From Unknown to UN_Charlotte Block_10.14.11


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  • Low economic growth: Disability, Lack Health Care, Lost Income, Absenteeism Poor Health: Unhealthy Environments, Poor access to health care, Lack of information
  • Origins of life Infectious disease Funding (conflict of interest) “ Non-main” NCDs (mental health, neurological disorders, disability, injuries, skin disorders) Multi-sector: agriculture, food industry, regulation & taxation, urban planning, public awareness, medical training, health systems, data
  • Ship missions in 1958 Changing reality today – shift in disease burden
  • 5 steps for self care is recognised as a “global Model” by the IDF in 2005. Project HOPE is a leader in “peer education” curriculums and took part in a WHO consultation calling for further research on the promise of peer support.
  • This is the diabesity project and you have a handout in your folder that gives more detail about this. This initiative targets 9-10 year olds as national statistics indicate that children entering puberty obese have an 80% change of lifelong obesity. It promotes 3 healthy habits: 1) Eating 5 or more fruits & veg a day – less “junk food” 2) Drinking 2 litres of water per day – less sugary drinks 3) exercise 1 hr per day – less TV.
  • In India we are training a new cadre of Health Professionals called Diabetes Educators in collaboration with the IDF
  • From Unknown to UN_Charlotte Block_10.14.11

    1. 1. NCDs and the Future of Global Health CORE Group Fall Meeting October 14 th , 2011 Charlotte Block, MS, RD Global Health Program Officer NCDs/Nutrition [email_address]
    2. 2. Agenda <ul><li>Introduction to NCDs </li></ul><ul><li>The history and policy leading up to, during and beyond the UN NCD High Level Meeting </li></ul><ul><li>Key messages from USAID </li></ul><ul><li>Examples of current approaches in NCD programming </li></ul><ul><li>Q&A </li></ul><ul><li>If time remaining – group discussion </li></ul>
    3. 3. NCDs Defined <ul><li>Chronic Disease </li></ul><ul><li>Non-Communicable Disease </li></ul><ul><li>Chronic Non-Communicable Disease </li></ul><ul><li>“ Diseases of long duration and generally slow progression” </li></ul><ul><li>- WHO definition of chronic disease </li></ul>
    4. 4. Why NCDs? Why Now? <ul><li>1. What are some chronic diseases? </li></ul><ul><li>2. Do you know someone with a chronic disease? </li></ul><ul><li>3. Have you seen evidence of chronic diseases where you work? </li></ul>
    5. 5. NCDs 101 <ul><li>4 x 4 </li></ul>X Diseases Risk Factors
    6. 6. Some statistics <ul><li>63% of deaths globally caused by NCDs (36 million) </li></ul><ul><li>80% in LMICs (28 million) </li></ul><ul><li>29% of NCD deaths are under the age of 60 in LMICs </li></ul><ul><li>80% of the 4 main NCDs prevented by eliminating the 4 shared risk factors. </li></ul>
    7. 7. The Big Picture WHO Non-Communicable Disease Country Profiles 2011 Proportion of premature NCD mortality by income group of countries
    8. 8. The Vicious Cycle Vicious Cycle
    9. 9. Economic Burden
    10. 10. WHY?
    11. 12. Key Determinants
    12. 13. The Bigger Picture
    13. 14. Early Origins of Health Mother Fetus Newborn Adult Anemia Tobacco Drugs Stress Nutrition Diabetes Hypertension Infection Obesity
    14. 15. Connecting the Dots <ul><li>NCDs </li></ul><ul><li>Infectious Disease </li></ul>
    15. 16. Infectious Disease – Tuberculosis <ul><li>Diabetes triples the risk of developing TB. </li></ul><ul><li>Rates of TB are higher in people with diabetes </li></ul><ul><li>Diabetes is a common comorbidity </li></ul><ul><li>in people with TB </li></ul><ul><li>Diabetes can worsen the clinical </li></ul><ul><li>course of TB </li></ul><ul><li>TB can worsen glycemic control in </li></ul><ul><li>people with diabetes </li></ul>Collaborative Framework for Care and Control of Tuberculosis and Diabetes 2011
    16. 17. Infectious disease - HIV <ul><li>HIV+ associated with abnormal blood lipids </li></ul><ul><li>High prevalence of CVD risk factors in HIV+ individuals </li></ul><ul><li>Risk for heart attack is 70-80% higher in patients on ART </li></ul><ul><li>CVD contributes to mortality in HIV+ patients receiving ART-> risk increases with longer exposure to treatment </li></ul><ul><li>Suspected links between HIV drugs and elevated blood sugar levels/insulin resistance. </li></ul><ul><li>Partially adapted from FHI360 Kenya project presentation </li></ul>
    17. 18. Funding Opportunities <ul><li>Only 2.3% of public and private funding goes towards NCDs. </li></ul><ul><li>Need for country-level commitments </li></ul><ul><li>Bulk of funding from private sector/industry </li></ul><ul><li>Concerns regarding conflict of interest </li></ul>
    18. 19. Other NCDs <ul><li>Neurological disorders: Alzheimer's, epilepsy </li></ul><ul><li>Mental illness </li></ul><ul><li>Disabilities/injuries </li></ul><ul><li>Skin disorders </li></ul><ul><li>Arthritis </li></ul><ul><li>Oral health </li></ul><ul><li>… . </li></ul>
    19. 20. Multsectoral Solutions Private Industry
    20. 21. <ul><li>Project HOPE’s </li></ul><ul><li>Diabetes Programs </li></ul>
    21. 22. Helping People Help Themselves
    22. 23. Global Diabetes Burden: Large and growing Total #s (prevalence% ) Mexico 6.8 M (10.1%) Brazil 7.6 M (6%) China 43.2 M (4.5%) India 50.8 M (7.1%) Egypt 4.8 M (10.4%) Kenya 0.5 M (2.8%) South Africa 1.3M (4.5%) UAE 0.4 M (12.2%) Oman 0.2 M (11.1%) Indonesia 7 M (4.6%) USA 26.8 M (12.3%) UK 2.1 M (4.9%) Australia 1 M (7.2%) Japan 7 M (7.3%) Canada 2.9 M (11.6%) Russia 9.6 M (9%) Source: IDF Diabetes Atlas 2010, MedMarket Diligence, LLC
    23. 24. Project HOPE Programs Mexico 2001-present India 2007-present China 1996-present New Mexico, USA 2010- present S. Africa 2011-present Nicaragua 2010 - present
    24. 25. Diabetes Medical Training - China Qingdao Chengdu Xi’an Beijing Guangzhou Hangzhou Shanghai Ruijin Shanghai Huashan Harbin Nanjin g <ul><li>Rural and Urban Training Centers </li></ul><ul><li>Trained >40,000 health care providers </li></ul><ul><li>Reaching >170,000 patients and families </li></ul><ul><li>MoH partnership -> National Standards </li></ul>
    25. 26. Diabetes Education - Mexico <ul><li>Curriculum development: </li></ul><ul><ul><li>5 Steps for Self-Care Patient Course </li></ul></ul><ul><ul><li>Lend a Hand in Self-Care TOT Course </li></ul></ul><ul><li>Adopted by government and community health centers </li></ul><ul><li>Incorporates peer support training model </li></ul>
    26. 27. School-Based Education - Mexico <ul><li>“ Diabesity” – targeting 3 rd graders </li></ul><ul><li>Holistic approach – school & home </li></ul><ul><li>Health vs. illness focused </li></ul><ul><li>Promotes 3 healthy habits </li></ul><ul><li>Expanded to New Mexico & India </li></ul>Layers of Obesity
    27. 28. HABITS for LIFE – New Mexico, USA <ul><li>Targeting health disparities using Telehealth </li></ul><ul><li>US/Mexico rural border communities </li></ul><ul><li>Prevention, screening & access to specialty care </li></ul><ul><li>HW training to build clinical & educational capacity </li></ul>
    28. 29. Gestational Diabetes – Latin America <ul><li>Pilot project in Nicaragua & Mexico </li></ul><ul><li>Training government health workers </li></ul><ul><li>Trainees screen and educate pregnant patient groups at health centers . </li></ul>
    29. 30. Diabetes Educators - India <ul><li>National Diabetes Education Program </li></ul><ul><ul><ul><li>Master Trainer/ToT model </li></ul></ul></ul><ul><ul><ul><li>Distance learning </li></ul></ul></ul><ul><ul><ul><li>Launching DE profession </li></ul></ul></ul><ul><ul><ul><li>12 Diabetes Centers </li></ul></ul></ul><ul><ul><li>Healthy Habits </li></ul></ul><ul><ul><li>Workplace Wellness </li></ul></ul><ul><ul><li>CHW training </li></ul></ul>
    30. 31. HOPE Center – Johannesburg, SA <ul><li>CHWs training in diabetes focused curriculum </li></ul><ul><li>Peer education groups to empower patients with diabetes prevention and management activities </li></ul><ul><li>S creening services including: HbA1c, lipid profile, cholesterol, retinal scan, and foot screening </li></ul>
    31. 32. References <ul><li>WHO Chronic Disease and Health Promotion </li></ul><ul><li> </li></ul><ul><li>NCD Alliance </li></ul><ul><li> </li></ul><ul><li>International Diabetes Federation </li></ul><ul><li> </li></ul><ul><li>World Heart Federation </li></ul><ul><li> </li></ul><ul><li>Union for International Cancer Control </li></ul><ul><li> </li></ul><ul><li>International Union Against Tuberculosis and Lung Disease </li></ul><ul><li> </li></ul><ul><li>C3 Collaborating for Health </li></ul><ul><li> </li></ul><ul><li>Global Health Council </li></ul><ul><li> </li></ul><ul><li>Project HOPE </li></ul><ul><li> </li></ul>
    32. 33. Thank you! Questions? For further information: Charlotte Block [email_address]
    33. 34. Group Discussion <ul><li>Break into groups </li></ul><ul><li>Take X amount of time to discuss where/how NCD programming would fit into your current or future programs </li></ul><ul><li>Groups report back and share ideas </li></ul>