Non-Communicable Disease Treatment Falters Under COVID-19

The WHO surveyed 155 countries. Although low-income countries were most affected, COVID-19’s negative impact on non-communicable disease treatment was found across the nations surveyed. The findings paint a grim picture for those seeking care for non-communicable diseases during the global pandemic:

• 31% of countries reported disruptions in treatment of cardiovascular emergencies
• 42% of countries reported disruptions in treatment of cancer
• 53% of countries reported disruptions in treatment of hypertension
• 63% of countries reported disruptions in rehabilitative services

Rehabilitative services were the single most disrupted treatment, with nearly two-thirds of countries reporting issues. WHO suggests that rehabilitation continues to be wrongly perceived as a non-essential health service when, for many patients, it is indeed essential. The shortfall in care adversely affects the millions of patients with rheumatic and musculoskeletal conditions, among others.

Because people with a non-communicable disease also may be at higher risk for COVID-19 complications, the lack of treatment access has a compounded effect during the pandemic. The WHO’s Dr. Bente Mikkelsen explained that “not only are people with [non-communicable diseases] more vulnerable to becoming seriously ill with the virus, but many are unable to access the treatment they need to manage their illnesses.”

Disruptions stem from several factors:

• Closures and social distancing measures. To prevent infections, appointments for screenings and management are being postponed.

• Staffing. Some services are being curtailed because staff are being reassigned and resources reallocated.  Of the countries in the study, 94% reported that health staff working with non-communicable diseases were either partially or fully reassigned to support COVID-19 patients.

• Cancellations and lack of public transportation.  The study reported that some patients canceled treatment due to a lack of access to public transportation.  Others may cancel out of fear of leaving their homes or of potentially risking COVID-19 exposure by visiting a clinic or hospital.

Many countries were lacking even before the pandemic. WHO reports chronic underinvestment in the prevention, early diagnosis, screening, treatment and rehabilitation for non-communicable diseases over the past decade. For example, fewer than half of countries had guidelines for the four major non-communicable diseases. And while considerable progress occurred between 2000 and 2010 in the prevention and treatment of non-communicable diseases, the momentum has since slowed.

A bright spot in the survey was the alternative treatments health professionals found to be effective during the pandemic. Of the countries who reported disruptions in health services, 58% said they are now using telemedicine. Triaging patients to determine priority was also reported in two-thirds of the countries surveyed.

Moving forward, finding still more innovative ways to protect access for people with non-communicable diseases should be top of mind for policymakers.