true

Non Communicable Disease

 

Applying the Health Equity Lens to NCDs

Background Image

About

Non-communicable diseases tend to be of long duration, and are the result of a combination of genetic, physiological, environmental and behavioral factors, and disproportionately impact people in low- and middle-income countries. When individuals with NCDs face tremendous healthcare costs and a restricted ability to work, their households struggle with increased financial risk. These factors, especially when combined with lack of access to NCD screening and treatment services, can lead to high rates of NCDs, which in turn can perpetuate poverty, strain economic development, and burden fragile health systems, making countries less resilient when emergencies like infectious disease outbreaks from natural disasters occur. 

Our Focus

At BD, we focus our Global Public Health programming and investments on cancer, peripheral arterial disease (PAD), and kidney disease. Each of these conditions carries high morbidity and mortality rates [vi] that disproportionately impact communities already facing health disparities due to lack of screening and access to treatment.[vii],[viii]

Our Impact

  • Cervical Cancer caused by the human papillomaviruses (HPV), an estimated 342,000 women died from cervical cancer, worldwide, in 2020[ix] – even though the disease is preventable and curable when detected early and managed effectively. 
    • About 90 percent of cervical cancer deaths occur in low and middle-income countries, where screening, prevention and treatment are almost non-existent.[x] 
    • Research shows that in the U.S., 60 percent of cervical cancer cases occur among unscreened women, with Hispanic women experiencing the highest rates of cervical cancer; and Black women experiencing the highest rates of dying from the disease.[xi] 

 

That’s why BD is supporting the World Health Organization in its goal to eliminate cervical cancer with a comprehensive approach to prevention, screening and treatment.

Key BD Global Public Health efforts to eliminate HPV include:

  • BD is supporting access to HPV self-collection to reach underserved communities and increase screening rates in a variety of settings. Screening programs offering self-collection provide women the option to either visit their healthcare practitioner for a traditional exam, or to take their own sample in the comfort of their own home or in a private area of a clinic. This removes many workforce constraints and has also proven to be highly accepted across many different communities. 
  • In the U.S., BD supports the goals of the White House Cancer Moonshot initiative, which seeks to reduce the death rate from cancer with one focus being increased prevention and screening measures. HPV testing, particularly among underserved communities, will be a key component of closing the cervical cancer screening gap.
  • In Kenya, BD collaborated in 2023 with the Ministry of Health to launch a pilot program that provides end-to-end cervical and breast cancer awareness, screening leveraging self-collection, early diagnosis and timely linkage to care. We plan to scale this program to additional underserved nations in 2024 and beyond.
  •  In Colombia, BD is working across the public and private sector to promote awareness of HPV screening best practices. We’re also supporting a study conducted by Javeriana University to assess self-HPV-collection in underserved communities.

 

Recognizing the need for data to understand how vulnerable populations are impacted by drug-resistant infections, BD initiated the Cancer & AMR Consortium, which seeks to fill the data gap to accelerate advocacy, policy, and innovation.

  • Over 800 million people worldwide suffer from chronic kidney disease – 10% of the world’s population.[xii]  Kidney disease represents an especially large burden in LMICs.[xiii] Kidney diseases are a leading cause of death in the United States, impacting 37 million U.S. adults, or one in seven people.[xiv] Every 24 hours, 360 people in the United States begin dialysis for treatment for kidney failure. Kidney disease also disproportionately impacts historically underserved communities. One third of U.S. kidney disease patients in the U.S. are Black, and the disease also disproportionately impacts Hispanic and Native American patients. [xv] This is an area where BD is developing partnerships and programs.
  • Over 200 million people worldwide and around 8.5 million in the United States are affected by peripheral artery disease (PAD).[xvi] In the United States, patients of low socioeconomic status, those residing in rural areas, and those of Africa-American or Native American ethnicity are at the highest risk of amputation.[xvii] For patients who undergo amputation, the 5-year mortality rate of PAD patients has been estimated to be 50-74%.[xviii] Driving awareness of PAD for both patients and healthcare professionals is key to getting ahead of disease progression.
    • A BD program Love Your Limbs provides important disease information and support to help educate patients, and BD supports efforts to expand access to PAD screening and diagnosis.

Our Global Public Health Priorities

References

[vi] Demsas F, Joiner MM, Telma K, Flores AM, Teklu S, Ross EG. Disparities in peripheral artery disease care: A review and call for action. Semin Vasc Surg. 2022 Jun;35(2):141-154. doi: 10.1053/j.semvascsurg.2022.05.003. Epub 2022 May 8. PMID: 35672104; PMCID: PMC9254894.

[vii] Zavala, V. A., Bracci, P. M., Carethers, J. M., Coggins, N. B., R., M., Davis, M., De Smith, A. J., Dutil, J., Figueiredo, J. C., Fox, R., Graves, K. D., Gomez, S. L., Llera, A., Neuhausen, S. L., Newman, L., Nguyen, T., Palmer, J. R., Palmer, N. R., J., E., . . .  Fejerman, L. (2021). Cancer health disparities in racial/ethnic minorities in the United States. British Journal of Cancer, 124(2), 315-332. https://doi.org/10.1038/s41416-020-01038-6

[viii] GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385: 117–71.

[ix] https://www.who.int/news-room/fact-sheets/detail/cervical-cancer; accessed 11/03/2023

[x] Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021:71:209–49. doi:10.3322/caac.21660.

[xi]Benard VB, Jackson JE, Greek A, Senkomago V, Huh WK, Thomas CC, Richardson LC. A population study of screening history and diagnostic outcomes of women with invasive cervical cancer. Cancer Med. 2021 Jun;10(12):4127-4137. doi: 10.1002/cam4.3951. Epub 2021 May 21. PMID: 34018674; PMCID: PMC8209614.

[xii] Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011). 2022 Apr;12(1):7-11. doi: 10.1016/j.kisu.2021.11.003. Epub 2022 Mar 18. PMID: 35529086; PMCID: PMC9073222

[xiii] Same as xii

[xiv] https://www.kidneyfund.org/all-about-kidneys/quick-kidney-disease-facts-and-stats#:~:text=37%20million%20Americans%20have%20kidney,are%20living%20with%20kidney%20failure.&text=Kidney%20disease%20is%20growing%20at,greater%20risk%20for%20kidney%20failure.; accessed 11/03/2023

[xv] https://www.kidney.org/atoz/content/minorities-KD#:~:text=Yes%2C%20one%20in%20three%20people,increased%20risk%20for%20kidney%20disease.; accessed 11/03/2023

[xvi] Garba Rimamskep Shamaki, Favour Markson, Demilade Soji-Ayoade, Chibuike Charles Agwuegbo, Michael Olaseni Bamgbose, Bob-Manuel Tamunoinemi,  Peripheral Artery Disease: A Comprehensive Updated Review,Current Problems in Cardiology, Volume 47, Issue 11,2022,101082,ISSN 0146-2806, https://doi.org/10.1016/j.cpcardiol.2021.101082.

[xvii] Epidemiology and Risk of Amputation in Patients With Diabetes Mellitus and Peripheral Artery Disease J. Aaron Barnes, Mark A. Eid, Mark A. Creager and Philip P. Goodney; Originally published25 Jun 2020 https://doi.org/10.1161/ATVBAHA.120.314595Arteriosclerosis, Thrombosis, and Vascular Biology. 2020;40:1808–1817

[vxiii] Norgren, L., Hiatt, W. R., Dormandy, J. A., Nehler, M. R., Harris, K. A., & Fowkes, F. G. R. (2007). Inter-society consensus for the management of peripheral arterial disease (TASC II). Journal of vascular surgery, 45(1), S5-S67., 4. Yost, ML. The Sage Group (2017). Critical Limb Ischemia by Rutherford Category: Prevalence and Markets in Patients and Limbs.