“NCDs have raised the risk of and the severity of the COVID-19 infection,” says Dr. Belén Garijo, Executive Board Member and CEO of Healthcare at Merck KGaA Darmstadt, Germany, in this week’s Friday Podcast. Women living with NCDs like cardiovascular disease, hypertension, cancer, mental health disorders, multiple sclerosis, and diabetes, have an increased risk of severe complications and death from COVID-19. “When you take a look at the mortality rate for one million inhabitants, you see a lot of diversity, and what has been consistent amongst all the countries is the association between severity of the infection and underlying diseases,” says Garijo.

Around the world, approximately 18 million women of reproductive age die each year because of non-communicable diseases (NCDs), and two in every three deaths among women are due to an NCD. In fact, NCDs have been the leading cause of death among women globally for at least the past 30 years. And yet, women’s specific needs are often excluded from conversations about NCDs. They are underrepresented in clinical research and the effect of NCDs on women in particular is rarely considered. NCD-related symptoms during pregnancy are commonly misinterpreted or dismissed by clinicians.

Cervical cancer affects 570,000 women a year and kills 311,000. Nine in 10 (88 percent) of the deaths occur in developing countries. This cancer is caused by a common sexually transmitted infection, human papilloma virus (HPV), but is also considered a non-communicable disease (NCD) because of the slower way it presents. Yet, the disease is one of the most preventable and treatable cancers, and cost-effective solutions exist to prevent the disease. Given strong overlaps between HIV and reproductive health, we can and should do more to stop cervical cancer.

One-third of all maternal deaths can be traced to high blood pressure in pregnancy and in the weeks after giving birth. Yet many women don’t know how dangerous high blood pressure can be. And they may not realize they are at risk for many life-threatening conditions such as pre-eclampsia and eclampsia. Because high blood pressure can be asymptomatic, women with hypertension may not feel unwell or even know that their health is compromised.

Multiple sclerosis (MS) is a non-communicable disease that affects maternal health. MS is an unpredictable chronic disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. The progress of this disease, its severity, and specific symptoms cannot yet be predicted and varies by individual. Symptoms may disappear or diminish completely, or they may persist and worsen over time. Typical symptoms include fatigue, numbness and tingling, blurred vision, imbalance, pain, and problems with memory and concentration.

Every day there are more than 800 maternal deaths worldwide. Who are these women? They are reproductive women across the globe. They are our sisters, aunts, friends, and co-workers. They are leaders in our community, family members, and caregivers. When assessing the state of maternal morbidity and mortality in the United States, one must consider not only what we know, but also what must change.