TY - JOUR T1 - Prioritizing Health-Sector Interventions for Noncommunicable Diseases and Injuries in Low- and Lower-Middle Income Countries: National NCDI Poverty Commissions JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 626 LP - 639 DO - 10.9745/GHSP-D-21-00035 VL - 9 IS - 3 AU - Neil Gupta AU - Ana Mocumbi AU - Said H. Arwal AU - Yogesh Jain AU - Abraham M. Haileamlak AU - Solomon T. Memirie AU - Nancy C. Larco AU - Gene F. Kwan AU - Mary Amuyunzu-Nyamongo AU - Gladwell Gathecha AU - Fred Amegashie AU - Vincent Rakotoarison AU - Jones Masiye AU - Emily Wroe AU - Bhagawan Koirala AU - Biraj Karmacharya AU - Jeanine Condo AU - Jean Pierre Nyemazi AU - Santigie Sesay AU - Sarah Maogenzi AU - Mary Mayige AU - Gerald Mutungi AU - Isaac Ssinabulya AU - Ann R. Akiteng AU - Justice Mudavanhu AU - Sharon Kapambwe AU - David Watkins AU - Ole Norheim AU - Julie Makani AU - Gene Bukhman AU - NCDI Poverty National Commissions Authorship Group; NCDI Poverty Network Secretariat Y1 - 2021/09/30 UR - http://www.ghspjournal.org/content/9/3/626.abstract N2 - Key FindingsNational Noncommunicable Disease and Injury (NCDI) Poverty Commissions were established in 16 low- and lower-middle-income countries (LLMICs) to define local NCDI epidemiology, determine an expanded set of priority NCDI conditions, and recommend cost-effective, equitable health-sector interventions.Commissions prioritized an average of 35 health-sector interventions estimated to cost an additional US$4.70–US$13.70 per capita or approximately 9.7%–35.6% of current total health expenditure (0.6%–4.0% of current gross domestic product).Commissions demonstrated positive outcomes in understanding NCDIs of poverty, informing national planning and implementation of NCDI health-sector interventions, and improving governance and coordination for NCDIs.Key ImplicationsPolicy makers should use findings from the National NCDI Poverty Commissions to provide evidence-based, locally driven determination of priorities to guide health-sector policies, programs, and investments for NCDIs.External financing will be required to bridge the gap in financing for NCDIs to achieve universal health coverage in LLMICs.Health sector priorities and interventions to prevent and manage noncommunicable diseases and injuries (NCDIs) in low- and lower-middle-income countries (LLMICs) have primarily adopted elements of the World Health Organization Global Action Plan for NCDs 2013–2020. However, there have been limited efforts in LLMICs to prioritize among conditions and health-sector interventions for NCDIs based on local epidemiology and contextually relevant risk factors or that incorporate the equitable distribution of health outcomes. The Lancet Commission on Reframing Noncommunicable Diseases and Injuries for the Poorest Billion supported national NCDI Poverty Commissions to define local NCDI epidemiology, determine an expanded set of priority NCDI conditions, and recommend cost-effective, equitable health-sector interventions. Fifteen national commissions and 1 state-level commission were established from 2016–2019. Six commissions completed the prioritization exercise and selected an average of 25 NCDI conditions; 15 conditions were selected by all commissions, including asthma, breast cancer, cervical cancer, diabetes mellitus type 1 and 2, epilepsy, hypertensive heart disease, intracerebral hemorrhage, ischemic heart disease, ischemic stroke, major depressive disorder, motor vehicle road injuries, rheumatic heart disease, sickle cell disorders, and subarachnoid hemorrhage. The commissions prioritized an average of 35 health-sector interventions based on cost-effectiveness, financial risk protection, and equity-enhancing rankings. The prioritized interventions were estimated to cost an additional US$4.70–US$13.70 per capita or approximately 9.7%–35.6% of current total health expenditure (0.6%–4.0% of current gross domestic product). Semistructured surveys and qualitative interviews of commission representatives demonstrated positive outcomes in several thematic areas, including understanding NCDIs of poverty, informing national planning and implementation of NCDI health-sector interventions, and improving governance and coordination for NCDIs. Overall, national NCDI Poverty Commissions provided a platform for evidence-based, locally driven determination of priorities within NCDIs. ER -