What score can we get in fighting chronic disease?

An international study involving China and 22 other countries about their performance in reducing the burden of NCD (non-communicable disease) has been published today in the Lancet.

The new method shows that although China, like other upper- and middle- income countries (UMICs), has an even stronger government leadership in combating NCD, the control of major risk factors and the health system reform in response of NCDs are relatively weak, indicating that there’s still a long way to go.

The NCD Scorecard Study measured performance across governance, risk factors, surveillance/research, and health system response. Scores were gathered in each of the 23 countries, mostly low- and middle- income countries, for 51 indicators from representatives of government, private sector, non-governmental and academic institutions.

In the past few decades, China has experienced rapid economic development and fast aging, and both are driving the increases in the burden of NCD, which accounts for 86% of total deaths according to the National Health and Family Planning Commission, and costs a lot for treatment.

In terms of the progress in prevention and control of NCDs, the NCD Scorecard Report shows that compared with other UMICs, China performed well in governance and development of national plans, as well as having a fairly good system for the surveillance of NCD mortality and major risk factors, with a score of 67% and 64% respectively.

On health system response, China made it at 63%, which was 8% less than other UMICs. Like other UMICs, China had the worst score on control of risk factors with a score of only 33%.

Yangfeng Wu, Professor from The George Institute for Global Health at Peking University Health Science Center, coordinator of the study in China, said that the low score on risk factors control was expected and explainable which called for effective and sufficient actions from the national level.

“However, as many responders might not really understand the questions and health system level issues, China received a lower score than expected on health system responses,” said Professor Wu. “For example, China received a score of zero on the item ‘Number of health workers/10,000 of population’. That may just reflect the strong desire of Chinese responders for increasing the number of health workers in China, rather than the actual degree of fulfilling the health needs.”

In the next 5 years, China will face an even bigger challenge. “The control and prevention of NCD is long-term work. Led by the government, all sectors of the society need to be involved to achieve the goal of ‘25*25’ set by World Health Organization,” said Professor Wu.

“It requires us to continuously strengthen the primary health system, invest more in the national NCD action plan, implement more national programs on control of major risk factors, improve the NCD surveillance system and develop more cost-effective and scalable interventions suitable to Chinese society.”

Full results for all indicators for each country are available at www.ncdglobalscorecard.org, and reports on each country identify areas where countries are doing well and the priorities for action.