World Bank

Access Accelerated and the World Bank partnered in 2017 to support governments to respond to pressing and emerging needs in addressing the growing burden of non communicable diseases (NCDs). The World Bank Group and Access Accelerated have been working together to accelerate sustainable and scalable solutions to NCD prevention, treatment, and care. The World Bank’s work through the partnership tells the story of impact at local, national, regional, and global levels. To date, resources from Access Accelerated funded small grant projects in over 35 countries, with several regional and global ones.

The World Bank grants supported by Access Accelerated informed the World Bank–financed projects and new projects amounting to investments of 3.7 billion dollars across the six years. The World Bank is the world’s leading health financing agency. Priorities of the World Bank include decreasing poverty and increasing shared prosperity, building human capital, and supporting countries to achieve universal health coverage. The World Bank’s health strategy includes three main pillars, and NCDs cut across all three of them. They include the expansion of financial protection so that no one is tipped into poverty because of catastrophic health spending. The second pillar is increasing coverage of quality health for the poorest 40 percent of the population. Lastly, the third pillar is to foster a healthy society, including investments that reduce risk factors. The World Bank’s collaboration with Access Accelerated demonstrates that there is only one way of achieving such outcomes in health, including addressing NCDs: by building resilient health systems with a strong foundation set in primary health care and public health.

By being needs-driven, multisectoral, and systemsoriented, the World Bank’s work with Access Accelerated created enabling policy environments for NCDs and established a new body of evidence that countries can look to tackle these diseases. The reach of the World Bank is possible not only because of its large multisectoral expertise, but because of its commitment to generating evidence, building local capacities, and providing technical support and analytical work.

Actions, Outcomes and Impact in 2022

Access Accelerated support enabled the World Bank to produce 118 knowledge products in 2022, representing 58% of all knowledge products produced by partners. This included, for example, six 2022 knowledge products in Kenya, including a report on the economic and social consequences of cancer and an investment case which supports the prioritization and strengthened resource allocation for cancer. Together, these knowledge products enable policymakers in Kenya to make judicious choices about strategies and options to prevent cancer and strengthen service provision. The World Bank’s contribution to knowledge allows for shifts in attitudes towards NCDs by simplifying their management, giving illustrations of what can be done, and showcasing how multiple entry points can support improved NCD outcomes.

The World Bank’s projects covered a diverse array of work in 2022, which allowed it to provide contextualized support to key decision-makers based on specific needs and requirements. For example, the World Bank’s project on African Medicines Regulatory Harmonization worked with five out of eight recognized regional economic communities under the African Union to increase access to good quality, safe, and effective medicines through the harmonization of medicines regulations and processes; and by expediting the registration of essential medicines and potential availability at the national level.

The project supported the update and harmonization of pharmaceutical regulations, regulatory systems’ capacity strengthening, and the establishment of the African Medicines Agency, to ensure that all manufacturers (local and international) either registering, importing, or producing medicines in these regions comply with international standards. Strengthening regulatory oversight of pharmaceutical markets in these regions aims first at reducing the risk of exposure to substandard and falsified medicines to protect populations, while also having the potential to advance universal health coverage through the development of healthier, more transparent, efficient, and attractive pharmaceutical markets ensuring better access to good quality, affordability and accessibility of medicines. Multiple World Bank projects worked to integrate NCDs in primary care settings. An example of this is the work done in Chile to universalize primary health care to ensure access to primary care services free of charge and in a timely manner. The World Bank also implemented projects on digital health solutions, mental health, healthy aging, and human capital, among others, showcasing its ability to adapt and respond to local needs and contexts.

The World Bank grants supported by Access Accelerated informed the World Bank-financed projects and new projects amounting to investments of 3.7 billion dollars across the six years.

CASE STUDY: How ready are countries to address NCDs among aging populations?


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.

CASE STUDY: Primary Health Care as an avenue to respond to national and regional needs


A key challenge for people living with NCDs is having consistent access to care. Such care can be delivered equitably through health systems based on primary health care (PHC). PHC represents an important, and often first, point of care for patients. It is also an avenue through which health systems can find cases and detect diseases, identify individuals with high-risk status, and provide psychosocial interventions with long-term follow-up and regular monitoring. As NCDs continue to rise, adding pressure on health systems, especially at secondary and tertiary levels of care, it is essential that primary health care is strengthened.

The World Bank is acutely sensitive to the importance of primary health care and several projects funded by Access Accelerated support this first point of care. For example, the World Bank developed a rapid assessment tool of NCD management best practices to identify actions that improve national investments in NCD management. The tool is being deployed in Ghana, Dominica, St. Vincent and the Grenadines, and Gujarat state in India. The World Bank leverages its analytical capacity to collate a series of examples that integrate NCD management into PHC systems. These will support the identification of best practices and models for countries seeking to strengthen PHC.

In Chile, the World Bank supports the universalization of PHC so that all people, regardless of their health insurer, can access PHC services free of charge and in a timely manner. The project emphasizes the expansion of effective access to preventive care and evidence generation for the management of NCDs. It works in a phased approach to test the operational and organizational aspects covering regulatory, resource, and coordination aspects of the healthcare network. The World Bank leverages its analytical capacity to assess municipalities’ capacities to expand PHC services, identifying strengths and barriers for progressive implementation and assessing the feasibility of pilot projects. The analysis supports the national strategy to consolidate comprehensive, person-centered care, especially in the context of multimorbidity. In addition to working with the Chilean Ministry of Health to prepare the first level of health care to respond to needs derived from the universalization of access to PHC, the World Bank works with selected communities to identify how PHC services can be made socially pertinent and acceptable. The full diagnosis approach of assessing the enabling environment, as well as the social dialogue and plan for a phased implementation, represents a responsive, bottomup approach to expanding PHC services. 

By strengthening PHC services, health systems can leverage existing infrastructure to respond to emerging needs. With COVID-19, it became evident that access to uninterrupted care is a necessity for people living with chronic conditions. Improving the efficiency of procurement systems and financing mechanisms and expanding access and use of transformed PHC services will lead to a better quality of care and quality of life for people living with NCDs. The World Bank’s work in PHC also offers lessons on the relevance of leveraging different analytical capacities to address one health systems entry point through varied and context-specific ways, rather than in a siloed approach. The World Bank is uniquely positioned to do this well as its reach and technical know-how enable it to address changing needs.

CASE STUDY: Sustaining human capital across the life-cycle

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.