Session 1: Nicola Watt


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Nicola Watt: “(personal) reflections on the NCD Summit”

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Session 1: Nicola Watt

  1. 1. (personal) reflections on the NCD Summit Nicola Watt, LSHTM
  2. 2. Why am I here? <ul><li>Non government </li></ul><ul><li>Non-NGO </li></ul><ul><li>Not-really-an-academic </li></ul><ul><li>Think of me as a fly on the wall reflecting on some of the things she’s seen…. </li></ul>
  3. 3. Multilateral negotiations – a parallel universe <ul><li>What can any one country achieve? </li></ul><ul><li>What can the negotiation as a whole achieve? </li></ul>Pictures thanks to UN <ul><li>How does anyone work out what’s really going on? </li></ul>
  4. 4. The main achievement – a startling consensus on pathways <ul><li>Even Moscow to New York a decisive “jump” </li></ul><ul><li>declaration more comprehensive and enlightened (in terms of determinants) than most of us imagined </li></ul><ul><li>NCDs really arrived on collective conscience </li></ul>Beaglehole et al Lancet April 2011
  5. 5. the “numbers game” <ul><li>4 x 4 diseases and risk factors </li></ul><ul><li>5 priority actions </li></ul><ul><li>4 questions </li></ul><ul><ul><li>is there really a global crisis of NCDs; </li></ul></ul><ul><ul><li>how is NCD a development issue; </li></ul></ul><ul><ul><li>are affordable and cost-effective interventions available; </li></ul></ul><ul><ul><li>and do we really need high-level leadership and accountability? </li></ul></ul><ul><li>2 urgent follow up actions </li></ul><ul><ul><li>Dissemination of the declaration </li></ul></ul><ul><ul><li>Short term milestones for agreement of targets </li></ul></ul>1 2 3 4 5
  6. 6. 3 Conundrums <ul><li>The Christmas tree accusation – horizontal vs vertical, shopping list vs broad and vague…. </li></ul><ul><li>The causes of the causes of the causes of the causes of the…. </li></ul><ul><li>The vexing vested interest </li></ul>
  7. 7. Conundrum 1 – the Christmas tree of NCDs <ul><li>Mental health “excluded”? </li></ul><ul><li>Manageability and ease of communication? Or flexibility to country context? </li></ul><ul><li>Inevitably leads to the horizontal vs vertical debate </li></ul>
  8. 8. Conundrum 2 - Are the best buys the best bet? <ul><li>For: </li></ul><ul><li>Focus on the risk factors gave the debate momentum </li></ul><ul><li>If governments do nothing else, they’d still save lives </li></ul><ul><li>Against/on the fence </li></ul><ul><li>is focus on the low-hanging fruit right in the long term? - even ignoring immediate hurdles to implementation </li></ul><ul><li>Focusing on social determinants gives maximum common ground with rest of the development agenda…. </li></ul>
  9. 9. Conundrum 3 – the importance of ego <ul><li>“ conflict of interest” arguments rein </li></ul><ul><li>Different levels – </li></ul><ul><ul><li>importance to both developed and developing countries - unites and divides </li></ul></ul><ul><ul><li>economic interests make it incredibly difficult for governments to see their way through the political and economic arguments </li></ul></ul>ME ME ME
  10. 10. The opportunity and the challenge <ul><li>NCDs threat “commensurate” with global financial imbalances (WEF Global Risks 2011) </li></ul><ul><li>sustainable development agenda (Rio +20 round the corner) </li></ul>What kind of society do we want? <ul><li>MDG deadline looming; little appetite for bottomless GH funding </li></ul><ul><li>global community newly sensitised to NCDs…. </li></ul><ul><li>an opportunity to think big? </li></ul>
  11. 11. Who said this? <ul><li>“ We need to act with boldness and determination”  </li></ul>Today’s challenges might be tomorrow’s big idea. Thank you