Table 3

Key informant perspectives on the value of the investment cases

Armenia The NCD investment case was instrumental in informing the advocacy strategy of the Ministry of Health to adopt the Tobacco Control Law in 2020. Staggering results from the economic analysis made the Government, and especially the Ministry of Finance, consider health as an investment, not a cost.
Barbados The investment case has helped to promote the idea that allocating resources to NCD prevention and control is an investment rather than cost.
Cambodia The NCD investment case is considered a valuable source of data not only for promoting action on NCDs, but also for planning of broader public health interventions.
Ethiopia The investment case has been widely used as an advocacy tool since its launch in 2019, as well as a background paper guiding NCD action. For instance, it contributed to building the argument to increase the budget of the NCD team within the Ministry of Health.
Findings from the investment case supported collaboration between Ministries of Health and Finance around the taxation on health harming products, that is, tobacco and alcohol. It was also used to support the ban on alcohol advertisement.
Jamaica The investment case showed a significantly high ROI for the tobacco control policy package, generating political appetite for comprehensive tobacco law(s). Jamaica is currently debating a comprehensive tobacco control law in Parliament, which includes adequate taxation.
Data around the NCD burden, which is specific to the national context, rather than aggregated regional or global data, were picked up very quickly by the Ministry of Health to guide prioritization of funding towards national health system strengthening programmes particularly focused on the control of NCDs.
The NCD investment case provided the rationale to increase funding to the NCD response.
Kyrgyzstan The investment case report supported the MOH in building the argument to increase excise taxes on tobacco products, by disseminating solid economic data and establishing an effective dialogue with the Ministry of Finance.
Tobacco control initiatives and interventions recommended in the investment case report were moved forward also by government sectors other than health. Municipalities have implemented smoke-free parks and playgrounds, and academia is being sensitized to advocate for smoke-free university campuses.
Philippines The investment case process was an opportunity to bring NCDs higher on the UN agenda: and NCD-related targets are included in the UN Sustainable Development Cooperation Framework of the Philippines.
In 2020, during the COVID-19 pandemic the Government tried to address the disruption of NCD-related services, by promoting telemedicine. However, the pandemic proved a challenge to following up on the investment case recommendations except for developing and disseminating public health messaging around NCD risk factors.
Russian Federation The national stakeholder mapping and the relevant analysis contained in the ICA assisted the MOH convening a consultation to develop and adopt a new anti-tobacco legislation.
The Ministry of Health used economic results from the investment case to convince the Ministry of Finance to allocate adequate resources for a Federal Project on Public Health and Risk Factor Prevention(…). As a result of the regional public health programme, awareness raising campaigns were organized, regional and municipal public health programmes were introduced.
The investment case provided the Ministry of Health and the Ministry of Finance with common vocabulary.
Thailand The investment case report has been used to develop key advocacy messages addressed to sectors other than health, including awareness campaigns jointly developed by WHO and UNDP.
Türkiye The investment case provided the argument to strengthen delivery of NCD-services in PHC. This resulted in family physicians and family health workers receiving positive performance payments which will be increased depending on screening and monitoring rates.
The NCD investment case helped the Ministry of Health build a solid economic argument to advocate with the Ministry of Finance for increased budget to implement NCD-related clinical interventions at the primary healthcare level.
Uganda Academia and civil society organizations not only participated in the development of the NCD investment case, but contributed to supporting its dissemination, as well as the implementation of interventions. Civil society and other implementing partners used data from the NCD investment case to plan the roll out of HIV/NCD integration into PEPFAR 2022 operational plan implementation.
Uzbekistan The NCD investment case was a real eye-opener for the Government; economic data convinced ministries other than health that it was necessary to tackle NCDs.
The investment case helped to secure political commitment to tackle NCDs, from the President and the Prime Minister. The President’s Decree (December 2018) launched the National NCD Strategy 2019–2022, which entailed a re-organization of the structure of the Ministry of Health and the establishment of the Healthy Lifestyle Center with its regional units across the country, as well as the creation of an intersectoral coordination commission for disease prevention and public health, with a dedicated budge, In November 2020.
The national media has promoted messages around NCD prevention and control, including data extrapolated from the investment case.
Zambia The NCD investment case report was integrated into the Zambia NCDI Poverty Commission Report 2022, the findings of which contributed to securing financial support from the Center for Infectious Disease Research towards implementing the WHO Package of Essential NCD interventions.
The NCD investment case (1) facilitated advocacy with policy makers on promotion of healthy lifestyles in workplaces, (2) leveraged partnerships to support the PHC package towards the attainment of UHC, (3) elevated the priority of NCDs, by framing action as an investment rather than a cost, and (4) findings were incorporated in the National Health Strategic plan 2022–2026 and the NCD Strategic plan draft.
  • ICA, institutional and context analysis; MOH, Ministry of Health; NCD, non-communicable disease; NCDI, National Noncommunicable Disease and Injury; PEPFAR, President's Emergency Plan for AIDS Relief; PHC, primary healthcare; ROI, return on investment; UHC, universal health coverage; UN, United Nations; UNDP, United Nations Development Programme.