WHO methodology for the selection of priority medical devices for NCD management Medical technologies for essential cardiovascular, stroke, diabetes, and chronic respiratory disease health-care interventions Title : Diabetes in India Credit : WHO /Atul Loke Date of exposure : 12/02/2016 13/12/18 M de Mar Elena, Karen Kulp and Adriana Velazquez Berumen

These interventions often rely on access to medical devices. Introduction: Sustainable Development Goals - Goal 3: Ensure healthy lives and promote well-being for all ages 71% of global deaths caused by noncommunicable disease 40% die before their 70th birthday 85% of early deaths from noncommunicable disease occur in low- and middle-income countries Morbidity and mortality can be reduced through early detection and effective management. These interventions often rely on access to medical devices. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death; https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases

How do you select, procure and use so many different products? Challenges: Providing health-care to manage non-communicable disease requires resources. So, which investments are the most beneficial?   NCD target to be attained by 2025: “An 80% availability of the affordable basic technologies and essential medicines, incl. generics, required to treat NCDs” There are over 10,000 different types of medical devices and over 500,000 products commercially available. How do you select, procure and use so many different products? https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death; https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases

Tertiary care Secondary care Primary care    The clinical interventions need technologies that should be appropriate for each health care facility, to respond to health care worker and population needs within the financial constraints   Tertiary care Secondary care Primary care Tertiary Specialized care Regional or teaching hospital Specialized outpatient diagnostics or treatment Secondary District and regional hospitals Outpatient labs and clinics Primary Community health centers Health post or health center Self use Home

Priority intervention medical device packages by income level Fragile states: 1.Basic intervention packages Low health care coverage: 1.Vulnerable populations 2.Vaccinations 3.Diagnostic Medium health care coverage: 1.Prevention, health promotion, and diagnostics 2.Limited treatments 3.Rehabilitation 4.Specialized NCD interventions 5.Vertical programs for specific or vulnerable populations (as resources allow) Strong health system with universal coverage: 1.Prevenataive services 2.Diagnostics 3.Treatments 4.Rehabilitation 5.Palliative care 6.Home care/telehealth 7.Age-specific interventions Health Systems for UHC The need to prioritize is higher where resources are limited Population coverage, financial, technological resources and health workforce

Previous publications in this series: Objective: To develop a list of priority medical devices for selected noncommunicable diseases Previous publications in this series:

International Classification of Diseases: codification of WHY the use of a medical device is needed ICD-11 is the 11th revision of the International Classification of Diseases. Epidemiology, health management, and clinical use. Analysis of the general health of population groups. Monitoring the incidence and prevalence of diseases. Providing a picture of the general health situation of countries. ICD-11 is used for: ICD-11 LINK: https://icd.who.int/

International Classification of Health Interventions: codification of HOW the medical device was used International Classification of Health Interventions began in 2007. ICHI Beta-2 2018 is now available. Recording information about clinical interventions. Enabling statistical analysis and international comparison. Monitoring interventions across healthcare delivery settings. Codifies the target, action and means of an intervention. ICHI is used for: ICHI LINK: https://mitel.dimi.uniud.it/ichi/

A pilot of the new ICMD system is being presented at this forum! International Classification of Medical Devices: codification of WHAT medical device was used A pilot of the new ICMD system is being presented at this forum! Registration for market approval for patient/clinician safety Tracking for post-market surveillance for patient/clinician safety Supporting efficient exchange of information for UHC Simplify procurement, supply chain, inventory and budgeting Standardization of processes throughout the lifecycle of the device ICMD will be used for: ICMD LINK: https://icd.who.int/dev11/l-m/en X Extension Codes / Health Devices, Equipment and Supplies

Cardiovascular disease: Current status of the project We are here

Example of the cross-referenced list for cardiovascular disease 23/05/2019

Example of the cross-referenced list for cardiovascular disease

Stroke: Current status of the project We are here

Example of the cross-referenced list for stroke

Diabetes: Current status of the project We are here

Example of the cross-referenced list for diabetes

Chronic respiratory diseases: Current status of the project We are here

WHO kindly requests your assistance Please help us make this list of priority medical devices for selected noncommunicable diseases ready and available. Review Consult Collaborate and disseminate To review the list of health interventions derived from clinical guidelines and the list of associated medical devices. To consider the possibility of participation in consultations to be held in the coming months where these lists will be reviewed and finalized with the input of other global experts from each of the six WHO regions. To consider ongoing collaboration on mattered related to this project, including providing your input into the content of the upcoming publication for dissemination as a freely available public good.

Thank you! Adriana Velazquez Berumen, M de Mar Elena and Karen Kulp WHO 20, Avenue Appia 1211 Geneva