A new study by the Pan Amer­i­can Health Or­ga­ni­za­tion (PA­HO) has found that ex­ten­sive dis­rup­tions in the di­ag­no­sis and man­age­ment of non-com­mu­ni­ca­ble dis­eases (NCDs) in the Amer­i­c­as, in­clud­ing the Caribbean, oc­curred dur­ing the coro­n­avirus (COVID-19) pan­dem­ic.

PA­HO said that the study found that the sit­u­a­tion had a “sig­nif­i­cant ad­verse im­pact on the re­gion”.

The study, ti­tled “What is the NCD ser­vice ca­pac­i­ty and dis­rup­tions due to COVID-19? Re­sults from the WHO non-com­mu­ni­ca­ble dis­ease coun­try ca­pac­i­ty sur­vey in the Amer­i­c­as re­gion,” has been pub­lished in the British Med­ical Jour­nal.

It re­vealed “sig­nif­i­cant and sus­tained dis­rup­tions,” af­fect­ing all coun­tries of the re­gion from 2019 to 2021, re­gard­less of the lev­el of in­vest­ment in health­care or NCD bur­den.

“Peo­ple with NCDs re­quire time­ly di­ag­no­sis, con­tin­u­ous treat­ment and ac­cess to es­sen­tial med­i­cines, as well as on­go­ing mon­i­tor­ing of their con­di­tions,” Sil­vana Lu­ciani, Chief of Non­com­mu­ni­ca­ble Dis­eases at PA­HO and one of the au­thors of the study.

“Yet the study shows that many coun­tries were un­able to meet these de­mands over the past three years,” she added.

The study found that while 81 per cent of the 35 coun­tries sur­veyed iden­ti­fied NCDs ser­vices as part of the gov­ern­ment’s core set of es­sen­tial health ser­vices to be main­tained dur­ing the pan­dem­ic, on­ly 34 per cent re­port­ed func­tion­ing out­pa­tient ser­vices for NCDs.

It said over 90 per cent re­port­ed dis­rup­tions in the pro­vi­sion of es­sen­tial pri­ma­ry care ser­vices, in­clud­ing can­cer screen­ing and the man­age­ment of di­a­betes and hy­per­ten­sion.

A quar­ter of all coun­tries al­so re­port­ed stock-outs of di­ag­nos­tic tools, as well as es­sen­tial med­i­cines and tech­nolo­gies for the treat­ment and man­age­ment of NCDs.

To mit­i­gate some of these dis­rup­tions, 67 per cent of coun­tries re­placed in-per­son con­sul­ta­tions with telemed­i­cine, and oth­ers im­ple­ment­ed home-based care, triage and pri­or­i­ti­za­tion of care based on the sever­i­ty of the con­di­tion.

“While more da­ta is cer­tain­ly need­ed, the re­sults of this study are con­cern­ing,” said Lu­ciani, not­ing that “around 240 mil­lion peo­ple cur­rent­ly live with a chron­ic con­di­tion in the Amer­i­c­as”.

She said ac­cess to di­ag­no­sis and treat­ment ser­vices for NCDs is es­sen­tial to man­ag­ing these con­di­tions and pre­vent­ing pre­ma­ture death.

PA­HO said it is rec­om­mend­ing in­te­grat­ing NCDs in­to uni­ver­sal health cov­er­age and ac­cess, with a fo­cus on en­sur­ing af­ford­able, qual­i­ty care for NCD pre­ven­tion and treat­ment as part of pri­ma­ry health care and em­pow­er­ing peo­ple liv­ing with NCDs to man­age their con­di­tions.

In ad­di­tion, NCDs should be con­sid­ered as part of na­tion­al emer­gency pre­pared­ness plans to en­sure the con­ti­nu­ity of es­sen­tial NCD ser­vices, even dur­ing health emer­gen­cies and nat­ur­al dis­as­ters.

PA­HO said it will con­tin­ue to pro­vide sup­port to coun­tries of the Amer­i­c­as to main­tain es­sen­tial ser­vices. It said it is al­so work­ing to mit­i­gate some of the chal­lenges posed by the COVID-19 pan­dem­ic by pub­lish­ing guide­lines to as­sist with triag­ing pa­tients, telemed­i­cine, mul­ti-month pre­scrib­ing, and the re­or­ga­ni­za­tion of on­col­o­gy ser­vices.

WASH­ING­TON, Mar 28, CMC

CMC/af/ir/2023