Welcome to Module 2 of the course dedicated to the topic of Non Communicable disease surveillance. My name is ….. And I am a regional adviser for non communicable disease prevention and control in PAHO office in WDC, with the area of responsibility: surveillance of NCDs Knowledge and evidence should be a base of decision making what well conveyed to you by professor Ross Brownson in Module 1. The importance of timely, relevant and quality information on health is crucial. Each country should look what strategic information it needs for good decision making… .In the last decade in our Continent there has been good advances regarding quality and access to information that can serve surveillance purposes..
Individual responsibility can only have its full effect where individuals have equitable access to a healthy life, and are supported to make healthy choices. All sectors and all levels within governments, international partners, civil society, non-governmental organization's and the private sector have vital roles to play in shaping healthy environments and making healthier diet options affordable, and easily accessible.
At recent Pan American Sanitary Conference, all Ministers of health of the Americas have adopted a resolution on CSP28R13 on Strategy for Prevention and control of NCDs where Surveillance systems have a separate paragraph with he following text:
Noncommunicable Diseases in the Americas_Branka Legetic_4.23.13
2004Noncommunicable diseases in the Americaspost UN commitments & advances Branka Legetic, MD, MPH, PhD PAHO-WHO Regional Adviser on Prevention and control of NCDs Pan American Health Organization
FACING THE FACTS IN THE AMERICAS: disease burden 149 million smokers Chronic respiratory disease 25% persons >15 years old obese Other NCDs Diabetes TOTAL NCD DEATHS 2008 Cardiovascular diseases 3,9 M 36% deaths are Cancer below age 70 yearsApprox. 200 million people living with an NCD in the Americas
Potential life expectancy gain inthe absence of selected risks to global & regional health,
2004 POST UN HLM and PAHONCD Regional Strategy 2012Plan of Action with regional targets andindicators2. Technical cooperation with Member States3. Continue advocacy in global forums: SocialDeterminants, G8/G20, Summit of the Americas, etc.4. Promote multi-sector partnerships • Pan American Forum for Action on NCDs5. Broader engagement in NCDs with other regional UNagencies Pan American Health Organization
Regional Action Plan 2013 : 2004OBJECTIVE 1: Multi sector policies and partnerships1.1: To establish multi-sector partnerships and integration ofNCD prevention policies into sectors outside of healthOBJECTIVE 2: NCD risk factor reduction & protection2.1: To reduce tobacco use and exposure to second-hand smoke.2.2: To reduce the harmful use of alcohol.2.3: To promote healthy eating and active living (salt, Trans fat)OBJECTIVE 3: Health System Response to NCDs3.1 To strengthening the capacity of primary health care providers3.2 To implement a model of integrated management of NCDs3.3. To secure supplies for NCD drugs.3.4. To secure coverage of multi-drug therapyOBJECTIVE 4: NCD surveillance and research4.1.quality of NCD and risk factor surveillance systems, includingcancer registries Pan American4.2. improve utilization of NCD and risk factor surveillance systems to Health Organizationplan and monitor NCD program
CARMEN Network 2012 34 Members Argentina, Anguilla, Aruba, Barbados Bahamas, Bolivia, Brazil, Canada, Colombia, Costa Rica, Cuba, Curacao, Chile, Dominica, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Mexico, Nicaragua, Panama, Paraguay, Peru, Puerto Rico, St Kitts & Nevis, St Lucia, Trin. & Tobago, Uruguay, Surinam, Prospective Members Venezuela, Bolivia Collaborating members SLU,USF,NHLBI,CDC,PHAC, RAFA,ILSI,F&V, CI, HCC, IHF, Special • USA-Mexico (border)
B rasilia 2012260 participants from:Government officials from 36 countries24 private sector/companies45 CSOs & academic organizations6 International Organizations
UN Declaration calls on Member States to:– Advance the implementation of multisectoral, cost- effective population-wide interventions in order to reduce the impact of the common NCD risk factors -- tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol– Initiate the implementation of interventions to reduce salt, sugar and saturated fats, and eliminate industrially produced trans-fat.– Promote increased access to cost-effective vaccinations to prevent infections associated with cancers.– Promote increased access to cost-effective screening programmes as determined by national situations..– Strengthen health systems to deliver cost-effective treatment services.
2004 Advances: policy• NCD Policy Observatory: with Public Health Agency, Canada – Policy Monitoring (national capacity survey & registry of laws for diabetes, obesity & CVD) – Research: case studies: C Rica, Brazil; T&T, Barbados – Development/revision of National Action plans: Belize, Ecuador,. Rica, Paragvay – Policy dialogues/advocacy: e.g., • CARICOM Summit of Heads on chronic diseases • CARMEN MERCOSUR, SICA, CAN Pan American Health Organization
Advances: Promotion and Prevention• Ratification and full implementation of FCTC• Trans Fat Free Americas Initiative : Argentina, Chile, Brazil, Ecuador, Mexico, Canada, Colombia, Central America,• Regional Salt reduction initiative : Argentina, Barbados, Brazil, Canada, Chile, Colombia, C Rica, Mexico, Paraguay, Uruguay, US.• Urban Planning and development of public transport to improve physical activity: 38 cities in Americas; Ciclovia network, Active cities reward
winnersPirapora, Brasil(medio ambiente urbano) Belo Horizonte, Brasil (movilidad y transporte)Ciclopaseo, Quito(recreación y deporte) TransMilenio, Bogota (mención especial)
Advances : Integrated Management• Integrated Chronic Care model• CAMDI – Central American Diabetes Intervention• VIDA Project Mexico on integrated chronic care• TATI project – Peru on cervical cancer screening• TATI 2 Honduras, Bolivia, El Salvador• CVD control through community workers Chile, Guatemala, Argentina• CVD risk assessment approach Argentina, Ecuador, Jamaica,• NCD drugs and basic technology in PAHO Strategic fund to reduce cost of drugs ;• HPV Vaccine in PAHO Revolving fund