Universal Health Coverage and Intersectoral Action for Health

Excerpt

In 1993, the World Bank published Disease Control Priorities in Developing Countries (DCP1), an attempt to systematically assess value for money (cost-effectiveness) of interventions that would address the major sources of disease burden in low- and middle-income countries (LMICs) (Jamison and others 1993). A major motivation for DCP1 was to identify reasonable responses in highly resource-constrained environments to the growing burden of noncommunicable diseases (NCDs) and of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in LMICs. The World Bank had highlighted the already substantial NCD problem in country studies for Malaysia (Harlan, Harlan, and Oii 1984), for China (Jamison and others 1984), and in a New England Journal of Medicine Shattuck Lecture (Evans, Hall, and Warford 1981). Mexican scholars (Bobadilla and others 1993; Frenk and others 1989) pointed to the rapid growth of NCDs in Mexico and introduced the concept of a protracted epidemiological transition involving a dual burden of NCDs combined with significant lingering problems of infectious disease. The dual burden paradigm remains valid to this day. The World Bank’s first (and so far only) World Development Report (1993) dealing with health drew heavily on findings from DCP1 to conclude that a number of specific interventions against NCDs (including tobacco control and multidrug secondary prevention of vascular disease) were attractive even in environments where substantial burdens of infection and insufficient dietary intake remained policy priorities (World Bank 1993).