3 Disease prevalence in the employed working-age population in

Chapter 3 examines the health burden of NCDs in Saudi Arabia in the future, particularly the impact that the demographic transition will have on the burden of NCDs. The forecasting study focuses on three causes of disability and death: cardiovascular diseases, cancer, and diabetes. Cardiovascular diseases have an especially important impact on middle-age adults, with ischemic heart disease and stroke accounting for one-sixth of all disability-adjusted life years (DALYs).2 The chapter shows how the health burden could more than double in the next three decades if nothing is done and how modest changes in smoking, diet, and exercise can reduce the DALY burden due to NCDs by 3–5 percent. The chapter then calculates the cutoff cost at which reductions would be cost-effective.

Chapter 4 models the economic burden of NCDs in Saudi Arabia and explains the methodologies used to capture the direct and indirect costs of NCDs. It calculates the estimated direct costs of NCDs to be 23 percent of current health expenditure. The presence of chronic conditions, moreover, accounts for 2.7 absent days from work, on average, at a direct cost of uS$22.5 billion, or 1.12 percent of gross domestic product (GDP) (2018 data). The chapter finds that the indirect costs of NCDs, when considering all aspects of productivity losses, may reduce GDP by nearly 7 percent. Such costs can be prevented and minimized through high-impact, cost-effective interventions to reduce the risk factors of NCDs.

Chapter 5 reviews the global literature on how NCDs affect human capital and then quantifies the impact of Saudi Arabia’s avertable mortality on the human capital index (HCI).3 The chapter, culminating in a framework outlining the pathways of how NCDs affect human capital, shows that NCDs affect human capital directly by leading to early death or retirement and loss of productivity as well as by affecting the learning and schooling of children. But NCDs also affect human capital indirectly, by diverting resources toward treatment of disease and by lowering labor market participation because people who might otherwise be employed are caring for the ill. The quantitative modeling and impact of NCDs on the HCI is seen mainly in their impact on adult survival (to age 60). The chapter finds that if all NCD-related deaths could be averted, Saudi Arabia’s HCI score would increase by 5 percent. moreover, the country would achieve the first part of the uN Sustainable Development Goal 3 target of reducing NCD mortality by one-third by 2030.

Saudi Arabia has already initiated several activities in the field of NCD prevention, and chapter 6 summarizes the country’s current strategies and policies. Several international, regional, and national strategies exist to guide the prevention and control of NCDs in Saudi Arabia. These strategies include the National Plan of Action of the World Health organization (WHo)’s Regional office for the eastern mediterranean NCD Strategy, several vertical strategies (the mental Health Strategy, Cancer Strategy), and both the Gulf Plan for Prevention and Control of NCDs 2014/2025 and the master Plan on environmental Health currently being developed. Together, these strategies outline a direction and monitoring framework for the prevention and control of NCDs in Saudi Arabia. The ministry of Health (moH) regularly reports to agencies, such as the WHo, that monitor progress on NCDs at regional and global levels. While such commitment is commendable, the moH and the Saudi Public Health Authority have expressed a need for more to be done to guide implementation and improve the monitoring and evaluation of existing efforts.

Chapter 7 reviews the global literature on population-wide interventions to prevent NCDs and the underlying evidence of their effectiveness and