By: Alanna Shaikh

So to continue our previous discussion, what can we do to eliminate both non-communicable diseases and neglected tropical diseases? There are two things – we can improve governance and we can strengthen health systems.

I’ve written before about the impact that governance has on health. Whether you are looking at emergency response, stopping an epidemic, or fighting chronic illnesses, you need a government that can create an environment that supports good health and functional health care. That means decent roads, packaged food that’s clearly labeled and safe to eat, access to fresh food, access to safe drinking water, public trash collection…the list goes on and on. Improving health is nearly impossible when the government can’t support the effort.

So, good governance is vitally important to reducing both non-communicable diseases and neglected tropical diseases. And, to be fair, not just NCDs and NTDs, but all health issues. The strong environmental linkages to NTDs and NCDs, though, make governance especially important.

And then we have health systems. It’s always hard to write about health systems. I can practically feel people’s eyes glazing over in advance. But the fact is that without a solid health system, you can’t defeat any kind of health issues, let alone face the thorny complexity of eliminating neglected tropical diseases or non-communicable diseases.

Here’s what the World Health Organization says a health system requires:

The exact configuration of services varies from country to country, but in all cases requires a robust financing mechanism; a well-trained and adequately paid workforce; reliable information on which to base decisions and policies; well-maintained facilities and logistics to deliver quality medicines and technologies.

Here’s what health systems in resource-constrained countries tend to lack: everything. Facilities are old and under-equipped, provider salaries are low and their education is limited and out of date, the whole system lacks funding and there is no system to track patient information, medicine, or supplies. No wonder it’s hard for people to get good health care.

Building up the health system improves care for every health issue. Training health care providers and paying them better improves the quality of health services and decreases the number of bribes patients have to pay to get care. Repairing health care facilities improves diagnostics, access to care, and patient safety. Tracking supplies and establishing a mechanism to get them where they are needed makes treatment better. Keeping good patient records improves care across the board. Increasing funding to the health system, and ensuring that funding is used efficiently, supports all other aspects of the system.

NCDs and NTDs don’t have to be an either/or. Sure, training providers on proper treatment for diabetes isn’t the same as training them on removing a guinea worm. But training providers on how to counsel patients and help them change their behavior benefits both conditions. And the rest of the health system factors – facilities, logistics, recordkeeping, provider pay and everything else – they benefit not just people with NCDs or NTDs, but everybody who requires medical care.

Alanna Shaikh is an expert in health consulting, writing about global health for UN Dispatch and about international relief and development at Blood & Milk. She also serves as a frequently contributing blogger to ‘End the Neglect.’ The views and opinions expressed by guest bloggers are not necessarily the views and opinions of the Global Network. All opinions expressed here are Alanna’s own and not those of any employer or the US government.