Intergenerational NCDs in The Lancet

Failure to integrate maternal and child health services with NCD prevention is a missed opportunity with long-term implications for the growing global NCD pandemic, says FIGO, with new comment piece published in The Lancet December 8 issue. 

While annual rates of death from infectious diseases look set to decline in the coming decade, non-communicable diseases (NCD) deaths will rise globally: an estimated 52 million lives lost annually by 2030, with intergenerational transmission amplifying the crisis.

As it stands, no single country will meet their reduction target in mortality from NCDs by 2030.

There is an urgent need for prevention, and clear evidence that this must begin in the womb, says the International Federation of Gynecology and Obstetrics (FIGO) — a professional membership organisation that works to ensure that all women achieve the highest possible standards in health and wellbeing.

The golden opportunity of pregnancy and the preconception period for engaging health-professionals is addressed in The Lancet this month by a group of leading NCD researchers and experts. The authors of this commentary Intergenerational burden and risks of NCDs: need to promote maternal and child health highlight FIGO’s recent Global Declaration on Hyperglycemia in Pregnancy as an example of how low-cost diagnostic procedures can lead to effective preventive intervention.

The FIGO Declaration recommends all pregnant women are tested for hyperglycaemia with a single-step procedure early in pregnancy, an example of prevention of maternal-to-offspring transmission of NCDs.

This strategy has been optimised in the communicable disease community, with success in reducing transmission rates of HIV and hepatitis B; but it is still not viewed as a priority for NCDs.

“Mother to child transmission of some infectious diseases has been dramatically reduced. Why is this approach not a priority for NCDs? After all, even though they are called ‘non-communicable’ we know that risk of NCDs is transmitted across generations. It is urgent to reduce this by new initiatives, especially in maternal health before and during pregnancy and after birth,”

said Professor Mark Hanson, lead author, Professor of Cardiovascular Science at the University of Southampton, and co-chair of FIGO’s Committee on Pregnancy and NCDs.

FIGO raised the issue of links between maternal health and NCDs at the High Level meeting of the UN General Assembly on Prevention and Control of NCDs this summer, asking that any efforts begin with, and substantially focus on, preconception and maternal health.

Dr Anil Kapur, representative of FIGO’s Committee on Pregnancy and NCDs affirmed the UN’s own 2011 statement that “maternal and child health is inextricably linked with NCDs and their risk factors.”

Unfortunately, despite significant efforts from a number of leading NGO’s and membership bodies, including FIGO, no formal commitment was included in the 2018 UN Political Declaration on the prevention and control NCDs which followed. This is a missed opportunity with life-threatening consequences for present and future generations. Said Dr Kapur,

“It is extremely disappointing that the recent Political Declaration of the third high-level meeting of the General Assembly on the prevention and control of NCDs has paid no heed to the developmental origins of health and the impact of NCDs on maternal health, and of maternal health on NCDs,”

Integration of maternal and child health services with health promotion and NCD prevention at the primary care level and beyond is critical to avert this punishing cycle. We must build a sustainable future health for generations who are not yet born, but are already at risk.

About FIGO

FIGO is a professional organisation that brings together obstetrical and gynecological associations from 132 countries to advocate, educate and promote best practice and policy dialogues that improve women’s health.

FIGO’s vision is a world where all women achieve the highest possible standards of physical, mental, reproductive and sexual health and wellbeing throughout their lives. We advocates on a global stage, especially in relation to the Sustainable Development Goals (SDGs) and lead on global programme activities, with a particular focus on sub-Saharan Africa and South East Asia.

FIGO is in official relations with the World Health Organization (WHO) and has consultative status with the United Nations (UN).