Published on Columbia University Academic Commons.
Recognizing the need for greater attention worldwide to noncommunicable diseases (NCDs) such as cardiovascular disease and diabetes, implementers are increasingly putting NCD programs in place. This effort is yielding practice-based experiences and evidence that may not be systematically documented and shared, reflected in a limited body of peer-reviewed and gray literature and few platforms for knowledge exchange. To draw on such knowledge that is grounded in experience, we gathered information through reviews of literature, local needs assessments, technical dialogues at the national and local levels, and structured global stakeholder engagement events to yield four principles that reflect the current state of knowledge on developing and implementing community-based services for health promotion and disease management: (1) Support and empower people living with chronic disease to provide better self-care and advocate for improved services. (2) Invest in integrating NCDs into existing development platforms but do not underestimate true costs and effort. (3) Engage a broad range of front-line health workers to champion care. (4) Build coalitions to leverage the strengths of both the public sector’s and private sector’s capacity and leadership. If applied consistently by funders and implementers, these principles have the potential to accelerate progress in reaching low-resourced communities with NCD care and treatment services. At the same time, if implementers commit to proactively, transparently, and collaboratively sharing experience-based learning, the NCD movement will not only pick up speed and be well supported by evidence but will also benefit from programmatic, financial, and political synergies at the global, national, and local levels.