Submitted by Shreyasi Chhetri
13 May 2024

Building resilience against disasters: integrating care for non-communicable diseases into anticipatory action frameworks for Nepal's hazard-prone areas

The Danish Red Cross, in collaboration with the Nepal Red Cross Society, the Canadian Red Cross and academic partners at Aarhus University, is embarking on an innovative new project, ‘Strengthening NCD (non-communicable disease) care resilience in disaster-prone municipalities of western Nepal’. This aims to seamlessly integrate NCD care within an anticipatory action framework, ensuring uninterrupted access to essential services for people living with NCDs before and during emergencies.

NCDs claim nearly 41 million lives globally,1 with a staggering 86 per cent of premature NCD-related deaths occuring in low-income and middle-income countries, according to the World Health Organization. The urgency of this issue is underscored by the fact that the associated financial burden is projected to reach 21.3 trillion US dollars between 2011 and 2030.2 In countries such as Nepal, which is grappling with a surge in NCDs – including cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, cancer and mental health issues – coupled with climate-induced hazards, the crisis is particularly acute.

NCDs are a neglected aspect of disaster-management planning. In times of emergencies, people living with NCDs face the risk of being deprived essential healthcare services. This stark reality not only amplifies their vulnerability, but also turns a crisis into a potentially life-threatening ordeal.

To address this, the new project will develop innovative ways of incorporating NCD care within anticipatory action systems, which are increasingly regarded as a best-practice model by the government of Nepal and other stakeholders. The aim is to enhance the resilience of people living with NCDs, for example by helping them to access support services when a hazard occurs. The project’s three main components are to:

  • design a package of essential NCD interventions for disaster preparedness and response
  • integrate this within existing and tested approaches to anticipatory action and early warning/early action
  • test the feasibility of this package for anticipatory action and early warning/early action for floods, both through a simulation and an actual response.

A game-changer for people living with non-communicable diseases in Nepal

David Fogden, the country cluster manager for Bangladesh and Nepal at the Danish Red Cross, elaborated on the significance of the initiative: “Nepal is facing a double burden. We are witnessing first-hand the impacts of the climate crisis and a growing frequency and intensity of disasters, but this is now converging with another threat: non-communicable diseases, which are the primary cause of death in Nepal.

“NCDs require ongoing management, but this is often a neglected part of disaster-management planning. We recognize the urgent need to consider the unique vulnerabilities of people with NCDs before, during and after disasters. As such, we are extremely excited to launch this initiative with the Novo Nordisk Foundation and Aarhus University.”

The Red Cross has long been pioneer in early warnings, early action and anticipatory action, but this will be the first time that NCDs have been integrated into anticipatory action approaches. “It has the potential to be a game-changer for people with NCDs in Nepal,” David added.

Funded by the Novo Nordisk Foundation, the two-year project will work in Bhajani, Kailai District, and Laljhandi, Kanchanpur District. Combined, it will cover 13,933 households (79,072 people) in areas vulnerable to flooding from the Karnali and Dodha rivers. With funding of around 4.6 million Danish krone (approx. 656,000 US dollars/614,000 euros), which includes funds for health-related research, the project represents a vital step towards addressing the complex challenges of NCD care in disaster-prone areas, and ensuring equitable access to essential services for vulnerable populations.


[1] Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 – Results. Seattle, WA: Institute for Health Metrics and Evaluation, 2020.

[2] Bloom, D.E., Cafiero, E.T., Jané-Llopis, E. et al. The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum, 2011.

The Danish Red Cross works as part of an integrated network of International Federation of Red Cross and Red Crescent Societies in Nepal.

Photo: Amid emergencies, people living with NCDs face the risk of vital disruptions in their care, heightening their vulnerability and potentially tipping crises into life-threatening scenarios.