Pekka Puska, MD, PhD, MPolScDirector GeneralNational Institute for Health and Welfare (THL),FinlandVice President, Int. As...
Background and vision• Health is important for every individual, public welfare  and sustainable social and economic devel...
:Sourceof premature deaths from NCDs occur in developing countries 90%         million 25                               To...
04.12.12   Pekka Puska, Director General   4
04.12.12   Pekka Puska, Director General   5
RECENT POLITICAL SUPPORT  UN high-level summit on NCDs  New York Sept 2011   • Preceeded by     Ministerial Conference    ...
Changing global burden of disease    WHO´s NCD strategy in 2000• NCD prevention and control is a global  health priority• ...
INTEGRATED PREVENTION04.12.12           Pekka Puska, Director General   8
Cornerstones of NCD preventionand control (WHO global strategy)• Attention to behavioural risk factors           –   Tobac...
Redirection of health services• Reorientation and strengthening of health systems• Primary health care:    ”Now more than ...
Surveillance/monitoring• Monitoring of                   • ”Best buys”:    Diseases                        NCD mortality...
NCD FRAMEWORK FOR ACTION/MONITORING                                GENETICS           Health               Prevention     ...
The journey to scale up global action                  Global Strategy for the Prevention and           2000   Control of ...
Action Plan 2007-      2012        #New Action Plan in preparation 04.12.12           Pekka Puska, Director General   14
Comprehensive action and partnershipfor national NCD prevention•   Health services•   Governments (national, local)•   Civ...
During the last few years a greatnumber of strategies and plans forevidence-based, effective preventionand health promotio...
From priorities to implementation    IDENTIFYING                                        IMPLEMENTING    PRIORITIES        ...
NCD prevention is possible!The potential is great  • Quite rapid impact  • Human impact on health and    wellbeing  • Impa...
Change in age-adjusted mortality ratesFinland, males aged 35–64 (per 100 000 population)                                  ...
Intersectoral work towards prevention- ”Health in all policies”• People’s lifestyles are influenced by decisions in  diffe...
Examples of intersectoral work 1.Development of Finnish                             Change in fat contentRapeseed oil     ...
Examples of intersectoral work 2.Biscuit example:• Leading Finnish biscuit manufacturer (LU Finland Ltd) has   removed som...
04.12.12   Pekka Puska, Director General   23
8th Global WHO Conference on health promotion- “Health in all policies”          From Ottawa to Helsinki (June 2013)04.12....
WHO/EMRO region• Shows great leadership and  example on effective regional  action• Great experience and potential04.12.12...
World Congress of Cardiology                             World Congress of Cardiology                                  Sci...
THE MAIN CHALLENGE FOR          SUCCESSFUL NCD           PREVENTION IS NOT WHAT             TO DO, BUT HOW TO           IM...
The Future Challenge    To match the public health    importance of NCD’s and    potential health gains with    needed att...
Ban Ki-Moon:”We should all work to meet the targets to reduce NCDs”04.12.12                 Pekka Puska, Director General ...
Thank you04.12.12     Pekka Puska, Director General   30
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The vision and road map for addressing ncds

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Pekka Puska
Rriyadh KSA 10.09.2012

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  • World Health Organization December 4, 2012 And what's drastic here – 90% of the premature death from NCDs occur in developing countries – countries that are already vulnerable and will also been hit heavily by global economic crisis and negative effects of climate changes. (Over the next decades, it is predicted that billions of people, particularly those in developing countries, face shortages of water and food and greater risks to health and life as a result of climate change 1 ) 1 Climate Change: Impacts, Vulnerabilities and adaptation in Developing Countries (2007) United Nations Framework Convention on Climate Change (UNFCCC).
  • The vision and road map for addressing ncds

    1. 1. Pekka Puska, MD, PhD, MPolScDirector GeneralNational Institute for Health and Welfare (THL),FinlandVice President, Int. Association of National Public Health Institutes(IANPHI)Past President, World Heart Federation (WHF), Geneve The vision and road map for addressing NCDs Int. Conference on Healthy Lifestyles and NCDs in the Arab World and the Middle-East; Riyadh, KSA, 10-12.9.2012 04.12.12 1
    2. 2. Background and vision• Health is important for every individual, public welfare and sustainable social and economic development• Current situation and the future– A few chronic non communicable diseases are greatest determinants of public health– These NCD’s are to great extent and to late in life preventable Vision: world free of avoidable NCD’s (=healthy ageing) Goal: Effective comprehensive action on global, regional, national and local level04.12.12 Pekka Puska, Director General 2
    3. 3. :Sourceof premature deaths from NCDs occur in developing countries 90% million 25 Total number of deaths in the world 2.3M million 20 M 6 ..8 M6 8 2.3M million 15 10.2M 3.7M 10.2M 13.6M 13.6M million 10 0.5M 5.9M 5.9M M 3 ..3 0.6M M3.0M 3 3 3.3M3.0M 3.0M 0.9M 1.1M 3.0M High-income Upper Lower Low-income countries middle-income middle-income countries Group III - Injuries Low-income countries Group II – Other deaths from noncommunicable diseases Group II – Premature deaths from noncommunicable diseases (below the age of 60), which are preventable Group I – Communicable diseases, maternal, perinatal and nutritional conditions 04.12.12 Pekka Puska, Director General 3
    4. 4. 04.12.12 Pekka Puska, Director General 4
    5. 5. 04.12.12 Pekka Puska, Director General 5
    6. 6. RECENT POLITICAL SUPPORT UN high-level summit on NCDs New York Sept 2011 • Preceeded by Ministerial Conference in Moscow (April 2011). • Political declaration • Action on global NCD prevention and control” • WHO’s leadership, intersectoral support04.12.12 Pekka Puska, Director General 6
    7. 7. Changing global burden of disease WHO´s NCD strategy in 2000• NCD prevention and control is a global health priority• Comprehensive actionis needed, but from public health point of view population based prevention is the key (most cost- effective and sustainable)• Integrated prevention: targeting common, lifestyle related risk factors (tobacco, diet, physical activity, alcohol)04.12.12 Pekka Puska, Director General 7
    8. 8. INTEGRATED PREVENTION04.12.12 Pekka Puska, Director General 8
    9. 9. Cornerstones of NCD preventionand control (WHO global strategy)• Attention to behavioural risk factors – Tobacco use – Unhealthy diet – Physical inactivity – Harmful use of alcohol• Monitoring and surveillance of – Risk factors and diseases – Preventive actions• Redirection of health services – Prevention (esp. primary health care) – Chronic care model04.12.12 Pekka Puska, Director General 9
    10. 10. Redirection of health services• Reorientation and strengthening of health systems• Primary health care: ”Now more than ever” (WHR 2008)• Special emphasis for NCDs • Chronic care model • Preventive practices04.12.12 Pekka Puska, Director General 10
    11. 11. Surveillance/monitoring• Monitoring of • ”Best buys”:  Diseases NCD mortality trend  Risk factors/behaviours Risk factor trends  Determinants  Prevention & control process (health service response)• National institutional base for surveillance and links with national health monitoring• International standardization and collaboration• Active use of surveillance results: Feed-back, communication 04.12.12 Pekka Puska, Director General 11
    12. 12. NCD FRAMEWORK FOR ACTION/MONITORING GENETICS Health Prevention Treatment promotion SOCIETAL HEALTH SERVICES RESPONSES (HiAP)04.12.12 Pekka Puska, Director General 12
    13. 13. The journey to scale up global action Global Strategy for the Prevention and 2000 Control of Noncommunicable Diseases 2003 Global Strategy on Diet, Physical Activity and Health Action Plan on the Global Strategy for the 2004 Prevention and Control of NCDs 2008 Global Strategy to Reduce the Harmful Use of Alcohol 2009 WHO Global Status Report on NCDs 2010 2011 UN Political Declaration on NCDs04.12.12 Pekka Puska, Director General 13
    14. 14. Action Plan 2007- 2012 #New Action Plan in preparation 04.12.12 Pekka Puska, Director General 14
    15. 15. Comprehensive action and partnershipfor national NCD prevention• Health services• Governments (national, local)• Civil society (NGOs)• Private sector• Media• International collaboration04.12.12 Pekka Puska, Director General 15
    16. 16. During the last few years a greatnumber of strategies and plans forevidence-based, effective preventionand health promotion have beenproducedMany important prioritieshave been identified04.12.12 Pekka Puska, Director General 16
    17. 17. From priorities to implementation IDENTIFYING IMPLEMENTING PRIORITIES THEM • “Less is more” • Policy support • Institutional base • Media support • Resources • Monitoring04.12.12 Pekka Puska, Director General 17
    18. 18. NCD prevention is possible!The potential is great • Quite rapid impact • Human impact on health and wellbeing • Impact on health service costs and socioeconomic development04.12.12 Pekka Puska, Director General 18
    19. 19. Change in age-adjusted mortality ratesFinland, males aged 35–64 (per 100 000 population) Rate per 100 000Coronary heart disease 1969- 2006 Change 1971 from start of the North Karelia Project 1969-1971 to 2006 extension of the Project All causes 1328 583 -56% nationally All 680 172 -75% North Karelia -85% cardiovascular Coronary 489 103 -79% heart disease All cancers 262 124 -53% All Finland -80% Gain of some 10 healthy years in Finnish popupaltion04.12.12 Pekka Puska, Director General 19
    20. 20. Intersectoral work towards prevention- ”Health in all policies”• People’s lifestyles are influenced by decisions in different sectors of society (much of them beyond the health sector)• Health in general and NCD prevention in particular should be taken into account in decisions made by different sectors (health impact assessment)• Social change process combining government policies, expert guidance, broad health promotion and mobilization of people04.12.12 Pekka Puska, Director General 20
    21. 21. Examples of intersectoral work 1.Development of Finnish Change in fat contentRapeseed oil of Finnish cow milk 45 45 Fen: y = -0.16x + 362 44 44 43 g/kg Fen 43 42 Gen Gen: y = -0.16x + 358 42 41 1970 1975 1980 1985 1990 1995 2000 2005 2010 Year04.12.12 Pekka Puska, Director General 21
    22. 22. Examples of intersectoral work 2.Biscuit example:• Leading Finnish biscuit manufacturer (LU Finland Ltd) has removed some 80.000 kg of SAFA by changing the fats used• All trans fats removed and major transfer to rapeseed oil Salt concentration (%) Salt level in Finnish sausagesMeat product example: 2.4HK (Leading Finnish meat company) 2.2since 2007 annually: 2.0• 40.000 kg less salt• 100.000 kg less saturated 1.8 fat in their products 1.6 1975 1980 1985 1990 1995 YEAR04.12.12 Pekka Puska, Director General 22
    23. 23. 04.12.12 Pekka Puska, Director General 23
    24. 24. 8th Global WHO Conference on health promotion- “Health in all policies” From Ottawa to Helsinki (June 2013)04.12.12 Pekka Puska, Director General 24
    25. 25. WHO/EMRO region• Shows great leadership and example on effective regional action• Great experience and potential04.12.12 Pekka Puska, Director General 25
    26. 26. World Congress of Cardiology World Congress of Cardiology Scientific Sessions Scientific Sessions18-21 April, 201218-21 April, 2012 Dubai, UAE Dubai, UAE www.worldcardiocongress www.worldcardiocongress .org .org04.12.12 Pekka Puska, Director General 26
    27. 27. THE MAIN CHALLENGE FOR SUCCESSFUL NCD PREVENTION IS NOT WHAT TO DO, BUT HOW TO IMPLEMENT THE NEEDED ACTIONS!04.12.12 Pekka Puska, Director General 27
    28. 28. The Future Challenge To match the public health importance of NCD’s and potential health gains with needed attention, resource use and political decision making.04.12.12 Pekka Puska, Director General 28
    29. 29. Ban Ki-Moon:”We should all work to meet the targets to reduce NCDs”04.12.12 Pekka Puska, Director General 29
    30. 30. Thank you04.12.12 Pekka Puska, Director General 30
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