key documents, tools and resources to support development practitioners, service providers, policy makers and people with disabilities. We welcome your suggestions: please send comments or suggested additions to sourceassistant@hi-uk.org.

Selected resources

Books, reports, etc

Ageing and the challenge of non-communicable diseases in low and middle-income countries : a position paper

HELPAGE INTERNATIONAL
2011

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This position paper presents detailed information to advocate for a "whole life course approach to NCDs, which is inclusive of all ages, should be adopted for any recommendations on detection and diagnosis, and strategies for prevention, management and treatment as well as more effective care." It concludes with key messages and recommendations, and is useful for anyone interested in ageing and non-communicable disease in low and middle-income countries

AHP cancer toolkit

NHS LONDON

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"This toolkit has been developed by a range of clinicians working in cancer. The information has been provided by a national collaboration of clinicians in conjunction with their professional bodies and is based on available research evidence. This toolkit provides information on the following: Which interventions most positively benefit patient care; What range of interventions over time will reap the most benefits during illness and lead to independence; How do the interventions match to the NHS Outcomes Framework and the Improving Outcomes: a strategy for cancer (Jan 2011); Which interventions are able to save money to the system; How is the functional ability of patients enabled by using Allied Health Professionals (AHPs)...This information is aimed at those involved in commissioning or developing cancer services. The toolkit will provide an interactive method of ensuring that patient care is meeting quality standards and providing essential elements of the QIPP agenda"

AHP diabetes toolkit

NHS LONDON

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"This toolkit has been developed by a range of clinicians working in diabetes care. The information has been provided by a national collaboration of clinicians in conjunction with their professional bodies and is based on available research evidence....This toolkit provides information on the following: Which interventions most positively benefit patient care; What range of interventions over time will reap the most benefits during illness and lead to independence; How do the interventions match to the Outcomes Framework; Which interventions are able to save money to the system; How is the functional ability of patients enabled by using Allied Health Professionals (AHPs)...This information is aimed at those involved in commissioning or developing diabetes care. The toolkit will provide an interactive method of ensuring that patient care is meeting quality standards and providing essential elements of the QIPP agenda"

AHP stroke toolkit

NHS LONDON

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"This toolkit has been developed by a range of clinicians working in stroke care. The information has been provided by a national collaboration of clinicians in conjunction with their professional bodies and is based on available research evidence...This toolkit provides information on the following: Which interventions most positively benefit patient care; What range of interventions over time will reap the most benefits during illness and lead to independence; How do the interventions match to the Outcomes Framework; Which interventions are able to save money to the system; How is the functional ability of patients enabled by using Allied Health Professionals (AHPs)...The toolkit will provide an interactive method of ensuring that patient care is meeting quality standards and providing essential elements of the QIPP agenda"

Call for the recognition of ageing, Alzheimer’s disease and other dementias in the 2011 UN Summit on NCDs

ALZHEIMER’S DISEASE INTERNATIONAL
et al
2011

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This joint position paper highlights that ageing and the associated risk of Alzheimer’s disease and other dementias is a key factor for the 21st century’s social and economic sustainability and should therefore be an essential component of the UN’s NCD considerations. This paper outlines seven related considerations for the UN Summit on NCDs and highlights eight recommendations. This paper is useful to anyone interested in NCDs and ageing

Clinical practice guidelines

WORLD STROKE ORGANISATION STROKE GUIDELINE SUB- COMMITTEE
June 2009

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"This handbook has been developed to provide a basic guide for healthcare professionals who wish to develop or adapt clinical guidelines for stroke care across any point in the continuum of care. This handbook is particularly intended for healthcare professionals who manage stroke patients in developing countries or where healthcare resources are scarce. It aims to promote the use of evidence-informed care through locally developed or adapted guidelines without compromising the quality of the resource"

Diabetes and cardiovascular disease policy brief

OLCHINI, Davide,
PASQUIER, Estelle,
GUIMET, Pauline
September 2012

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"This policy brief is an introduction to Handicap International’s 2012 policy paper on diabetes and other cardiovascular risk factors. It provides an overview of Handicap International's activities in this sector"
Policy brief 6

Diabetes and other cardiovascular risk factors

GUIMET, Pauline,
PASQUIER, Estelle,
OLCHINI, Davide
July 2012

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"This document is an operational guideline produced specifically for Handicap International’s programmes. It is intended to provide them with guidance and a framework for each stage of the project cycle (project development, implementation, monitoring and evaluation) for projects tackling the theme of diabetes and other cardiovascular risk factors (CVRF)"
Policy paper 6

Diabetes prevention and control projects in countries with limited resources|Lessons from experience : know-how analysis

BONARERI, Elizabeth
et al
December 2009

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This analysis paper presents the ‘know-how’ acquired by Handicap International in its diabetes prevention and control projects. It provides six practical know-how analysis sections focusing upon stakeholder mobilisation, services in communities, the decentralisation of diabetes care, diabetes clubs for persons with diabetes, supporting associations of persons with diabetes and conducting a study on a disabling disease project. This report would be useful to anyone interested in diabetes prevention and control in developing countries

Disability and non communicable disease

HANDICAP INTERNATIONAL (HI)
et al
2011

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"This brief discusses the actions urgently needed to ensure that people with impairments due to NCDs have access to treatment and appropriate, timely, affordable, and high quality rehabilitation interventions for all those who need them. These actions are in line with the Proposed Outcomes Document for the Prevention and Control of NCDs, recommendations of the World Report on Disability and the principles and standards of international human rights law, in particular the Convention on the Rights of Persons with Disabilities"

From disease specific toward comprehensive and integrated management of disabling diseases : diabetes, lymphatic filariasis and buruli ulcer

GUIMET, Dr Pauline,
BANTUS, Dr Pierre,
DE LAMARZELLE, Julie
March 2010

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This report documents the exchange of knowledge from a disabling disease seminar focusing upon diabetes, lymphatic filariasis and buruli ulcer. A comprehensive and integrated approach is emphasised, highlighting integrated chronic wound management and lymphoedema care at the community level This resource would be of interest to development practitioners interested in management of disabling diseases
Disabling Diseases Seminar
Nairobi, Kenya
7-11 December 2009

Global status report on noncommunicable diseases 2010

WORLD HEALTH ORGANIZATION (WHO)
2011

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"This report sets out the statistics, evidence and experiences needed to launch a more forceful response to the growing threat posed by noncommunicable diseases. While advice and recommendations are universally relevant, the report gives particular attention to conditions in low- and middle-income countries, which now bear nearly 80% of the burden from diseases like cardiovascular disease, diabetes, cancer and chronic respiratory diseases. The health consequences of the worldwide epidemic of obesity are also addressed"

IDF diabetes atlas

UNWIN, Nigel
et al
2010

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This report presents evidence that diabetes is a global epidemic. It contains comprehensive information in the following sections: What is diabetes?; The Global Burden; Regional Overviews; Diabetes and Development; Linking Local to Global; Resources and Solutions; References; Additional Resources. This report is useful for health professionals, scientists, economists, policy-makers, and national and international agencies

Losing sight : eye health and NCDS

PATEL, Archana,
IRELAND, Elaine
2011

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This position paper presents information to support that "chronic eye conditions which can lead to visual impairment and blindness should be included within prevention, treatment and control strategies for non-communicable, chronic diseases. These include diabetic retinopathy, cataract, glaucoma and age related macular degeneration (AMD). The prevalence and impact of these conditions are rising with changing lifestyles, an ageing population and increased exposure to risk factors such as obesity and hypertension. Governments should act now to include eye health within non-communicable disease (NCD) control and ensure the development of systems which can realistically address these challenges"

NCDs and millennium development goals

THE NCD ALLIANCE

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The Millennium Development Goals (MDGs) state that health is critical to the economic, political and social development of all countries, yet they contain no goals or targets for non-communicable diseases, the largest burden of disease in low- and middle-income countries. This paper highlights the links among MDGs and non-communicable diseases including cardio-vascular disease, asthma, diabetes and cancer

Needs assessment to develop diabetes control and prevention projects in limited-resource countries

HANDICAP INTERNATIONAL
June 2009

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This toolkit provides a guide for international NGOs to implement a needs assessment to develop diabetes control and prevention projects in limited-resource countries. This practical toolkit highlights the necessary details for related log books, guides, frameworks, checklists, job descriptions, reports and templates. This guide is useful for organisations interested in needs assessment to develop diabetes control and prevention projects in limited-resource countries

Non-Communicable diseases in an ageing world : a report from the International Longevity Centre UK, HelpAge International and Alzheimer’s Disease International lunch debate

BAMFORD, Sally-Marie,
SERRA, Valentina
July 2011

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This report, based on the discussion and recommendations from the expert meeting, presents information about the need for a life-course focus on prevention, treatment, management and related care issues on NCDs and for dementia to be addressed as a global priority for action. "The first part of the report highlights salient policy and political issues on the NCD question and summarises some of the key international developments in this regard. The latter section of the report provides a summary of the presentation by Professor Martin Prince, and identifies some of the key themes which emerged from the meeting"
Expert stakeholder lunch meeting
London, UK
4 May 2011

Nutrition, physical activity and NCD prevention : a briefing document

THE NCD ALLIANCE
2011

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"The NCD Alliance Proposed Outcomes Document calls on governments around the world to commit to actions in a number of key areas to tackle the global burden of Non-Communicable Diseases (NCDs). This briefing document works in synergy with the Proposed Outcomes Document and provides evidence-based actions for nutrition and physical activity related aspects of NCD prevention...(This) briefing document is divided into two sections. Part A provides Key Messages and Guiding Principles together with clear Calls for Action to improve nutrition and increase physical activity. Part B presents an overview of the available evidence of nutrition, physical activity and NCDs, and of effective policies and interventions to reduce the common risk factors"

Sustaining human development : addressing NCDs and disability across the lifecourse

THE NCD ALLIANCE
et al
2013

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This report explores three interconnected global trends — a growing burden of non-communicable diseases (NCDs), the rising prevalence of disability, and changing global population demographics (including rapidly ageing populations). The report highlights that there issues were collectively neglected as policy priorities during the era of the Millennium Development Goals (MDGs). It stresses that the unique opportunity to ensure a future framework that fully integrates NCDs, that goals and targets drive progress for all people including persons with disabilities, and that a lifecourse and rights-based approach underpins all goals and targets to ensure no one is left behind

United Nations High Level Meeting on non-communicable diseases

DUTTINE, Antony,
PASQUIER, Estelle
December 2011

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"During the 66th UN General Assembly in New York a High Level Meeting on Non-Communicable Diseases (NCDs) was convened. This was only the second time that a health issue had been discussed at such an international forum. The resulting political declaration recognised this global health challenge, which has reached pandemic proportions, and took steps to recommend action on prevention, treatment and coordination for the management of NCDs. Many NCDs can be potentially disabling for individuals who live with them and persons with disabilities can be also susceptible to developing NCDs. Handicap International, with the approval of several other disability focussed organisations, attended the meeting and advocated for the inclusion of disability within the NCD agenda. This document describes the outcomes of the High Level Meeting and collaborations engaged in before, during and afterwards. It recommends future action to continue to push for the inclusion of disability into the NCD agenda though a collaborative approach"

Databases

Data

INTERNATIONAL DIABETES FEDERATION (IDF)

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This section of IDF’s website contains key diabetes statistics from the seven regions of the world in 2010. The diabetes statistics include the prevalence estimates, death attributes and health expenditure. This data is useful for anyone interested in regional diabetes statistics

Global health observatory (GHO) : non-communicable diseases (NCD)

WORLD HEALTH ORGANIZATION (WHO)

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This area of the global health observatory (GHO) provides access to WHO's global non-communicable disease (NCD) statistics. It presents general NCD information, mortality and morbidity statistics, risk factors, and the health system’s response and capacity to address and respond to NCDs. Links are also provided to related NCD data products. This database is useful to anyone interested in NCD related statistics and data

Information center

LEGS TO STAND ON

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Legs to Stand On is an initiative to prevent disease and restore the lives of persons afflicted with disabling diseases of the lower limb in countries with limited resources. The initiative targets four of the leading causes of disability worldwide (lymphatic filariasis, leprosy, Buruli ulcer, diabetes) and other physical problems affecting the foot and lower limb. This information center presents useful information about their projects, partner projects, e-achieve, disabling diseases and a press center

Resources

THE NCD ALLIANCE

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This section provides resources such as reports, presentations, statements, press releases and other forms of media coverage about non-communicable diseases and the initiatives of The NCD Alliance. This resource is useful to anyone interested in non-communicable diseases

The WHO global infobase

WORLD HEALTH ORGANIZATION (WHO)

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"The WHO Global InfoBase is a data warehouse that collects, stores and displays information on chronic diseases and their risk factors for all WHO member states...The Infobase assembles, for the first time in one place, non-communicable disease (NCD) risk factor data collected from WHO Member States. NCD risk factor data are crucial for predicting the future burden of chronic diseases in populations and also for identifying potential interventions to reduce the future burden. The Infobase online dissemination tool provides not only data but also health information to help users understand health enquiries worldwide and improve the health of nations." NCD indicators, mortalities and country profiles are provided, displaying the information with user-friendly tools including graphs, maps and data tables. This database is useful to anyone interested in NCD related statistics and data

Journal articles

Obesity in disabled children and adolescents : an overlooked group of patients

REINEHR , Thomas
et al
April 2010

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This article presents the results of a literature review about the relationship between disability and obesity in childhood and adolescence. "A total of 38 relevant articles were identified. All studies agreed that the prevalence of overweight and obesity in children with disabilities was almost twice that in their non-disabled peers. No effective, long-lasting interventions for obesity in disabled children and adolescents have been published. Conclusion: Since a high proportion of disabled children and adolescents are overweight or obese, effective strategies for preventing and managing excess weight need to be developed so as not to further endanger their social participation. Moreover, risk factors for overweight in disabled children and adolescents should be identified and their weight status carefully monitored"
Deutsche Arzteblatt International Journal, Vol 107, Issue 15

Tackling NCDs : a different approach is needed

DE MAESENEER, Jan
et al
May 2012

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"The NCD Alliance aims to put non-communicable diseases (NCDs) on the global agenda to address the NCD-crisis. Improving outcomes in morbidity and mortality by 2015 will clearly depend to a large extent on tackling the burden of NCDs, especially in developing countries"
To access this article, users need to register (free) online
The Lancet, Vol 379, Issue 9829

Websites

High level meeting on non-communicable diseases

GENERAL ASSEMBLY OF THE UNITED NATIONS

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This website presents information from the high-level meeting of the General Assembly on the prevention and control of non-communicable diseases. The high-level meeting addressed the prevention and control of non-communicable diseases worldwide, with a particular focus on developmental and other challenges and social and economic impacts, particularly for developing countries. Background information, key documents, civil society participation, resources and letters are provided. This website is useful to anyone interested in prevention and control of non-communicable diseases worldwide
High level meeting on non-communicable diseases
New York, New York
19-20 September 2011

World diabetes foundation

WORLD DIABETES FOUNDATION

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The World Diabetes Foundation supports the prevention and treatment of diabetes in developing countries through partnerships. This website presents information about the Foundation, their key focus areas, global projects and stories from the field

World heart federation

WORLD HEART FEDERATION

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The World Heart Federation urges greater action from policy makers, healthcare professionals, patient organizations and individuals to work together to reduce the burden of heart disease and stroke, and ensure people all over the world can have longer and better lives. This website presents information about the federation, activities and members, as well as background information about cardio-vascular health. Details about related congress and events, publications and press are also provided