Slowing growth of the global population of more than 8 billion people brings a new focus on aging. Aging populations accelerate the shift from communicable diseases to NCDs, particularly in Europe and Central Asia (ECA) which is home to the world’s fastest-growing aging populations. Ninety-four percent of elders over age 70 die from NCDs in the ECA region. The implications of large aging populations extend beyond the economy and health system readiness. They demand a re-imagined approach to NCD care. 

Access Accelerated support enables the World Bank to reimagine care in two distinct ways. Leveraging the World Bank’s ability to collate actionable evidence and conduct advanced analytical work, the regional ECA project produced a report that guides countries with aging populations to assess their readiness to respond to NCDs. The report presents three stages of readiness — early, progressing, and advanced — depicting countryn archetypes based on NCD risk factors and disease burdens, levels of political commitment, implementation capacity for effective and accessible service delivery, and capacity to collect and utilize data to inform policy. Countries are invited to use these archetypes to assess their current state of readiness to address NCDs and determine the most effective levers to move forward. Actions include establishing a more enabling environment, enhancing monitoring and evaluation, or building implementation capacity. The archetypes offer a starting point for countries to think about what to do next, highlighting that a step in the right direction is always possible, irrespective of current stage.

The analysis presented in the ECA report informed discussion of upcoming frontiers in NCD care during a two-day conference held in late 2022 in Sweden, organized by World Bank, Karolinska Institutet, and Uppsala University. Identified frontiers include the role of digital technologies in supporting older populations and addressing shortages in medical devices and life-saving tools. In addition to the lively discussions, the event welcomed ministerial representatives from multiple countries, highlighting the high-level passion and attention that NCDs receive across the region. 

The World Bank’s ECA effort operates at the regional and national level, and in addition to the regional work on readiness, five countries in the region conduct analyses to identify ways to prevent the erosion of human capital by addressing NCDs. For example, in Bosnia and Herzegovina, the World Bank is assessing the involvement of private providers in NCD care. The focus in Croatia is to mobilize evidence to facilitate investments in NCDs. 

The ECA project exemplifies the World Bank’s commitment to supporting countries, demonstrating a focus on emerging challenges and solution-oriented dialogue. The project reveals that success is possible through the power of collaboration and participating countries’ passion for NCD action. Together, these components enable the creation of trust and connective tissue — with growing attention and changes in demand for NCD action, the World Bank works hand in hand to identify locally-relevant and systems-wide ways to address NCDs, facilitating knowledge exchange and enhancing social capital.

The most important resource in a society is its human capital — or the collective knowledge, skills, and health that people accumulate throughout their lives. From early childhood development through formal education and healthy aging, human capital enables individuals to realize their full potential as productive members of society. As new employment markets arise and shift the skills needed for societies to prosper, human capital allows individuals and societies to adapt and thrive.

Safeguarding human capital is no simple task, especially as national health priorities transition from communicable diseases toward NCDs. More people than ever are living beyond the age of 60, but longevity does not necessarily equate to good health. While a longer life is a valuable resource, declines in physical and mental capacities at later stages in life strain health systems around the world. Moreover, NCDs across different stages of life affect the productivity of people both immediately and long term, and the cost of inaction to prevent complications arising from NCDs has the greatest impact on elderly populations. This raises the question of how to ensure that people can get to later stages of life in good health and with practical skills. Many of the World Bank’s projects in partnership with Access Accelerated work to enhance individuals’ abilities to age healthily, particularly by prioritizing access to new knowledge and financing. This allows the World Bank to identify new ways of aging, with older members of society remaining productive, capable, and healthy.

The Healthy Longevity Initiative exemplifies the World Bank’s work in sustaining human capital across the life cycle. The initiative explores the nexus between healthy longevity, NCDs, and human capital and identifies future policy needs related to the preservation of human capital in adults. HLI aims to provide new knowledge and access to financing to promote and enhance healthy longevity and address its implications for low- and middle-income countries (LMICs) through supporting cutting-edge research and policy dialogue on healthy longevity. The project works in three broad areas: economic analysis and sectoral knowledge, interventions and strategies and data and measurement.

Capacity in these three areas is key in documenting how NCDs affect productivity and human capital, and the implications for policies, programs, and funding structures for NCDs that are also more effective in addressing gender-based gaps in health and human capital outcomes. The work identifies whole-of-society approaches to stimulate healthy longevity and estimates the types of investments needed to improve the underlying data infrastructures in countries. This project alone produced 17 papers and 3 country-specific data dashboards. The World Bank’s work in countries such as Colombia, Mexico, Sierra Leone, and India, among others, continues to inform future NCD investments and expand NCD service delivery.

Through a focus on human capital across the life cycle, the World Bank positions the prevention and management of NCDs at the forefront of economic growth and development. This shift in understanding how the growing burden of NCDs impacts human capital and development presents an important opportunity for the global health community to identify and prioritize NCD action that safeguards people’s prosperity. The World Bank’s work on human capital and NCDs also offers lessons on the value of knowledge generation to create enabling environments which understand the breadth of needs for women and men living with NCDs as well as the urgency with which they ought to be addressed.