Prevention and Control of Noncommunicable Diseases in the Republika Srpska, Bosnia and Herzegovina. The case for investment.

Abstract

This report is the result of the initial phase of a project to develop an investment case for interventions aimed at the prevention and control of noncommunicable diseases (NCDs) in the Republika Srpska, Bosnia and Herzegovina. It considers the current NCD health and economic burdens along with current risk levels, the healthcare institutional context, potential barriers to change, as well as current NCD policies. Noncommunicable diseases such as cancer, cardiovascular disease, diabetes and chronic respiratory disease (or chronic obstructive pulmonary disease) pose a significant threat to health and economic development in the Republika Srpska, Bosnia and Herzegovina. Already, NCDs are collectively the leading cause of death and the total economic toll is roughly 6.4% of its gross domestic product. An ageing population, high levels of tobacco consumption, poor diet, excess weight, hypertension and air pollution are among the drivers of NCDs in the Republika Srpska. Although some positive efforts to reduce risks and improve NCD diagnosis and care have taken place, these are insufficient to comprehensively address this burden. Research for this report examined the costs and benefits of five intervention packages which could play a role in addressing the NCD burden in the Republika Srpska. While all could yield important benefits, two in particular – reducing salt consumption and tobacco control – would lead in the next 15 years to economic growth which far outpaced the size of the investment in the measures themselves. Together, the two packages would likely save more than 6,250 lives over the next 15 years. This report, drafted by United Health Futures, draws on inputs from a United Nations Development Programme Institutional Context Analysis which examined the institutional, governmental, and stakeholder arrangements and relationships relevant to managing, preventing and controlling NCDs in the Republika Srpska. The methodology for the analysis is provided in Appendix A. In addition, a team from the Russian National Research Centre for Preventive Medicine provided an extensive economic analysis which, for this report, looked in depth at the economic burden which NCDs pose for the Republika Srpska, as well as determining the return on investment of several potential interventions to lessen the burden of NCDs. The methodology for the economic analysis can be found in Appendix B.

Link: republic-srpska-ncd-report-2023.pdf