The vision and road map for addressing NCDs


Published on

Published in: Health & Medicine
1 Like
  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide
  • World Health Organization September 12, 2012 And what's drastic here – 90% of the premature death from NCDs occur in developing countries – countries that are already vulnerable and will also been hit heavily by global economic crisis and negative effects of climate changes. (Over the next decades, it is predicted that billions of people, particularly those in developing countries, face shortages of water and food and greater risks to health and life as a result of climate change 1 ) 1 Climate Change: Impacts, Vulnerabilities and adaptation in Developing Countries (2007) United Nations Framework Convention on Climate Change (UNFCCC).
  • The vision and road map for addressing NCDs

    1. 1. Pekka Puska, MD, PhD, MPolScDirector GeneralNational Institute for Health and Welfare (THL),FinlandVice President, Int. Association of National Public Health Institutes(IANPHI)Past President, World Heart Federation (WHF), Geneve The vision and road map for addressing NCDs Int. Conference on Healthy Lifestyles and NCDs in the Arab World and the Middle-East; Riyadh, KSA, 10-12.9.2012 12.09.12 1
    2. 2. Background and vision• Health is important for every individual, public welfare and sustainable social and economic development• Current situation and the future– A few chronic non communicable diseases are greatest determinants of public health– These NCD’s are to great extent and to late in life preventable Vision: world free of avoidable NCD’s (=healthy ageing) Goal: Effective comprehensive action on global, regional, national and local level12.09.12 Pekka Puska, Director General 2
    3. 3. :Sourceof premature deaths from NCDs occur in developing countries 90% million 25 Total number of deaths in the world 2.3M million 20 M 6 ..8 M6 8 2.3M million 15 10.2M 3.7M 10.2M 13.6M 13.6M million 10 0.5M 5.9M 5.9M M 3 ..3 0.6M M3.0M 3 3 3.3M3.0M 3.0M 0.9M 1.1M 3.0M High-income Upper Lower Low-income countries middle-income middle-income countries Group III - Injuries Low-income countries Group II – Other deaths from noncommunicable diseases Group II – Premature deaths from noncommunicable diseases (below the age of 60), which are preventable Group I – Communicable diseases, maternal, perinatal and nutritional conditions 12.09.12 Pekka Puska, Director General 3
    4. 4. 12.09.12 Pekka Puska, Director General 4
    5. 5. 12.09.12 Pekka Puska, Director General 5
    6. 6. RECENT POLITICAL SUPPORT UN high-level summit on NCDs New York Sept 2011 • Preceeded by Ministerial Conference in Moscow (April 2011). • Political declaration • Action on global NCD prevention and control” • WHO’s leadership, intersectoral support12.09.12 Pekka Puska, Director General 6
    7. 7. Changing global burden of disease WHO´s NCD strategy in 2000• NCD prevention and control is a global health priority• Comprehensive actionis needed, but from public health point of view population based prevention is the key (most cost- effective and sustainable)• Integrated prevention: targeting common, lifestyle related risk factors (tobacco, diet, physical activity, alcohol)12.09.12 Pekka Puska, Director General 7
    8. 8. INTEGRATED PREVENTION12.09.12 Pekka Puska, Director General 8
    9. 9. Cornerstones of NCD preventionand control (WHO global strategy)• Attention to behavioural risk factors – Tobacco use – Unhealthy diet – Physical inactivity – Harmful use of alcohol• Monitoring and surveillance of – Risk factors and diseases – Preventive actions• Redirection of health services – Prevention (esp. primary health care) – Chronic care model12.09.12 Pekka Puska, Director General 9
    10. 10. Redirection of health services• Reorientation and strengthening of health systems• Primary health care: ”Now more than ever” (WHR 2008)• Special emphasis for NCDs • Chronic care model • Preventive practices12.09.12 Pekka Puska, Director General 10
    11. 11. Surveillance/monitoring• Monitoring of • ”Best buys”:  Diseases NCD mortality trend  Risk factors/behaviours Risk factor trends  Determinants  Prevention & control process (health service response)• National institutional base for surveillance and links with national health monitoring• International standardization and collaboration• Active use of surveillance results: Feed-back, communication 12.09.12 Pekka Puska, Director General 11
    12. 12. NCD FRAMEWORK FOR ACTION/MONITORING GENETICS Health Prevention Treatment promotion SOCIETAL HEALTH SERVICES RESPONSES (HiAP)12.09.12 Pekka Puska, Director General 12
    13. 13. The journey to scale up global action Global Strategy for the Prevention and 2000 Control of Noncommunicable Diseases 2003 Global Strategy on Diet, Physical Activity and Health Action Plan on the Global Strategy for the 2004 Prevention and Control of NCDs 2008 Global Strategy to Reduce the Harmful Use of Alcohol 2009 WHO Global Status Report on NCDs 2010 2011 UN Political Declaration on NCDs12.09.12 Pekka Puska, Director General 13
    14. 14. Action Plan 2007- 2012 #New Action Plan in preparation 12.09.12 Pekka Puska, Director General 14
    15. 15. Comprehensive action and partnershipfor national NCD prevention• Health services• Governments (national, local)• Civil society (NGOs)• Private sector• Media• International collaboration12.09.12 Pekka Puska, Director General 15
    16. 16. During the last few years a greatnumber of strategies and plans forevidence-based, effective preventionand health promotion have beenproducedMany important prioritieshave been identified12.09.12 Pekka Puska, Director General 16
    17. 17. From priorities to implementation IDENTIFYING IMPLEMENTING PRIORITIES THEM • “Less is more” • Policy support • Institutional base • Media support • Resources • Monitoring12.09.12 Pekka Puska, Director General 17
    18. 18. NCD prevention is possible!The potential is great • Quite rapid impact • Human impact on health and wellbeing • Impact on health service costs and socioeconomic development12.09.12 Pekka Puska, Director General 18
    19. 19. Change in age-adjusted mortality ratesFinland, males aged 35–64 (per 100 000 population) Rate per 100 000Coronary heart disease 1969- 2006 Change 1971 from start of the North Karelia Project 1969-1971 to 2006 extension of the Project All causes 1328 583 -56% nationally All 680 172 -75% North Karelia -85% cardiovascular Coronary 489 103 -79% heart disease All cancers 262 124 -53% All Finland -80% Gain of some 10 healthy years in Finnish popupaltion12.09.12 Pekka Puska, Director General 19
    20. 20. Intersectoral work towards prevention- ”Health in all policies”• People’s lifestyles are influenced by decisions in different sectors of society (much of them beyond the health sector)• Health in general and NCD prevention in particular should be taken into account in decisions made by different sectors (health impact assessment)• Social change process combining government policies, expert guidance, broad health promotion and mobilization of people12.09.12 Pekka Puska, Director General 20
    21. 21. Examples of intersectoral work 1.Development of Finnish Change in fat contentRapeseed oil of Finnish cow milk 45 45 Fen: y = -0.16x + 362 44 44 43 g/kg Fen 43 42 Gen Gen: y = -0.16x + 358 42 41 1970 1975 1980 1985 1990 1995 2000 2005 2010 Year12.09.12 Pekka Puska, Director General 21
    22. 22. Examples of intersectoral work 2.Biscuit example:• Leading Finnish biscuit manufacturer (LU Finland Ltd) has removed some 80.000 kg of SAFA by changing the fats used• All trans fats removed and major transfer to rapeseed oil Salt concentration (%) Salt level in Finnish sausagesMeat product example: 2.4HK (Leading Finnish meat company) 2.2since 2007 annually: 2.0• 40.000 kg less salt• 100.000 kg less saturated 1.8 fat in their products 1.6 1975 1980 1985 1990 1995 YEAR12.09.12 Pekka Puska, Director General 22
    23. 23. 12.09.12 Pekka Puska, Director General 23
    24. 24. 8th Global WHO Conference on health promotion- “Health in all policies” From Ottawa to Helsinki (June 2013)12.09.12 Pekka Puska, Director General 24
    25. 25. WHO/EMRO region• Shows great leadership and example on effective regional action• Great experience and potential12.09.12 Pekka Puska, Director General 25
    26. 26. World Congress of Cardiology Scientific Sessions18-21 April, 2012 Dubai, UAE www.worldcardiocongress .org12.09.12 Pekka Puska, Director General 26
    28. 28. The Future Challenge To match the public health importance of NCD’s and potential health gains with needed attention, resource use and political decision making.12.09.12 Pekka Puska, Director General 28
    29. 29. Ban Ki-Moon:”We should all work to meet the targets to reduce NCDs”12.09.12 Pekka Puska, Director General 29
    30. 30. Thank you12.09.12 Pekka Puska, Director General 30