Equitable NCD care in humanitarian settings: research and innovation on the road to the UN high-level meeting

Non-communicable diseases (NCDs) such as heart disease and diabetes are leading causes of death worldwide – a threat that worsens in crisis settings. Conflict, displacement, and fragile health systems block access to care, deepening inequities. Ahead of the UN high-level meeting (UNHLM) on NCDs and mental health this week, our Research Manager, Dr. Shivani Patel, unpacks the key factors affecting vulnerability and inequality in NCD outcomes, and highlights how research and innovation can help find and scale more inclusive approaches to NCD care.

‍Putting NCDs on the humanitarian agenda

‍A central theme of the upcoming UNHLM on NCDs and mental health is equity and the integration of care. NCDs such as cardiovascular disease and diabetes are leading causes of death worldwide, and their burden is magnified in humanitarian emergencies.

Conflict, displacement, and fragile health systems disrupt access to medications, diagnostics, and continuous care, resulting in preventable morbidity and mortality. For example, heart attacks and strokes are three times more likely after humanitarian emergencies, NCD care is too often excluded from emergency response planning.

As part of our commitment to advocating for the systematic integration of NCD care in crisis response, we are co-organising a side event on the margins of the UNHLM jointly with IFRC, WHO, UNICEF, IRC, IADA, Qatar Foundation, and the NCD Alliance. The session will reflect on progress and challenges, underscore the need for NCD and mental health care in humanitarian settings, elevate voices of affected people, showcase scalable local innovations, and drive global commitment toward equitable, inclusive, and well-financed care in crisis contexts. The session will be held on Tuesday 23 September from 17:00–18:30 EST. You can find out more and register to attend the event in person or virtually.

‍Drivers of vulnerability and inequality

In crisis contexts, overlapping vulnerabilities drive inequities in NCD outcomes:  

• Conflict, displacement, poverty, competing needs, and fragmented health systems limit continuity of care, meaning people with pre-existing conditions, such as disabilities, or chronic physical or mental health conditions, face even greater risks.  
• Women and girls encounter additional barriers to NCD care; for example, conditions such as gestational diabetes and hypertension, which can have chronic implications, are challenging to manage without access to integrated antenatal care.  
• Climate shocks such as floods, droughts, and extreme heat further compound these challenges by disrupting food security, water access, and service delivery.  
• Risk factor modification and prevention through dietary and lifestyle changes are also incredibly challenging in these settings, as the stress of crisis conditions continues to negatively impact mental health and self-management of NCDs.  

Together, these intersecting drivers deepen inequities and highlight the urgent need for inclusive approaches that ensure marginalised populations in humanitarian settings are not left behind.

Identifying inclusive solutions

Innovation and research are central to closing these gaps. Over the last decade, we have funded studies exploring community-based approaches to NCD care, such as integrating community health volunteers into management to enhance equitable access for Syrian refugees in Jordan. Other projects have examined barriers to services in Lebanon and the co-existence of NCDs with mental health conditions among displaced adults from Myanmar as a first step to understand inequities which exist amongst these populations.

Call for innovations

Momentum is shifting as global actors adopt more inclusive approaches in humanitarian responses, however, there is still more to be done.

Building on our Humanitarian Health Evidence Review and priority-setting work with IRC and the American University of Beirut, we are now partnering with the African Population Health Research Center on a Novo Nordisk Foundation–funded initiative to document scalable, equity-focused solutions for cardiometabolic diseases in Sub-Saharan Africa.

We are inviting innovators, researchers, practitioners, and community organisations to contribute to our call for innovations to identify solutions for cardiometabolic disease management or prevention in humanitarian settings in Sub-Saharan Africa. Locally relevant, inclusive, and scalable approaches have the potential to transform care for vulnerable populations in crisis-affected communities. This project brings together research and innovation to advance equity in the most challenging circumstances.