Scientific Article
Time to Align: Development Cooperation for the Prevention and Control of NCDs

Téa E Collins (email:, Rachel Nugent, Douglas Webb, Erika Placella, Tim Evans, Ayodele Akinnawo
Collins Téa E, Nugent Rachel, Webb Douglas, Placella Erika, Evans Tim, Akinnawo Ayodele et al. Time to align: development cooperation for the prevention and control of non-communicable diseases BMJ 2019; 366 :l4499
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Time to Align: Development Cooperation for the Prevention and Control of Non-Communicable Diseases

Research analysis

Key messages

  • Investments in NCD prevention and control offer great potential to countries at all income levels to advance their economic growth
  • Adequate catalytic development funds for NCD prevention and control are particularly important in low income and fragile countries, where resources are limited but the needs are great
  • Traditional North-South development assistance is increasingly being replaced by South-South and triangular cooperation
  • Scope and funding of national multisectoral plans for NCD prevention and control are insufficient, perpetuating a misalignment between development cooperation and the needs and priorities of recipient countries


Financing sustainable development, especially for health, is important for dealing with the tremendous challenges faced by low income countries. Many cannot meet their populations’ basic needs from domestic public resources alone. Traditionally, high income countries have considered external assistance to be a foreign policy matter, influenced by national political and economic considerations. They have usually seen areas of health, such as infectious diseases, as having major implications for their national security.

Until recently, however, non-communicable diseases (NCDs) have not been seen as part of the global development agenda, and external resources for their prevention and control have been negligible. A change in the disease profile from communicable diseases to NCDs in low and middle income countries resulted in the inclusion of NCDs in the 2030 agenda for sustainable development. Nonetheless, health systems in those countries are ill prepared to deal with the high epidemiological and economic costs of chronic conditions. These conditions have now been recognised in global political forums.

The increasing importance of NCDs in the development agenda was validated by the three United Nations General Assembly high level meetings on non-communicable disease prevention and control (in 2011, 2014, and 2018) and the 2030 agenda for sustainable development. The agenda includes a target of one third reduction of premature mortality from NCDs by 2030.

The 2030 agenda also emphasises the importance of official development assistance. It calls on high income countries “to reaffirm their commitment to achieve the target of 0.7% of gross national income for official development assistance to developing countries.”

What does the combination of greater political intent and weak existing ability to deal with NCDs mean for development assistance for health? A clear answer to this question is particularly important for low income and fragile countries, where government spending on health is low, public institutions and regulatory bodies are weak, and reliance on external help for basic health needs is high. We examine the challenges of mobilising and tracking resources for NCDs. Additionally, we highlight the importance of international cooperation to accelerate progress towards the NCD and the related targets of the 2030 agenda.

Source Website: The BMJ