Lancet NCDI Poverty Commission

Reframing NCDs and injuries for the poorest billion

The Lancet NCDI Poverty Commission was launched in January 2016 to address what is both one of the most glaring inequities in global health and one of the most critical barriers to reaching global and national goals for universal health coverage and sustainable development — the crushing burden of noncommunicable diseases and injuries on the world’s poorest populations. 

The Commission was formed with the hypothesis that the noncommunicable disease and injury (NCDI) burden experienced by those living in extreme poverty was different, but no less important, than the NCDI burden in other populations. The daily clinical experiences of many of the Commissioners working in rural health facilities in South Asia and sub-Saharan Africa had left a striking impression: namely, that NCDIs in these settings were an integral part of the death and suffering of the poorest; that these NCDIs struck young and nutritionally-deprived patients who were also vulnerable to infectious disease; and that the conditions grouped under the label of NCDIs were not dominated by a small number of diseases or “lifestyle” risk factors. The aim of the Commission is to rethink global policies, to mend a great disparity in health, and to broaden the NCDI agenda in the interest of equity.

The Commission brought together 23 leading NCDI researchers, clinicians, policy makers, and advocates from around the world, and was supported by the Program in Global NCDs and Social Change at Harvard Medical School and the NCD Synergies project of Partners In Health. The Commission was organized into four working groups with the following objectives:

  1. to asses the scale and pattern of the NCDI burden among the poorest;

  2. to identify and prioritize cost-effective, equitable interventions to address this burden;

  3. to examine the state of NCDI financing in the countries where the poorest billion live; and

  4. to better understand the history and current state of NCDI framing and governance at both global and national levels.

Drawing on the research and analysis of these working groups, the Commission developed key findings, messages, and recommendations that were presented in a report that was published and launched at an event in September 2020.