Presentation given by Arogya World CEO, Nalini Saligram, PhD, at the Geneva Health Forum - PS31 A gender lens to chronic conditions

1. Changing the Course of Chronic Disease,
One Community at a Time
Mobilizing Women in the
Fight Against NCDs
Nalini Saligram, Ph.D.
20 April 2012
PS31 A gender lens to chronic conditions
Geneva Health Forum
Arogya World is a U.S. based non-profit 501 © 3 organization. The name of the organization is simply an articulation of
our mission: Arogya in Sanskrit means good health. More literally it means to live a life without disease.

2. Non-Communicable Diseases (NCDs):
An Urgent Issue
 UN High Level Meeting on NCDs* Sep 19/20 2011
• NCDs: one of the leading health and development challenges of the century
• Political Declaration: “whole of government” and “whole of society” approach
 Nearly 2 out of every 3 deaths in the world due to NCDs
• 80% of NCD deaths occur in low- and middle-income countries
• But, only 3% of overall global development assistance for NCDs.
 Cost of Inaction > cost of action
• Economic Burden of NCDs: World Economic Forum/ Harvard** : NCDs (+ mental health) have
cumulative loss of economic output = $ 47 trillion.
• Action: WHO Best Buys*** cost $11 billion per year in LMICs , roughly 1$ per person per year
 Prevalence of NCDs alarmingly high
• >20% of population in India**** has at least one chronic disease; >10% more than one
* NCDs = Cardiovascular diseases, diabetes, cancers + chronic respiratory disease
**WEF/Harvard Global Economic Burden of NCDs Sep 2011;
***WEF / WHO Report – From Burden to Best Buys 2011
****The Lancet series January 12, 2011 © 2010 Arogya World. All Rights Reserved. 2

3. NCDs Leading Cause of Death Globally
NCDs cause >2X the number of deaths from HIV/AIDS, malaria, TB + all
maternal and childhood conditions + nutritional deficiencies COMBINED
Decrease by 10% over
next 10 years
9%
30%
Infectious Diseases, + maternal &
Increase by 71% over newborn conditions + nutritional
deficiencies
next 10 years
61%
Non-Communicable Diseases NCDs
58 million people die each year Injuries
35 million of them due to NCDs
© 2010 Arogya World. All Rights Reserved. 3

4. Prevention: The Holy Grail for Tackling NCDs
 WHO: a healthy diet, exercise and avoiding tobacco can prevent:
• 80% of premature heart disease
• 80% type II diabetes
• 40% of cancers
 Compelling Clinical Proof Exists that Diabetes Can Be Prevented
 Landmark Trial - Diabetes Prevention Program (DPP)
• 3,234 adults at risk for diabetes. Multiple centers in the US. 30 min of physical
activity a day + low-fat diet reduced the chance of getting diabetes by 58%, while
metformin reduced the chance by 31%. NEJM Feb 7, 2002.
• Follow-up of DPP in The Lancet (2009) …diabetes prevention through lifestyle
changes sustained for 10 years.
 Finnish Diabetes Prevention Study
 NEJM May 3, 2001.
 Indian Diabetes Prevention Programme
 Diabetologia. 2006 Feb;49(2):289-97.
© 2010 Arogya World. All Rights Reserved. 4

5. The Arogya World Approach to the NCD Crisis
Two-fold mission
Galvanize global action to address Implement Diabetes Prevention
non-communicable diseases through Lifestyle Changes in India
► Leverage UN NCD Summit Sep 2011
► Op-ed, blog and social media campaign ► Multipronged Approach in schools,
► Case studies workplaces and the community
► Women and NCDs ► Leverage technology and partnerships for
► Women for a Healthy Future Petition scalable, cost-effective programs
► 10,000 Women “Perspectives on NCDs” ► Science-based work
Global Survey ► Measure effectiveness and impact
© 2010 Arogya World. All Rights Reserved. 5

6. Why We Believe NCDs are a Women’s Issue
 Direct Impact - NCDs are the #1 killer of women
 Impact on women as caregivers
 Women disadvantaged in terms of prevention
 Integral part of Maternal and Child Health – low birth weight leads to
heart disease and diabetes later in life in the child
 Cooking over open fires – COPD
 NCDs impact next generation
 Sir George Alleyne video
© 2010 Arogya World. All Rights Reserved. 6

7. Women: A Powerful Solution to the NCD Crisis
WHO: 80% diabetes & heart disease,
40% cancers preventable with lifestyle changes.
 Improving the health of women has positive ripple effects on family +
community.
 Policymakers should educate pregnant women to have healthy pregnancies and avoid
low birth weight.
 Collect gender disaggregated morbidity and mortality data.
 Health systems not geared to deliver optimum healthcare for women, so
focusing on women can improve outcomes for all.
 Invest in educating women about NCD prevention through healthy
living, and they will teach their families.
© 2010 Arogya World. All Rights Reserved. 7

8. Women for a Healthy Future
Mobilizing Women in Fight Against NCDs
 Women for a Healthy Future - started in 2011 by Arogya World +
Global Health Council, NCD Child, Women Deliver, NCD Action, Public Health Institute, The Max Foundation,
Disruptive Women in Health Care, Hriday, NCD Alliance, World YWCA, Beyond Sport
 Online Petition
 mobilizing women to demand action against NCDs from world leaders – govt + biz.
 Raised 4,000 signatures.
 Press release to mark UN HLM, distributed to media + world leaders at UN + side events.
© 2010 Arogya World. All Rights Reserved. 8

9. Ensuring Women’s Voices Are Heard
 2012 work
 Continue dialog with food & beverage industry –Talking to experts. Engaging with IFBA.
 Global women’s perspectives on NCDs and their impact survey.
• 10,000 women; 1,000 women from each of 10 countries. US, UK, + 8 developing world countries
• Web and mobile technologies. SRBI Abt + Jana
• Currently seeking funding
• Advocacy Tool. Show what women care about, and identify NCD priorities
 Future work
 Adapt My Plate icon to other countries
 Develop and distribute educational materials for women
 Global communications campaign
© 2010 Arogya World. All Rights Reserved. 9

10. Back-Up

11. Arogya World Network of Influencers
Board*
Dr. Nalini Saligram – Arogya World; Dr. Pamela Yih, Treasurer – Pamela Y-F Yih Inc.; Kathryn Graves – Emory Univ
Rollins School of Public Health; Dr. MeryleMelnicoff– formerly at WISTAR Institute
Indo-US Scientific Steering Committee*
 Based in India - Dr K. Srinath Reddy – President, Public Health Foundation of India, Dr V. Mohan – Madras Diabetes
Research Foundation, Dr Ashok K. Das – Additional Director General Health Services, Dr Prabhakaran – Centre for
Chronic Disease Control, and PHFI, Dr Nikhil Tandon – All India Institute of Medical Sciences, Dr. Prasanna Kumar –
Bangalore Diabetes Hospital
 Based in the US - Dr K.M. VenkatNarayan – Emory University, Dr Sreekumar Nair – Mayo Clinic, Dr Francine
Kaufman – Medtronic, Dr KarmeenKulkarni – Abbott Diabetes Care, Dr Sethu Reddy – Merck, Dr. Om Ganda -Joslin
Advisors*
Dr A Ramachandran - India Diabetes Research Foundation, Chennai; Dr SubhankarChowdhury-IPGME&R and SSKM
Hospital, Kolkata; Monika AroraHriday-Shan; C.V. MadhukarPRS Legislative Research; Deanna M. HoelscherMichael
and Susan Dell Center for Advancement of Healthy Living; Dr Sudeep Singh Gadok, International Health and
Development Expert; Raj Dave ARE Consulting, Dr. ArunChockalingamWorld Hypertension League, Dr. David C
U’PrichardDruid Consulting
Behavior Change Task Force*
 Based in the US - Dr. Fran Kaufman, Medtronic, Dr. LinelleBlais, Emory University, Andrea Falls, Edelman
 Based in the UK – Zoe Hellman, Weight Watchers
 Based in India – Dr. Ranjani Harish, Dr. Mohan’s Diabetes Specialities Centre, Dr. Monika Arora, Hriday-Shan,
SukantiGhosh, APCO Worldwide, Dr. KanavKahol– PHFI
*all working pro-bono
+
Consultants
TheaJoselow (Washington DC – digital media expert), Dr. S Kumar (Bangalore - senior consultant India), Dr.
SandhyaRamalingam (Bangalore – market research expert), Beau Young (Philadelphia- accountant)

12. Our Track Record
• Feb 2009 – Workshop with 66 stakeholders in Delhi to gather input on priorities.
• World Diabetes Day 2009; 40 community walks in Delhi; 6,000 children asked MrsGursharanKaur, wife of Prime Minister
of India, for help in making policy changes
•Formalized as US-based non-profit organization March 2010.
•New Diabetes Friendly Recipe Created for Arogya World by celebrated Manhattan chef from Devi Nov 2010
•Initiated Schools diabetes education program in India 2011; completed year 1 program, encouraging results
•Clinton Global Initiative Commitment 2011 – 1 million consumers diabetes mHealth campaign in India; 30,000 consumers
received messages through March 2012.
• Healthy Workplace Stakeholder Input Session in India Bangalore, Feb 24, 2012
•Women for a Healthy Future – 2011 petition;