Investing in the prevention and treatment of noncommunicable diseases (NCDs) pays huge dividends, according to research that quantifies the health and economic returns of expanded health spending in low- and middle-income countries.

Research by data and analytics company Airfinity, commissioned by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), estimates that close to five million lives could be saved each year in low- and middle-income countries (LMICs) through an additional investment equivalent to 1% of gross domestic product (GDP) in public healthcare spending, with at least 40% directed toward cost-effective primary healthcare interventions for NCDs.

The World Health Organization (WHO) estimates that every dollar invested in cost-effective NCD prevention and control interventions can generate nearly seven dollars in social and economic returns in LMICs. Those returns come through reduced healthcare costs, improved workforce productivity, and healthier, more resilient societies.

WHO's evidence-based "Best Buys" set out cost-effective measures addressing major NCD risk factors — tobacco use, harmful alcohol consumption, unhealthy diets, and physical inactivity — together with interventions for the early detection and management of cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers. The list is periodically updated as new evidence on cost-effectiveness emerges, giving governments a practical menu of high-return options for their health budgets.

A persistent global burden

Despite this compelling investment case, progress has been inconsistent. Nearly two billion people globally are affected by NCDs, which remain a leading cause of premature death. Cardiovascular diseases such as heart attacks and strokes, cancers, chronic respiratory diseases including chronic obstructive pulmonary disease and asthma, and diabetes account for more than 80% of all premature NCD-related deaths worldwide. WHO puts the overall toll at roughly 41 million NCD deaths a year — about three quarters of all deaths worldwide — with more than three quarters of those deaths occurring in LMICs. That burden is also written into the global development agenda: Sustainable Development Goal target 3.4 calls on countries to cut premature mortality from NCDs by one third by 2030.

The burden is particularly severe in LMICs, where NCDs exact an enormous human, social, and economic toll. In the Philippines, a WHO and United Nations Development Programme (UNDP) investment case found that almost seven out of 10 deaths were caused by NCDs, and that Filipinos faced nearly a one-in-three chance of dying prematurely between the ages of 30 and 70 from one of the four major NCDs.

The WHO-UNDP investment case estimated that NCDs cost the Philippine economy P756.5 billion annually, equivalent to about 4.8% of GDP in 2017. That figure includes the direct costs of treatment, care, and social security provision, as well as the much larger indirect costs arising from premature deaths, workforce losses, absenteeism, and reduced productivity. Significantly, the indirect economic costs were estimated to be about nine times higher than the direct costs.

The scale of those indirect costs illustrates why NCDs cannot be viewed simply as a healthcare issue. When people become seriously ill during their most economically productive years, the consequences extend beyond patients and their families. Employers lose productive workers, household incomes suffer, healthcare systems face greater demand, and the economy loses human capital.

Prevention and treatment together

Changing the clinical, economic, and societal trajectory of NCDs therefore requires sustained and strategic investment. This means strengthening healthcare systems while investing across the continuum of prevention, screening, diagnosis, treatment, and long-term disease management.

Investing in NCDs should not mean choosing between prevention and treatment; an effective health system must do both. Reducing tobacco use, harmful alcohol consumption, unhealthy diets, and physical inactivity can lower the risk of disease. Vaccination can prevent certain cancers and other diseases. Screening and early diagnosis can identify conditions before complications develop, while timely access to quality medicines and appropriate treatment can prevent disability, hospitalization, and premature death.

For the Philippines, strengthening primary healthcare is particularly important. Universal Health Care (UHC) — anchored by the Universal Health Care Act (Republic Act No. 11223), signed into law in 2019, which automatically enrolls all Filipinos in the national health insurance program — provides an opportunity to move progressively from a system that often responds when people are already seriously ill toward one that prevents disease, identifies risks earlier, and manages chronic conditions continuously.

Programs such as PhilHealth's YAKAP can contribute to this transformation by expanding access to primary care consultations, screening, and early detection, and by connecting diagnosed patients to appropriate medicines and treatment. The earlier hypertension, diabetes, cancer risks, and other chronic conditions are detected and effectively managed, the greater the opportunity to prevent expensive complications and preserve people's quality of life and productivity.

Financing the response

Greater investment, however, requires sustainable financing. The Philippines continues to face significant competing demands on public resources, making it even more important that health expenditure is viewed in terms of the economic and social value it generates. House Bill No. 1973, currently pending in the House of Representatives, proposes to mandate an annual appropriation equivalent to at least 5% of GDP for public health services. Whatever financing mechanisms are ultimately adopted, increasing resources must go hand in hand with ensuring that they are allocated efficiently toward interventions that deliver measurable health outcomes.

To better understand how countries can overcome financing barriers, IFPMA engaged global consulting firm Charles River Associates (CRA) to examine NCD investment case studies, identify enabling factors, and propose policy recommendations that could lead to better clinical, economic, and societal outcomes.

The report, "Health system financing architecture: Leverage the opportunities from investing in NCDs," used a combination of literature review, case study analysis, and interviews with key stakeholders. One of its case studies examined the Philippine Sin Tax Law, the Sin Tax Reform Act (Republic Act No. 10351) enacted in 2012, which restructured excise taxes on tobacco and alcohol and earmarked a substantial share of the resulting incremental revenue for health programs, including expanded insurance coverage for poor households. The Philippine experience is particularly instructive because it demonstrates how fiscal and health policy can reinforce each other.

For the Philippines, these recommendations reinforce the importance of sustaining UHC implementation while strengthening primary healthcare and improving the way health resources are allocated and measured. Better data can help policymakers identify which interventions deliver the greatest health and economic returns, while stronger collaboration among government, healthcare providers, patient groups, the private sector, and development partners can help translate policy into better outcomes for patients.

Industry role

The pharmaceutical industry is committed to working with government and other key stakeholders to bring innovative approaches to NCD prevention and care, bridge gaps in diagnosis and treatment, and accelerate progress toward UHC and the Sustainable Development Goals. The industry contributes through research and innovation, medicines and vaccines, partnerships, health-system strengthening, and policy, advocacy, and communications initiatives that reinforce the importance of investing in NCD prevention and care.

For a country working to achieve UHC while sustaining economic growth, investing in NCD prevention and treatment is not simply a healthcare expense. It is an investment in human capital, productivity, and economic resilience.

Teodoro B. Padilla is the executive director of the Pharmaceutical and Healthcare Association of the Philippines, which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are at the forefront of developing, investing in, and delivering innovative medicines, vaccines, and diagnostics for Filipinos to live healthier and more productive lives.