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NCDs: a global view
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  • Congratulate MOH eastern Med region for organizing, Timeliness, Galvanizing global community Alos…clarity with background, specific goals, Complement them for …Review evidence and strategies…..…Roadmap and political awareness ………Regional instruments and norms and …………cooperation….regional momentum Kingdom of Saudi Arabia for their leadership in this area
  • Appointment register for HIV (on left) and diabetes (on right) at the same health facility in Swaziland
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    • 1. NCDs: a global view International Conference On Healthy Lifestyles And Non-communicableDiseases (Ncds) In The Arab World And The Middle East, Riyadh, Kingdom Of Saudi Arabia, 9-12 September 2012 Dr. Sania Nishtar Founder and President Heartfile Pakistan Heartfile, 2012
    • 2. Stocktaking• Where do we stand?• What needs to happen next?• Does the EMR have capacity?• What at the immediate next steps, at the regional level? Heartfile, 2012
    • 3. NCDs: Where do we Stand1• On a positive note – International consensus—Political declaration – Normative clarity • Evidence based best buys • Strategies, tools and instruments • Voluntary global targets • Civil society mobilization and public private convergence• Less auspicious – Paucity of development resources – NCDs are not (yet) fully part of domestic priorities – Capacity to cascade policy into action is limited Heartfile, 2012
    • 4. NCDs and HIV and AIDS Heartfile, 2012
    • 5. NCDs: Where do we Stand1• On a positive note – International consensus—Political declaration – Normative clarity • Evidence based best buys • Strategies, tools and instruments • Voluntary global targets • Civil society mobilization and public private convergence• Less auspicious – Paucity of development resources – NCDs are not (yet) fully part of domestic priorities – Capacity to cascade policy into action is limited Heartfile, 2012
    • 6. US $ 22 Billion spent on health by International AID agencies in in LMICGlobal mortality From NCD Overseas health aid Source IDF
    • 7. 2 What needs to happen nextRegionally• Step up capacity to be responsive to country needsDomestically1. Societal change2. Next generation public health, action outside health3. Reorienting health from episodic to chronic care Heartfile, 2012
    • 8. Framework for action: NCDs 1Nishtar S. Prevention of non-communicable diseases in Pakistan. Health Res Policy Syst. 2004 Heartfile, 2012
    • 9. Framework of action: NCDs 2 Lifestyle risks • Smoking • Un healthy diet • Lack of physical activity • Stress Biological risks • Obesity • Dyslipidaemia • Diabetes • High blood pressure Disease conditions • Cardiovascular disease • Diabetes • Lung conditions • Some cancers Heartfile, 2012
    • 10. Framework of action: NCDs 3 Health Systems for Policy both acuteSocietal action at and chronicchange all levels care Heartfile, 2012
    • 11. Societal choice• The imperative for societal change in EMRO – Six out of 10 countries with the highest prevalence of diabetes – Smoking amongst men ranges from 12-60% – Grossly overweight population • 50% women in the region overweight • Escalating level of obesity in children Policy action – Trends in per-capita sale of Behavior manufactured food and fizzy drinks change Market shaping Heartfile, 2012
    • 12. Policy action by all levels of government• Multi-sectoral action• Inter-sectoral action• Opportunity for embedding NCDs in – Medium term development frameworks – Sustainable development goals? – Universal coverage, the 21st century Health for all – Social protection agendas – Innovations dives (technological and design) – The poverty reduction strategies Heartfile, 2012
    • 13. Pakistan: Composition of Shocks categories of shocks
    • 14. Health systems; from acute to chronic3 care• Health information systems• Financing• Service delivery• Medicines and related products• Governance• Workforce Learning• Technology Innovations Heartfile, 2012
    • 15. Learning lessonsLeveraging innovations Slide courtesy: Miriam Rabkin Heartfile, 2012
    • 16. © Alison Koler 2010 Heartfile, 2012
    • 17. HIV—Lessons to be learnt for NCDs Rabkin, and Nishtar. J Acquir Immune Defic Syndr 2011 Heartfile, 2012
    • 18. ExamplesEthiopia Cambodia Slide courtesy: Miriam Rabkin Heartfile, 2012
    • 19. Does the EMR have capacity to deliver• Tier 1—capacity and resources exist• Capacity constraints in Tier I and II – Fiscal space – International development priorities – Health systems distortion Heartfile, 2012
    • 20. What will be the Riyadh promise for NCDs ? Heartfile, 2012

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