Launch of the Armenia Noncommunicable Diseases (NCDs) Investment Case report

Today, 03 May 2019, the World Health Organization, in collaboration with the Ministry of Health Armenia, has organized a launch of Armenia Noncommunicable Diseases (NCD) Investment Case (IC) report.

Investment in preventive policy measures aimed at addressing major risk factors of noncommunicable diseases (NCDs) would contribute to a more sustainable and prosperous economy in Armenia. According to a study by the UN Interagency Task Force on Prevention and Control of NCDs (UNIATF), implementation of four highly cost-effective packages of policy interventions over a period of 15 years would avert more than 30,000 deaths and would produce economic gains of more than 164 billion dram (334 million USD), which is equivalent to 2.9% of Armenia's current GDP. It was estimated that the current economic cost of NCDs to Armenia is equivalent to 36.7 billion drams per year (740.5 million USD) or 6.5% of the country’s current GDP.

The study was conducted by the WHO and the UNDP as part of their Global Joint Programme, in close cooperation with the Armenian government. It allowed to produce a tailor-made national investment case that assesses the current burden of NCDs in Armenia, the cost of potential interventions (both preventive and clinical), and the expected benefits of a timely response.

In his opening speech WHO Representative in Armenia, Dr Egor Zaitsev, said: “NCDs are the major cause of deaths and disability in Armenia. It is also big obstacle for economy. Total cost of NCDs to ARM economy is 6.5%.  In order to move forward we need to work together. Strong intersectoral collaboration is a paramount importance to achieve tangible results in NCD control”. 

Notably, Armenia, as the majority of other countries, is severely affected by high NCDs prevalence. It is estimated that over 90% of all deaths in the country are attributable to NCDs, while the probability of dying prematurely (before the age of 70 years) from one of the four major NCDs for a person living in Armenia was 22% in 2016. Aside from causing human suffering, the NCDs epidemic has a deteriorating impact on the national economy by reducing the size of the labour force and the workers' productivity.

The major driver of high NCDs incidence are the metabolic risk factors (raised blood pressure, overweight/obesity, raised blood glucose and raised cholesterol) and the behavioral ones such as tobacco smoking, harmful use of alcohol, unhealthy diet, and physical inactivity. Statistical research indicates that, in Armenia, 51% of men smoke tobacco, 46% of men drink alcohol, and half (47.7%) of the adult population is overweight or obese. The average daily salt intake is also high, exceeding the WHO norm by a factor of two. Furthermore, 37.8% of adults have raised blood pressure and 5.7% have raised blood glucose, which increases the risk of cardiovascular diseases (CVDs) and diabetes.

Four packages of preventive policy (aimed at addressing tobacco smoking, harmful use of alcohol, excessive salt consumption, and physical inactivity) and one package of clinical interventions (aimed at addressing CVD and diabetes) have been analyzed.

The overall cost of implementing the selected policy packages over a 15 year period was estimated at 19.1 billion dram (39.1 million USD), while the potential return was found to be substantially higher. According to the results of the study, every dram invested over a 15-year period would yield 4.14 to 14.51 dram in productivity gains. Particularly cost-effective is the tobacco control package, which is expected  to yield a high return on investment of 4.79 already after the first five years of implementation.

The package of CVD and diabetes clinical interventions was projected to have a strong positive effect, too, with the potential to avert more than 10 000 deaths over a 15-year period and result in 53.6 billion dram (109.6 million USD) of productivity gains. However, it involves much higher costs due to the need for medical treatment. Therefore, its potential return on investment is comparatively low, estimated at 0.29 after 15 years of implementation.

The findings featured in the investment case highlight an opportunity to contribute to Armenia's socio-economic development through investment in prevention and control of NCDs. The analysis draws attention to specific areas that need to be strengthened and scaled up in order to implement the WHO-recommended interventions. It also offers specific recommendations to the government and underscores the need for effective cooperation and coordination between different government institutions.

Efforts by Armenia to combat NCDs would contribute to achievement of the 2030 Agenda for Sustainable Development, in particular, its Goal No. 3. A number of other countries have already benefitted from the national investment cases developed by UNIATF and more work is envisaged in this area, thanks to financial support by the Russian Federation.


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