As part of the Springer Nature Sustainable Development Goals (SDG) Programme, we're interviewing leaders and researchers about the work that they're doing to address the 17 SDGs outlined by the United Nations. Read on for our interview with Katie Dain, CEO of the NCD Alliance.
Katie Dain is Chief Executive Officer of the NCD Alliance, a global network of civil society organizations that are dedicated to transforming the fight against non-communicable diseases (NCDs). She spoke with The Source's Lucy Frisch about how the NCD Alliance is working to address the UN's Sustainable Development Goal #3: to ensure healthy lives and promote well-being for all at all ages.
The interview has been transcribed below and edited for clarity.
What does the working relationship between the Non-communicable Disease (NCD) Alliance and the research community look like?
The NCD Alliance has very strong ties to the research community as a whole. We work very closely with different universities, with academics, with think tanks. We’ve built strong relationships with different medical journals over the years, as well as also being involved in research collaborations. And the reason why we’ve built such strong ties to the research community is advocacy 101: always ensure that your advocacy is evidence-based and informed by data. So we have always worked very closely with different academics and universities.
That also translates down to the local level: obviously with the global entity alliance, but we’ve got 60 national and regional entity alliances as well, and again, many of them have very strong connections to research. And the way that we have engaged in different ways is that, firstly, we’ve often helped shape research projects with different academics. We’ve obviously leveraged the results of those [projects] in papers. Also as an advocacy organization we try to distill and summarize a lot of the research out there for a policy audience, so we produce policy briefs, for example, which draw upon evidence from research partners. And then we obviously try and kind of amplify and promote what comes out through policy platforms like the UN and the World Health Organization, again, to focus it toward the policy audience.
Given your experience in policy and advocacy posts in NGOs [non-governmental organizations] and government, what do you think is the most productive way that researchers can engage policy makers? Are there resources that you know of for researchers to make their research more accessible for policy makers?
We do that, as part and parcel of what we do. We’ve been producing policy briefs since the beginning of 2009, and the way that we do it is we often create a kind of expert group, including academics, to be informing what we put out.
But I guess just some tips for researchers: I think one thing is to think about it and plan for it from the very beginning of research, rather than trying to bolt it on at the end, and having a really clear purpose of what you’re trying to when engaging policy makers, because otherwise, the challenge of engaging policy makers is that it’s very time consuming. It’s quite a messy landscape, and so you have to know the landscape and know who the important people are to try to talk to and influence.
So do your research upfront, before you just go out there and say “this is important”?
And I think the other thing, which links to our policy brief series, is knowing the audience: knowing the level of information that they need. You know, policy makers have fairly short attention spans. When I used to work in the UK’s government, I basically had to summarize huge amounts of research into a two-page summary for a minister to basically look at and decide, “okay.” So: take out the jargon, reduce the length.
Also, I think the other thing that policy makers are really interested in is actual case studies and success stories of what has worked in other countries, because then that obviously helps inform which policy direction they take as well.
You already mentioned that any good advocacy is evidence-based, but is there any other value position that you see researchers holding?
We are part of some research collaborations, so I think it’s quite useful when researchers are developing research proposals, for example, that they’re also thinking about how NGOs can be part of those kind of consortia. Because quite often, again, it’s a bit of an afterthought.
We also engage young researchers in placements within the organization as well, which is extremely valuable, I think, for both sides.
What are the favored channels that the NCD Alliance has [for communication] and do they vary regionally? Because you’re working with so many different governments and so many different countries, and we all have different ways of communicating as human beings, really. Do you find that there are some channels that make more sense than others, and does that vary regionally?
We have very targeted communications toward policymakers. So for example, we know our network of policymakers in Geneva, who are going to be potentially reading our policy briefs, and we have a targeted approach with email, directly, to those. But also, we’ve built up a strong social media platform, mainly through Twitter, which is read by a lot by policy makers, just to kind of try to get into the news through that as well.
We also have regular newsletters where we send things out. And again, that’s read by a lot of different policy makers because we just try and summarize what’s going on in the NCD policy landscape in a really kind of short form, so that they can just read something really quickly. And again, it goes back to the attention span—it’s just trying to summarize into very, very simple key points some of the trends that they should be interested in.
But it does vary by region as well. I mean obviously, in some places WhatsApp is a communication channel that you can [use to] get directly to some policy makers, which is quite incredible.
Yeah, with the group chats! I never realized that that was used beyond just personal use.
Yeah, some [...] of the regional alliances, for example in the Eastern Mediterranean region, they mainly communicate through WhatsApp.
And the same with Latin America. We’ve got a really strong Latin America alliance, and the way that they respond really quickly—for example, when a government is trying to introduce new NCD prevention policy or legislation, say for example on taxing unhealthy products or labelling restrictions, and often they experience significant industry pressure and push back from the industry, the regional alliance members communicate on WhatsApp and respond quickly by writing letters of support to the government with hundreds of organisations as signatories.
Do you think that there’s a different way in which NCDs are observed globally? They’re probably prioritized differently in different countries—we can look at smoking behavior, drinking behavior—but do you feel like, in your work, you have to address regionally how an NCD is seen? And do you see any difference between the global North and South in terms of which ones are prioritized?
There’s obviously a big difference within income settings in the way that NCDs are addressed and the way that they’re perceived. One way is, for example, in a lot of developing countries the priority is really around ensuring treatment for people living with NCDs and ensuring they strengthen the health system rather than, perhaps, focusing on the prevention side of things. Whereas in high income countries, where you’ve probably got a better, stronger health system already, the focus is on prevention. So the prevention/treatment dichotomy varies by region.
There’s always been this kind of view that NCDs are a high income country issue, they only affect older people—white, older men basically is the view—whereas, increasingly, NCDs are really hitting developing countries, and the poorest communities within those countries.
And I think the other way that it varies is that developing countries are more amenable to a broader integrated NCD approach, rather than creating disease silos within the health system around cancer, diabetes, or heart disease, for example. This is because many health systems in LMICs [low or middle-income countries] are currently not equipped and geared towards chronic NCDs, and resources are scarce. So it makes sense to integrate NCDs into existing health systems.
But yeah, as you say, obviously countries and regions completely vary by what they prioritize, what they focus on, and it depends on their own local context and what the data are showing them in terms of what they need to focus on. But we always try to advocate for a balance of the upstream public policy side of things like prevention as well as trying to reorient your health system to focus on the lifelong, chronic diseases that NCDs pose.
Do you think that there’s this private sector interest, or goals, or agendas, that are interrupting progress that’s being made? Is that something that you could say is a global trend?
It’s a global trend, but the way that it plays out in countries varies by region. For example, in Latin America, where there’s less regulation, the private sector and industry are right at the table with policy makers, making the decisions, calling the shots. In places in Africa, you’ve got the alcohol industry essentially writing alcohol strategies for countries. Whereas in high-income countries, there’s a bit more regulation and a bit more of a firewall between. So it plays out differently, but it is a global phenomenon that the unhealthy commodity industries—big tobacco, alcohol, ultra-processed food—is trying to undermine public policies that we know work for NCDs because they know it’s going to damage their bottom line, essentially.
What do you think is the most relevant way to measure the Sustainable Development Goals? There are tons of targets under each one, but do you feel that there are concrete ways that you can measure success, specific to the NCD Alliance?
As you say it’s 17 goals, 169 targets, 230 indicators. It’s a pretty massive agenda, and governments are not going to be able to prioritize and monitor all of it. I think since 2015, when the SDGs were adopted at the global level, what countries have been doing is then translating it and domesticating it for their own countries—and what that means is really having to prioritize. Because they can’t cover all of the 17 goals and 169 targets and 230 indicators. They’ve got to focus on where the need is the greatest and where they can make a big difference.
But I think, with the SDGs—it goes back to the point I made earlier about the integrated and indivisible nature of the SDGs—you can’t just focus on the health goals and achieve sustainable development. You need to be able to cluster these different issues to be able to make progress.
I think the other point about measurement is the actual capacity to measure—the fact that many developing countries’ surveillance systems are really, really weak for NCDs, specifically, but health more broadly. But the SDGs are a good impetus for strengthening them so that when you’ve got no data against one of the targets or indicators, that provides a good reason to then begin strengthening the data collection around those indicators. So the SDGs—even though they’re ambitious, they’re lofty—they help countries improve their surveillance systems.
Final question: what are your short and long-term goals for the NCD Alliance?
Our long-term goal has always been focused around the global target: by 2030, reducing NCD premature mortality by 30%. That’s our kind of long-term, lofty goal of what we’re trying to contribute. Obviously we alone can’t do it, but we as a global civil society network can help support it.
But then in terms of short-term goals: number one is trying to prioritize NCDs within national universal health coverage responses. Obviously, the UHC high level meeting is happening in September in a couple of weeks in New York, and after that it’ll really be up to governments to be developing UHC benefit packages for their countries. Our role is to ensure they include NCDs within that, but don’t just include NCDs, but include prevention. Because what we see with the UHC debate is that prevention just constantly falls off the table, and it gets very focused on treatment and health systems, when actually it should be more holistic.
Secondly, we continue to have a big focus on scaling up global resources for NCDs, because that’s been one of the major Achilles’ heels of the response, really: the fact that less than 2% of $22 billion of development assistance for health goes to NCDs today is just mind-boggling. So, you know, really trying to change that picture within financing.
And then thirdly, as an organization, really trying to strengthen the capacity of civil society organizations and alliances in developing countries, because our belief has always been that unless you’ve got a strong civil-society movement in countries on NCDs, you’re not going to see sustained progress. Because we, as advocacy organizations, can put the pressure on, build the demand for action and hold governments to account. So, [we’re] trying to ensure that we’ve got a strong civil-society movement in developing countries where there isn’t one already.
Wonderful. I hope all of those things are achieved and more. Thank you so much for your time.
Katie Dain is Chief Executive Officer of the NCD Alliance, a global network of civil society organisations dedicated to transforming the fight against non-communicable diseases (NCDs). Katie has worked with the NCD Alliance since its founding in 2009. Katie is widely recognised as a leading advocate and expert on NCDs. She is currently a member of the WHO Independent High-Level Commission on NCDs, co-chair of the WHO Civil Society Working Group on the UN High-Level Meeting on NCDs, and a member of The Lancet Commission on NCDIs of the Poorest Billion. Her experience covers a range of sustainable development issues, including global health, gender equality and women’s empowerment, violence against women, and women’s health. Before joining the NCD Alliance, she held a series of policy and advocacy posts in international NGOs and government, including the International Diabetes Federation (IDF) in Brussels, leading their global policy and advocacy programme; the UK Government as a gender policy adviser; Womankind Worldwide, a women’s rights organisation; and the Terrence Higgins Trust (THT), a HIV and sexual health charity. She has a BA in History from Sheffield University, and a Master’s degree in Violence, Conflict and International Development from the School of Oriental and African Studies (SOAS), London. Connect with Katie: @katiedain1