Preparing for the unexpected, supporting the vulnerable!
The significant impact of disastrous events, be they local (earthquake, floods, war, extreme weather) or global (the COVID-19 pandemic), affects the functioning and living conditions of the community as a whole, by definition resulting in one or more of the following consequences: human, material, economic and environmental losses and impacts.[1] Those affected by chronic disease, of which kidney patients represent more than 850 million people worldwide, are particularly affected by these disruptions, as the ability to access proper diagnostic services, treatments and care is greatly jeopardized.
Non-communicable diseases (NCDs), which include cardiovascular diseases, diabetes, cancer, hypertension, chronic lung diseases, and chronic kidney diseases (CKD), are known to be the leading causes of death and disabilities worldwide, significantly so in low- and middle-income countries. In the event of emergencies, this cohort of the community is among the most vulnerable in the population due to their ongoing requirements for consistently coordinated care – care, which is often lifelong, and involving complex ongoing treatment.
In recent years, the COVID-19 pandemic has provided a clear example of the challenges faced by health care systems in providing essential health services to patients with NCDs. The impact of COVID-19 on the health system has placed an added strain on this vulnerable population, who have had to deal with the risk of becoming infected while visiting health facilities, or indeed the suspension or cancellation of non-COVID-19 care due to health service capacity limits and lockdown policies. Health services have struggled to provide access to the ongoing incidence of new NCD cases needing diagnoses, management, and care. With no actual cure or treatment to prevent progression of CKD, the under-detected and unhindered progression of CKD to kidney failure will most certainly increase the global need for life-saving costly treatments of dialysis and transplantation.
Finally, the COVID-19 pandemic has aggravated an already insufficient global political health commitment on NCDs. NCDs are too often incorrectly perceived as due to poor lifestyle choices, with policy deficits compounded by allocation of insufficient public health funds that focus on management rather than prevention, and of only a few of the recognised NCDs – cardiovascular disease, cancer, diabetes, and chronic respiratory disease. Yet, it is estimated that 55% of the global NCD burden is attributed to diseases outside of this group, such as kidney disease. Furthermore, the burden of these four more favoured NCDs is amplified in the presence of kidney disease, frequently co-existing. Public health policy that better reflects the opportunities in preventative strategies and the importance of both the magnitude and synergistic aspects of kidney disease as part of the NCD burden are urgently needed.
Therefore, preparation for unexpected events is incredibly important for kidney patients.
- Policymakers need to adopt integrated health strategies that prioritize prevention, early detection, and management of NCDs, including kidney disease.
- Health care services should provide equitable and proper access to care for chronic patients in times of emergency.
- Governments should include emergency preparedness plans in the management and detection of NCDs and favor the prevention of these conditions.
- Patients should plan for emergencies by preparing an emergency kit that includes food, water, medical supplies, and medical records.
Credit: worldkidneyday.org