Sir George Alleyne, Alafia Samuels, and Karen Sealey explain the tensions between advocacy factions in the effort to reduce non-communicable diseases (and communicable diseases), and potential constructive resolutions.
Recent global health conferences have highlighted many of the issues that health and other sectors must address to prevent and control NCDs. This growing awareness about non-communicable diseases (NCDs), coupled with the upcoming United Nations High Level Meeting on Non-communicable Diseases, marks a significant milestone in the effort to raise the political priority of NCDs. However, this has brought to the fore several tensions inherent in focusing on any particular health problem.
First, there will inevitably be challenges that arise from the nature of the diseases or health problems themselves, as different constituencies attempt to promote to one or other group of diseases, and clamoring to highlight “their” category of disease or heath issue – for example, communicable diseases vs. NCDs. Further strain emerges within disease groupings, with “factions” and advocates using one or other metric to claim priority for their disease, e.g. within NCDs, cancer vs. chronic respiratory diseases. It is also salutary to note that there are also tensions within the communicable disease community as arguments arise over the attention paid to malaria versus other infectious diseases such as HIV/AIDS. Although these tensions may be decried as being unhelpful, they do exist, must be recognized and, if possible, converted into sources of creative energy for improving health.