The first time I sat across from a finance minister to talk about non-communicable diseases (NCDs), he looked at me and said, “Doctor, we don’t have a health crisis. We have a budget crisis.” He wasn’t wrong. Budgets are tight. But what he, and many like him, had yet to fully grasp was that NCDs are not just a health issue; they are quietly becoming one of the most significant and destabilising economic forces of our time.

For too long, the response to NCDs has been reactive, focused on treatment over prevention, and short-term costs over long-term value. Having worked globally in public health economics, I have seen firsthand the price we pay for this reactive mindset. And the truth is: we are spending far more by doing too little.

Why NCDs are an economic emergency

When a factory worker with diabetes faces complications and misses weeks of work, or when a 45-year-old mother suffers a preventable stroke, the effects extend far beyond hospital bills. These are economic shocks in slow motion, undermining household stability and national productivity alike.

Chronic conditions such as diabetes, cancer, cardiovascular disease, and chronic respiratory illnesses decrease productivity through absenteeism (days off work), presenteeism (reduced performance at work), and premature death, often occurring at the peak of working age.

Reframing health as an investment rather than a cost is not just a technical adjustment; it is a necessary shift in mindset.

In the six Gulf Cooperation Council (GCC) countries, estimates show that NCDs cost the economy nearly US$50 billion in a single year, equivalent to 3.3% of the regional GDP, not to new hospitals or innovation, but to lost productivity and early death. Moreover, in the 22 countries of the EMR, evidence showed that breast and cervical cancer cost the EMR US$15 billion in a single year, underscoring the economic impact of gender-related health disparities.

These are not abstract figures; they represent lost productivity, early deaths, and rising financial pressure on families and public systems. They represent mothers, fathers, and workers who never got the chance to grow old or contribute fully to their communities.

From cost to value

We need a new way of thinking, one that moves beyond cost containment and toward value creation. Reframing health as an investment rather than an expenditure is essential. Through collaboration with partners such as the United Nations Development Programme (UNDP), the World Health Organisation (WHO) and the Gulf Health Council, NCD investment cases have been developed for the six GCC countries to quantify costs and benefits of action. The results were clear: implementing a package of WHO-recommended interventions to control tobacco, salt intake, physical inactivity, and manage NCDs at the primary care level over 15 years would cost GCC countries US$14 billion over 15 years, but yield US$68.5 billion in economic benefits, a return of US$5 for every US$1 invested. This approach would also avert nearly 290,000 premature deaths and generate two million healthy life years. Health is not a drain on resources. It is one of the most strategic investments a country can make.

The investment case for women’s cancers in the EMR highlights that HPV vaccination, early detection, and comprehensive treatment can prevent thousands of premature deaths and deliver significant economic benefits. This also relates to equity: investing in women’s health is essential for developing inclusive and resilient health systems.

Leading the regional conversation

But data alone rarely changes minds. It’s what we do with that data that matters. Stakeholder engagement is essential for turning evidence into action. Presenting economic evidence and engaging directly with parliamentarians, finance ministries, and other relevant stakeholders has played a key role in influencing national conversations. For example, the policy dialogues with national councils in GCC (Majlis Shura in Oman, Majlis al-Umma in Kuwait, and Shura Council in Bahrain), and the parliamentarians in Georgia helped build support for integrating NCD investment into national health plans.

When health is treated as an investment, evidence shows that policymakers begin to prioritise prevention, allocate resources more strategically, and design systems that generate long-term economic and social returns. Economic evidence, when presented clearly and relevantly, can open doors for policy transformation. It also reflects the strategic use of health diplomacy to build consensus, shift mindsets, and accelerate reform.

The power of local evidence

The credibility and impact of this work come from local ownership. Each investment case was developed with in-country teams, using local cost data, disease burden estimates, and service delivery models. This made the results more persuasive and actionable, especially to ministries of finance and planning.

Equipping future public health professionals with the skills to generate and apply economic evidence is equally essential. Developing capacity in economic evaluation, policy engagement, and health systems research will support the next generation of leaders to promote health as a key development priority. Investing in public health students means supporting the next generation of professionals who will continue advocating for health as the region’s most valuable asset, not a cost.

Turning insight into action

Reframing health as an investment rather than a cost is not just a technical adjustment; it is a necessary shift in mindset. Over the years, I have seen how powerful economic evidence can be when brought into conversations beyond the health sector. By speaking the language of finance ministers, planners, and parliamentarians, we open doors that traditional public health arguments often can’t.

But data alone is not enough. Evidence only becomes powerful when paired with political will and country leadership. That’s why I believe strongly in working side by side with national teams, not just to generate numbers, but to build shared ownership and lasting capacity.

In my experience, real change happens when policymakers begin to see NCD prevention not as a cost to contain, but as a catalyst for economic growth, stability, and equity. Investment cases matter because they change the conversation. They help policymakers see the long-term returns on prevention, especially when health is positioned as a driver of economic growth and stability.

When this mindset takes hold, everything shifts. Prevention becomes a priority. Budgets are allocated more strategically. And health policies begin to align with long-term development goals. We can’t afford to wait. The costs are rising. The evidence is here. And the return on action has never been greater.