Jamaica: Investment Case for the Prevention and Control of Non-communicable Diseases

Background. In Jamaica, one in six noncommunicable disease (NCD) deaths occur in individuals younger than age 70, highlighting the need for health interventions that can accelerate progress toward UN Sustainable Development Goal 3.4, which aims to reduce premature mortality from NCDs in 2030 by one-third. Beyond the toll on health, NCDs also impose an economic burden. High healthcare costs afflict families and the government. In addition, individuals with NCDs are more likely to exit the labor force, miss days of work (absenteeism) and experience reduced capacity while at work (presenteeism).

Methods. We undertake an analysis to estimate the return on investment (ROI) from implementing policy and clinical interventions that reduce NCD prevalence. Over a 15-year time frame, a set of CVD, diabetes, tobacco, and alcohol interventions are scaled up from 2016 baseline levels to target coverages in line with Jamaica's National Strategic and Action Plan for the Prevention and Control of NCDs. We use the WHO OneHealth Tool (OHT) to calculate resulting health outcomes (avoided mortality and morbidity), and use the human capital approach to estimate productivity gains. Using the WHO CHOICE NCD costing tool, we estimate the yearly cost of implementing and enforcing each intervention. Benefits of interventions are divided by costs to obtain a ROI.

Results. Comparing the costs and benefits of each package of interventions, we find that all four categories of interventions—1) tobacco control policies, 2) alcohol policies, 3) CVD clinical interventions, and 4) diabetes interventions—generate benefits that exceed costs. Tobacco interventions have the highest return on investment: for every Jamaican dollar (JMD) invested in tobacco control, one can expect to see 5.37 JMD in return. The diabetes package has the next highest ROI (2.10), followed by the CVD package (1.90), and then the alcohol policy package (1.86).

Summary. The results show that there is an opportunity to reduce the burden of NCDs through preventative actions that target behavioral and metabolic risk factors for NCDs, while also ensuring treatment for those most in need. Investments in the health of the Jamaica population also increase economic productivity. In the first five years, Jamaica’s GDP is expected to grow an extra 0.11 percentage point as a result of the interventions analyzed in this analysis, contributing to Jamaica’s 5-year goal to grow the economy by five percent. Jamaica should seek to implement policies and clinical interventions.