Non-Communicable Diseases (NCDs) in Aging Population 2 - Solutions – Asrar Qureshi’s Blog Post #1168

Non-Communicable Diseases (NCDs) in Aging Population 2 - Solutions – Asrar Qureshi’s Blog Post #1168

Dear Colleagues! This is Asrar Qureshi’s Blog Post #1168 for Pharma Veterans. Pharma    Veterans Blogs are published by Asrar Qureshi on its dedicated site https://pharmaveterans.com. Please email to pharmaveterans2017@gmail.com  for publishing your contributions here.

Credit: Dongfang

Credit: Rajan Goswami

Preamble

This blog post is based on several Pakistani studies, UN report and McKinsey report. Links at the end.

Part 2: Bridging the Gap – Strategies, Innovations, and Pathways Forward

Given the magnitude of the challenge, what can governments, donors, health systems, communities, and the private sector do to narrow the care gap for NCDs in aging, developing nations? Below are key strategic directions which may be adapted to local environment.

Transform Primary and Community Care into Chronic-Care Hubs

Redesign primary care to act as the front line for chronic disease management; monitoring, counseling, medication, referrals, continuity.

Task shifting and community health workers (CHWs): Train CHWs and mid-level providers to support screening, monitoring, adherence counseling, and home visits.

Integrated care pathways: Build care systems that integrate primary, outpatient, hospital, rehabilitative, palliative care in a unified pathway.

Use of telehealth and remote monitoring: Especially in remote or underserved areas, use telemedicine, digital monitoring devices, mobile health (mHealth) apps for follow-up, symptom tracking, and adherence support.

Strengthen Infrastructure, Diagnostics & Supply Chains

Invest in laboratory networks, point-of-care diagnostics, systems for medication supply (including generics and essential drugs).

Ensure availability of affordable, quality medicines for NCDs.

Use pooled procurement, supply chain optimization, and local manufacturing to reduce costs and improve availability.

Build Workforce Capacity & New Models of Care

Develop training programs to upskill health workers in chronic care, geriatrics, integrated care, counseling, and digital tools.

Incentivize retention of health professionals in rural and underserved areas.

Encourage interdisciplinary care teams—physicians, nurses, pharmacists, social workers collaborating.

Strengthen Health Financing & Risk Protection

Expand health insurance schemes to cover chronic disease services, including outpatient care, diagnostics, and medications.

Introduce progressive subsidy models, where the poor get more support.

Reduce reliance on out-of-pocket payment, a major cause of catastrophic health expenditure.

Leverage Data, Monitoring, and Analytics

Build health information systems that track patient journeys, outcomes, and adherence.

Use data to flag patients at risk, monitor program performance, and evaluate interventions.

Support research and local evidence generation to inform policy.

Address Social Determinants & Promote Prevention

Invest in preventive programs: healthy aging, lifestyle interventions (diet, exercise, tobacco control), community awareness.

Integrate efforts across sectors (education, urban planning, food systems) to improve environments.

Target vulnerable groups early to reduce accumulation of risk over lifespan.

Engage Multi-stakeholder Partnerships & Innovation Ecosystems

Collaborate across government, NGOs, academia, private sector, civil society.

Use social enterprises, innovations, and strategic partnerships to pilot and scale models.

Encourage private sector involvement (tech firms, pharma) under public regulation and equity safeguards.

Phased Implementation & Scaling

Begin with pilot regions or districts to test models, learn, optimize.

Use “learning by doing” and adaptive scaling rather than one-size-fits-all mandates.

Align incentives and metrics for scale-up across levels.

Looking Ahead: A Vision for 2040

If these strategies are pursued with political will, coherence, and resources, the future could look radically better:

Many more older adults with NCDs receive continuous, high-quality care in the community, not just in hospitals.

Countries avoid massive costs of advanced disease complications.

Inequities narrow: rural, poor, and marginalized populations see better health outcomes.

Health systems become resilient and responsive, better able to handle future aging challenges (dementia, multimorbidity, palliative care).

Healthy aging becomes a reality, not a slogan.

Situation in Pakistan

The fundamental deficiencies are lack of coherence, integration, and longevity. Every successive government likes to initiate new programs with their name, rather than continuing the previous programs introduced by the previous government. Political expediency gets priority over real need, and the already limited resources get consumed in the wasted ways.

Pakistan had had a good health infrastructure starting from the basic health units, rural health centers, tehsil headquarters hospitals, district headquarters hospitals, and teaching hospitals. While the tertiary care got more attention, including cardiology institutes, primary care focus was lost. The trend continues with cancer-care hospitals bearing names of certain political leaders. 

Healthcare in Pakistan receives less than 1% of GDP (last year it was 0.9%). If this meagre allocation is also wasted, virtually all is lost.

We do claim a high percentage of young population; around 60%. However, it does not mean we do not have aging population. Our elderly people, who are not taken care of by their families, have nowhere to turn to for medical help.

Another segment of aged people that has gathered over the last several years is those parents/grandparents whose children have settled abroad. They may have financial resources but there is no one to take them to a doctor or hospital, when needed. 

These are additional issues related to NCDs in aging population in Pakistan.

Sum Up

The McKinsey report’s core message is stark but catalytic: the shift in global health burden toward NCDs in aging populations demands a reimagining of health systems—especially in developing nations. The care gap is not a distant threat; it is already a growing crisis. The choices made now will determine whether societies can support their aging citizens with dignity, cost-effectiveness, and equity.

The journey to bridge this gap is complex. But by designing chronic-care systems that are inclusive, sustainable, and rooted in community, developing nations have a real shot at converting aging into opportunity rather than crisis.

Concluded.

Disclaimers: Pictures in these blogs are taken from free resources at Pexels, Pixabay, Unsplash, and Google. Credit is given where available. If a copyright claim is lodged, we shall remove the picture with appropriate regrets.

For most blogs, I research from several sources which are open to public. Their links are mentioned under references. There is no intent to infringe upon anyone’s copyrights. If, any claim is lodged, it will be acknowledged and duly recognized immediately.

References: 

https://www.mckinsey.com/~/media/mckinsey/industries/social%20sector/our%20insights/aging%20developing%20nations%20and%20the%20care%20gap%20for%20noncommunicable%20diseases/aging-developing-nations-and-the-care-gap-for-noncommunicable-diseases_final.pdf?shouldIndex=false

https://www.emro.who.int/emhj-volume-28-2022/volume-28-issue-11/burden-of-noncommunicable-diseases-in-pakistan.html

https://uploads-ssl.webflow.com/5d02dff07c256562b40f66d5/5dee8b8813932a42923457ea_NCD%20policy%20brief_Pakistan_Final.pdf