Mr. Nassir Abdulaziz Al-Nasser of Qatar: “It seems to me that the pendulum of public health has swung too far. Much focus has been on a few diseases, while denying attention and help to those who suffer and die from less dramatic but no less fatal- diseases of the body and mind. While the four diseases discussed over the last two days are critical, they are by no means the only noncommunicable diseases threatening livelihoods and undermining development on a considerable scale. In particular, mental health including depression is a major threat to the health and well-being of people worldwide. Going forward I would encourage you to broaden your definition of “non communicable diseases”, while remaining equally vigilant and targeted in your approach.”
Session 1: David Stuckler
UN High Level Meetingon non-communicable disease
What are people saying? “This meeting has made the world sit up and take notice of the huge global burden that NCDs are placing on all countries” #UNSummit #NCDs Declar. = No targets No commitments No Money No hope for patients in dvelopng world.
Some highlights Recognize that the conditions in which people live and theirSocial determinants lifestyles influence their health and quality of life, and that poverty, uneven distribution of wealth, lack of education, rapid urbanization and population ageing, and the economic social, gender, political, behavioural and environmental determinants of health are among the contributing factors to the rising incidence and prevalence of non-communicable diseases; Recognize that effective non-communicable diseaseWhole-of-government prevention and control require leadership and multisectoral approaches for health at the government level, including, asapproach appropriate, health in all policies and whole-of-government approaches across such sectors as health, education, energy, agriculture, sports, transport, communication, urban planning, environment, labour, employment, industry and trade, finance and social and economic development; Advance the implementation of multisectoral, cost-effective, population-wide interventions in order to reduce the impact of theFiscal, regulatory, and common non-communicable disease risk factors, namely tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol,legislative measures through the implementation of relevant international agreements and strategies, and education, legislative, regulatory and fiscal measures
Not everyone agrees… “While regulation and tax both played important roles, a free society could not simply legislate those health problems out of existence. People and businesses must be engaged, and the food and drinks industry should be seen, not just as part of the problem, but part of the solution. Further, the healthy choice must not just be the right choice, but the positive, easy and fun choice. An emphasis on prevention, physical activity and personal and corporate responsibility could, alongside unified Government action, make a big difference.”
A long road ahead HIV-2001 NCD-2011 Political declaration of the High-level Meeting Declaration of Commitment on HIV/AIDS of the General Assembly on the Prevention “Global Crisis – Global Action” and Control of Non-communicable Diseases constitutes a global emergency constitutes one of the major challenges for development Solemnly declare our commitment to Call upon WHO, in collaboration with address the HIV/AIDS crisis by taking Member States through the governing action as follows, taking into account bodies of WHO... building on the work the diverse situations and already under way, to prepare circumstances in different regions and recommendations for a set of voluntary countries throughout the world; global targets for the prevention and control of non-communicable diseases,By 2005, reduce the proportion of infants before the end of 2012;infected with HIV by 20 per cent, and by50 per cent by 2010, by ensuring that 80per cent of pregnant women accessing Accelerate implementation by Statesantenatal care have ... parties of the WHO Framework Convention on Tobacco Control
Main Results• WHO is going to develop a comprehensive global monitoring framework and voluntary targets by the end of 2012• Secretary-General to submit a report at its 67th session on options for strengthening and facilitating multisectoral action• Secretary-General to submit a report at its 68th session on progress and impact on internationally agreed development goals, in preparation for the 2014 comprehensive review of progress
Many Calls to Action on NCDs...+1? -Adapted from Ebrahim IJE
Continuing Low Funding CDs NCDsNo significant relationship between aid and burden of disease e.g. Stuckler et al Lancet 2009; Sridhar and Batniji Lancet 2009; Suhrcke et al Bull WHO 2009
Where Next?• No money• No targets• No grassroots …building a social movement?
Re-frame debates“Processed foods, very high in salt, trans fats, and sugar,have become the new staple food in nearly every cornerof the world. They are readily available and heavilymarketed. For a growing number of people, they are thecheapest way to fill a hungry stomach. The worldcertainly needs to feed its population of nearly 7 billionpeople. But it does not need to feed them junk food.” – Margaret Chan 1“We plead for lifestyle changes” – Margaret Chan 2
Create and identify political opportunities Ann Keeling, “The good news is we now haveBan Ki Moon, “I especially call on more political momentum – and we have cost-corporations that profit from selling effective solutions for addressing both the riskprocessed foods to children to act factors, such as tobacco use and salt intake,with the utmost integrity. I refer not and the diseases themselves. It’s vital that weonly to food manufacturers, but also continue to build on this momentum, to forgethe media, marketing and a new partnership between governments, theadvertising companies that play UN, NGOs and the private sector, to tackle thecentral roles in these enterprises.” very preventable causes of this global epidemic”.