Non-Communicable Diseases in Humanitarian Contexts: What Do We Need to Know?

On September 4th Elrha launched our new report: Research Priorities for Non-Communicable Diseases in Humanitarian Crises: Focus on cardio-metabolic syndrome.  This report documents the results of a research priority setting exercise we funded, conducted by a team from the International Rescue Committee and the American University of Beirut.  Using a rigorous methodology the report brings together the most important research questions (as identified by non-communicable diseases (NCDs) in crises experts). 

NCDs are a growing and often overlooked threat in humanitarian crises. Globally, they account for 74% of deaths, but in conflict-affected countries like Ukraine and Syria, the numbers are even more staggering, with NCDs responsible for 92% and 75% of mortality, respectively. Conditions such as heart disease and diabetes compound the challenges faced by vulnerable populations, placing additional strain on already fragile healthcare systems. This is one reason why this exercise focused on cardio-metabolic syndrome – a cluster of conditions that increases the risk of heart disease, stroke and type 2 diabetes.  

Despite their growing prevalence, NCDs are often neglected in crisis settings, when there are so many competing priorities, from infectious disease, to maternal health, to trauma care.  This report seeks to bring together researchers, humanitarian practitioners and funding agencies around these research questions, to inform policies and practices that will ultimately improve care for people living with NCDs in crisis settings. 

While we were really excited to share the published report, we thought that it was equally important to engage in a broader conversation about how to apply these insights and address the challenges and opportunities for NCD research in crisis settings more generally.  To facilitate this, we hosted a webinar featuring an exceptional panel of presenters and experts with backgrounds in NCDs in crisis from research, practice and with lived experience. 

Here are the main takeaways from the launch event:  

1. Expert Consensus on Research Priorities:

The research priority-setting exercise gathered the inputs of 75 experts from around the world, to rank 43 questions.  The highest-ranked priorities focused on outcomes and processes of care y, likely reflecting the high number of health professionals who participated. This really demonstrates that front line health workers need better evidence for what works to provide quality, contextually appropriate care for their patients. 

2. The Growing Importance of NCD Research in Crises:

Prioritising NCD research and care in crises when there are many other needs can be challenging, but as global epidemiology and geographies of crisis shift, this will become an even greater priority for health responders.  Research is essential to ensure that response agencies and Ministries of Health are well equipped with the most evidence-informed approaches to care for individuals living with NCDs in crises.  

3. Developing Scalable, Adaptable Interventions:

Humanitarian responders face   significant operational and resource challenges. Research that identifies adaptable, scalable interventions can help overcome these challenges.  By evidencing integrated and sustainable models of NCD care, we can support health actors to make the most of their staff and financial capacity. 

4. Complexity of NCD Research in Crisis Settings:

Researching NCDs in crisis settings is by nature highly complex, with contextual challenges including health system and service disruptions that make delivering the highly personalised care that people living with NCDs need very difficult.  Conducting research in such circumstances can be really challenging, but by using implementation science, researchers can employ multi-disciplinary approaches to data collection to figure out what works, why and how it can be refined. (Here is an interesting article on the potential for implementation science in humanitarian settings.) 

5. Integrating Research Uptake from the Start:

For research findings to influence policy and practice, uptake strategies must be embedded from the start of the research process. It cannot be an afterthought. Building relationships and networks throughout the whole of the research cycle and identifying what you aim to influence early on (e.g. a guideline revision process) enables targeting research socialisation strategically. (See our research impact framework for ideas!) 

Finally, and most importantly, every expert on the webinar emphasised that it is essential to include people with lived experience of NCDs in crises throughout the research process – from conceptualisation to the uptake of findings by policymakers, practitioners, and communities. This is not a “nice to do” but a must do. 

See our participation case studies and our community engagement for research uptake lit review for inspiration on how to integrate people affected by crisis in research