Economic impacts of overweight and obesity: current and future estimates for 161 countries.

INTRODUCTION: The scope of the challenge of overweight and obesity (OAO) has not been fully realised globally, in part because much of what is known about the economic impacts of OAO come from high-income countries (HICs) and are not readily comparable due to methodological differences. Our objective is to estimate the current and future national economic impacts of OAO globally. METHODS: We estimated economic impacts of OAO for 161 countries using a cost-of-illness approach. Direct and indirect costs of OAO between 2019 and 2060 were estimated from a societal perspective. We assessed the effect of two hypothetical scenarios of OAO prevalence projections. Country-specific data were sourced from published studies and global databases. RESULTS: The economic impact of OAO in 2019 is estimated at 2.19% of global gross domestic product (GDP) ranging on average from US$20 per capita in Africa to US$872 per capita in the Americas and from US$6 in low-income countries to US$1110 in HICs.If current trends continue, by 2060, the economic impacts from OAO are projected to rise to 3.29% of GDP globally. The biggest increase will be concentrated in lower resource countries with total economic costs increasing by fourfold between 2019 and 2060 in HICs, whereas they increase 12-25 times in low and middle-income countries. Reducing projected OAO prevalence by 5% annually from current trends or keeping it at 2019 levels will translate into average annual reductions of US$429 billion or US$2201 billion in costs, respectively, between 2020 and 2060 globally. CONCLUSION: This study provides novel evidence on the economic impact of OAO across different economic and geographic contexts. Our findings highlight the need for concerted and holistic action to address the global rise in OAO prevalence, to avert the significant risks of inaction and achieve the promise of whole-of-society gains in population well-being.

Tailored support for national NCD policy and programme implementation: an over-looked priority.

Many low-income and middle-income countries (LMICs) are unlikely to achieve Sustainable Development Goal 3.4 to reduce premature deaths from non-communicable diseases (NCDs) by one-third by 2030. For some, the prospect is receding: between 2010 and 2020, the decline in premature deaths for the major NCDs slowed compared with the prior decade. Barriers to implementing effective strategies are well known, yet the value of tailored technical support to countries has been overlooked and downplayed. Tailored technical support is specialist guidance for country-specific application of technical tools, and capacity enhancement when needed, that enables an LMIC to advance its NCD priorities and plans. We present a model identifying pivotal junctures where tailored technical support can help surmount implementation obstacles. We draw on our experience preparing NCD investment cases with health ministries, development partners and technical agencies. National investment cases produce evidence based, locally tailored and costed packages of NCD interventions and policies appropriate to national needs and circumstances. They can include analysis of financing needs and point towards sustainable funding mechanisms. Enhancing the NCD-specific knowledge of government and Civil Society Organization leads can capitalise on existing expertise, aid integrative health system developments and unlock capabilities to use global tools and guidance. Investment cases form a platform to develop or review NCD plans and (re)prioritise action, then apply implementation science to trouble-shoot obstacles. Partnering national stakeholders with technical support in this process is critical to develop and implement effective NCD strategies.

Costs and cost-effectiveness of HIV/noncommunicable disease integration in Africa: from theory to practice.

: The current article reviews economic aspects of selected HIV/noncommunicable disease (NCD) service delivery integration programs to assess the efficiency of integration in limited capacity settings. We define economies of scope and scale and their relevance to HIV/NCD integration. We summarize the results of a systematic review of cost and cost-effectiveness studies of integrated care, which identified 12 datasets (nine studies) with a wide range of findings driven by differences in research questions, study methods, and health conditions measured. All studies were done in Africa and examined screening interventions only. No studies assessed the cost of integrated, long-term disease management. Few studies estimated the cost-effectiveness of integrated screening programs. The additional cost of integrating NCD screening with HIV care platforms represented a 6-30% increase in the total costs of the programs for noncancer NCDs, with cervical cancer screening costs dependent on screening strategy. We conducted 11 key informant interviews to uncover perceptions of the economics of HIV/NCD integration. None of the informants had hard information about the economic efficiency of integration. Most expected integrated care to be more cost-effective than current practice, though a minority thought that greater specialization could be more cost-effective. In the final section of this article, we summarize research needs and propose a 'minimum economic dataset' for future studies. We conclude that, although integrated HIV/NCD care has many benefits, the economic justification is unproven. Better information on the cost, cost-effectiveness, and fiscal sustainability of integrated programs is needed to justify this approach in limited-resource countries.