National strategies on NonCommnicable Diseases (NCD's) the place of the Private Sector in Kenya. ACORD Round table. Dr. Kibachio Joseph Mwangi; MD, MPH (Lshtm), Msc (Epi),
Head; Non Communicable Diseases Control Unit
Ministry Of Health,
Western Pacific Updates on Noncommunicable DiseasesAlbert Domingo
Western Pacific Updates on Noncommunicable Diseases - a presentation delivered by Dr Albert Francis Domingo (Consultant, WHO Regional Office for the Western Pacific) at the Philippines' DOH NCRO Operational Planning Workshop for Local Strategic Plans on Noncommunicable Diseases Prevention and Control Programs, 2-4 December 2015. (Adapted from an earlier presentation by Dr Susan Mercado, Director, DNH/WPRO.)
NCD Prevention and Control as a Health System Strengthening InterventionAlbert Domingo
Lecture on NCD Prevention and Control as a Health System Strengthening Intervention delivered by Dr Albert Francis Domingo at the UP Manila College of Public Health on 19 January 2018.
National strategies on NonCommnicable Diseases (NCD's) the place of the Private Sector in Kenya. ACORD Round table. Dr. Kibachio Joseph Mwangi; MD, MPH (Lshtm), Msc (Epi),
Head; Non Communicable Diseases Control Unit
Ministry Of Health,
Western Pacific Updates on Noncommunicable DiseasesAlbert Domingo
Western Pacific Updates on Noncommunicable Diseases - a presentation delivered by Dr Albert Francis Domingo (Consultant, WHO Regional Office for the Western Pacific) at the Philippines' DOH NCRO Operational Planning Workshop for Local Strategic Plans on Noncommunicable Diseases Prevention and Control Programs, 2-4 December 2015. (Adapted from an earlier presentation by Dr Susan Mercado, Director, DNH/WPRO.)
NCD Prevention and Control as a Health System Strengthening InterventionAlbert Domingo
Lecture on NCD Prevention and Control as a Health System Strengthening Intervention delivered by Dr Albert Francis Domingo at the UP Manila College of Public Health on 19 January 2018.
Noncommunicable diseases (NCDs) - mainly cardiovascular disease, diabetes, cancer and chronic respiratory disease - are not just one of the world’s most pressing health concerns but also a significant development challenge. They impede social and economic development and are driven by underlying social, economic, political, environmental and cultural factors, broadly known as ‘social determinants’.
Working alongside specialist health partners, actors outside the health sector are uniquely well positioned to address the social determinants of NCDs.
Overview of tackling non-communicable diseases in EnglandDr Justin Varney
A presentation I gave in 2014 to a senior delegation of officials from Iraq on our approach in England to addressing the challenge of non-communicable disease
Public health policy development in developing countries Ruby Med Plus
Public Health policy development in developing countries is addressed by four policy questions:
1. Does the introduction of a health policy at national, international level imply corresponding improvement in the quality of health of a country/population?
2. For effective health systems with efficient outcome: should health related policies be locally/nationally or internationally motivated (initiated)?
3. Should developing countries rely on the West for changes in the health of their population?
4. What is the impact of health policies adopted at the international scene on the health of populations in developing countries?
Presentation delivered by Dr Zsuzsanna Jakab, WHO Regional Director for Europe, at the 7th Meeting of the European Advisory Committee on Health Research (Copenhagen, Denmark, 6 April 2016)
Social Determinants and Economic Burden of Non Communicable Diseases (NCD) on...Ruby Med Plus
India is home to almost one fifth of world’s population living in different states and differ in their ethnic origin, culture and various other ways that influence their health status.
National Health Policy 2017 address the issue of NCDs.
There exist dual burden of NCDs and Infectious and maternal-child disease across different states of India.
This puts challenging situation to Indian Health Care System which must be tackled by larger health investments and a balanced approach in reducing infectious and maternal-child diseases and also blunt the rising tide of NCDs and Injuries.
Since 1990’s, the contribution of most of the major non-communicable disease groups like cardiovascular diseases, diabetes, chronic respiratory diseases, mental health and neurological disorders, cancers, musculoskeletal disorders, and chronic kidney disease to the total disease burden has increased all over India.
In 2016, three of the five leading individual causes of disease burden in India were non-communicable diseases, with ischaemic heart disease and chronic obstructive pulmonary disease as the top two causes and stroke as the fifth leading cause.
In 2016, the NCD burden across India was 9-fold for ischaemic heart disease, 4-fold for chronic obstructive pulmonary disease, and 6-fold for stroke, and 4-fold for diabetes.
Risks factors like unhealthy diet, high blood pressure, high blood sugar, high cholesterol, and overweight, which mainly contribute to ischaemic heart disease, stroke, and diabetes.
Diabetes in the Gulf: The policy challenge is a new Economist Intelligence Unit report, sponsored by Janssen. It assesses the current status and potential impact of diabetes in the six Gulf Co-operation Council states—Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the UAE; reviews current approaches to tackling the disease in the region; and explores further possible opportunities to help combat diabetes.
Noncommunicable diseases (NCDs) - mainly cardiovascular disease, diabetes, cancer and chronic respiratory disease - are not just one of the world’s most pressing health concerns but also a significant development challenge. They impede social and economic development and are driven by underlying social, economic, political, environmental and cultural factors, broadly known as ‘social determinants’.
Working alongside specialist health partners, actors outside the health sector are uniquely well positioned to address the social determinants of NCDs.
Overview of tackling non-communicable diseases in EnglandDr Justin Varney
A presentation I gave in 2014 to a senior delegation of officials from Iraq on our approach in England to addressing the challenge of non-communicable disease
Public health policy development in developing countries Ruby Med Plus
Public Health policy development in developing countries is addressed by four policy questions:
1. Does the introduction of a health policy at national, international level imply corresponding improvement in the quality of health of a country/population?
2. For effective health systems with efficient outcome: should health related policies be locally/nationally or internationally motivated (initiated)?
3. Should developing countries rely on the West for changes in the health of their population?
4. What is the impact of health policies adopted at the international scene on the health of populations in developing countries?
Presentation delivered by Dr Zsuzsanna Jakab, WHO Regional Director for Europe, at the 7th Meeting of the European Advisory Committee on Health Research (Copenhagen, Denmark, 6 April 2016)
Social Determinants and Economic Burden of Non Communicable Diseases (NCD) on...Ruby Med Plus
India is home to almost one fifth of world’s population living in different states and differ in their ethnic origin, culture and various other ways that influence their health status.
National Health Policy 2017 address the issue of NCDs.
There exist dual burden of NCDs and Infectious and maternal-child disease across different states of India.
This puts challenging situation to Indian Health Care System which must be tackled by larger health investments and a balanced approach in reducing infectious and maternal-child diseases and also blunt the rising tide of NCDs and Injuries.
Since 1990’s, the contribution of most of the major non-communicable disease groups like cardiovascular diseases, diabetes, chronic respiratory diseases, mental health and neurological disorders, cancers, musculoskeletal disorders, and chronic kidney disease to the total disease burden has increased all over India.
In 2016, three of the five leading individual causes of disease burden in India were non-communicable diseases, with ischaemic heart disease and chronic obstructive pulmonary disease as the top two causes and stroke as the fifth leading cause.
In 2016, the NCD burden across India was 9-fold for ischaemic heart disease, 4-fold for chronic obstructive pulmonary disease, and 6-fold for stroke, and 4-fold for diabetes.
Risks factors like unhealthy diet, high blood pressure, high blood sugar, high cholesterol, and overweight, which mainly contribute to ischaemic heart disease, stroke, and diabetes.
Diabetes in the Gulf: The policy challenge is a new Economist Intelligence Unit report, sponsored by Janssen. It assesses the current status and potential impact of diabetes in the six Gulf Co-operation Council states—Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the UAE; reviews current approaches to tackling the disease in the region; and explores further possible opportunities to help combat diabetes.
Strengthening ncd surveillance in malaysia, asean ncd forum 2013Feisul Mustapha
Zainal Ariffin Omar and Feisul Idzwan Mustapha. Strengthening NCD Surveillance in Malaysia. 15 September 2013. Working paper presented at the ASEAN Regional Forum on NCDs. Manila, Philippines.
Management of diabetes in malaysia, istanbul 2013[final]Feisul Mustapha
Management of Diabetes in Malaysia. Plenary paper presented by Dato' Sri Dr Hilmi Yahaya, Deputy Minister of Health Malaysia at the International Diabetes Leadership Forum. 15 November 2013. Istanbul, Turkey. Paper was prepared by Dr Zainal Ariffin Omar and myself
Non-Communicable Diseases: Malaysia in Global Public HealthFeisul Mustapha
Paper presented at a CME Session, held in conjunction with the NIH Research Week 2014, 26 November 2014 at the Institute for Health Management, Bangsar
Presentation made by Zsuzsanna Jakab, WHO Regional Director for Europe, at the meeting on Interdepartmental Plan for Public Health of Catalonia (PINSAP) Strategy and Programme, held in Barcelona, Spain on 14 February 2014.
A non-communicable disease (NCD) is a medical condition or disease that is not caused by infectious agents (non-infectious or non-transmissible). NCDs can refer to chronic diseases which last for long periods of time and progress slowly. Sometimes, NCDs result in rapid deaths such as seen in certain diseases such as autoimmune diseases, heart diseases, stroke, cancers, diabetes, chronic kidney disease, osteoporosis, Alzheimer's disease, cataracts, and others. While sometimes referred to as synonymous with "chronic diseases", NCDs are distinguished only by their non-infectious cause, not necessarily by their duration, though some chronic diseases of long duration may be caused by infections. Chronic diseases require chronic care management, as do all diseases that are slow to develop and of long duration.
NCDs are the leading cause of death globally. In 2012, they caused 68% of all deaths (38 million) up from 60% in 2000. About half were under age 70 and half were women.Risk factors such as a person's background, lifestyle and environment increase the likelihood of certain NCDs. Every year, at least 5 million people die because of tobacco use and about 2.8 million die from being overweight. High cholesterol accounts for roughly 2.6 million deaths and 7.5 million die because of high blood pressure.
WHO: Preventive Program and Chemical Substance SafetyRahul Valath
Title: Safeguarding Health: WHO Preventive Program and Chemical Substance Safety
Description:
This presentation sheds light on the World Health Organization's (WHO) impactful Preventive Program, focusing on the vital aspect of chemical substance safety. Uncover the global initiatives and guidelines implemented by WHO to protect public health from potential hazards associated with chemical exposure. Explore the comprehensive strategies aimed at preventing chemical-related illnesses and promoting safety across diverse industries. Delve into the importance of regulatory frameworks, risk assessments, and international cooperation in ensuring the safe handling, usage, and disposal of chemical substances. Join us in understanding how WHO plays a pivotal role in championing a healthier, safer world through proactive preventive measures and robust chemical substance safety protocols.
Scope: The action plan provides a road map and a menu of policy options for all Member States and other stakeholders, to take coordinated and coherent action, at all levels, local to global, to attain the nine voluntary global targets, including that of a 25% relative reduction in premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 2025.
Focus: The main focus of this action plan is on four types of NCDs — cardiovascular diseases, cancer, chronic respiratory diseases and diabetes — which make the largest contribution to morbidity and mortality due to NCDs, and on four shared behavioral risk factors — tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. It recognizes that the conditions in which people live and work and their lifestyles influence their health and quality of life.
Australia's health system needs to better connect the dots in a number of areas. Our work looks at connections between Australian chronic disease targets and indicators, WHO targets and indicators, and national progress.
Global health is an important new term, and an important new concept. The Institute of Medicine refers to global health as "health problems, issues and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions."
OBJECTIVES OF GLOBAL HEALTH CARE
Why should medical students learn about global health
CONTINUE…
Public health, medicine, and nursing: parts of the same puzzle
CHALLENGES IN GLOBAL HEALTH CARE
THE KEY CONCEPTS IN RELATION TO GLOBAL HEALTH
. THE DETERMINANTS OF HEALTH
CONTINUE..
CONTINUE..
Continue…
2. The Measurement of Health Status
CONTINUE..
CULTURE AND HEALTH
CONTINUE..
4. The global burden of disease
5. Key Risk Factors for Various Health Conditions
CONTINUE..
Trends in Global Deaths 2002-30
HEALTH PATTERNS IN RESOURCE POOR COUNTRIES
HEALTH PATTERNS IN RESOURCE RICH COUNTRIES
Sharing the information.Network formation
REFERENCES
THANK YOU
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Evaluation of antidepressant activity of clitoris ternatea in animals
NSM-NCD2013 Keynote Address - Multi-Sectoral Approach(MSA) to Prevent Non-Communicable Diseases
1. 4/15/2013
1
Keynote Address:
Multi-Sectoral Approach (MSA)
to Prevent
Non-Communicable Diseases
Lokman Hakim S, MD, PhD
Deputy Director General of Health (Public Health)
Ministry of Health, Malaysia
NSM NCD Conference 2013
26 March 2013
Kuala Lumpur
lokman.hakim@moh.gov.my
Ministry of Health
Malaysia
The Causation Pathway For
Non-Communicable Diseases
Underlying
Determinants
•Globalization
•Urbanization
•Population
Ageing
Common Risk
Factors
•Unhealthy diet
•Physical Inactivity
•Tobacco & Alcohol use
•Age (non modifiable)
•Heredity
(non modifiable)
Intermediate
Risk Factors
•Overweight/obesity
•Raised blood sugar
•Raised blood
pressure
•Abnormal blood
lipids
Source: Adapted from Preventing Chronic Disease: A Vital Investment. Geneva, WHO 2005.
2
2. 4/15/2013
2
There are Four Major Groups of Non-
Communicable Diseases;
Four major lifestyles related risk factors
Modifiable causative risk factors
Tobacco use
Unhealthy
diets
Physical
inactivity
Harmful
use of
alcohol
Noncommunicablediseases
Heart disease
and stroke
Diabetes
Cancer
Chronic lung
disease
3
8.3
14.9
20.8
6.5
9.5
10.7
1.8
5.4
10.1
4.3 4.7 5.3
0
5
10
15
20
25
NHMS II (1996) NHMS III
(2006)
NHMS 2011
Prevalence(%)
Prevalence of Diabetes,
≥30 years (1996, 2006 & 2011)
Total diabetes
Known
Undiagnosed
IFG
Source: National Health & Morbidity Surveys (NHMS)
32.2 32.7
12.8
19.8
0
5
10
15
20
25
30
35
NHMS III (2006) NHMS 2011
Prevalence(%)
Prevalence of Hypertension,
≥18 years (2006 & 2011)
Total HPT
Known
Undiagnosed
20.6
35.1
8.4
26.6
0
5
10
15
20
25
30
35
40
NHMS III (2006) NHMS 2011
Prevalence(%)
Prevalence of Hyper-cholesterolaemia,
≥18 years (2006 & 2011)
Total HChol
Known
Undiagnosed
4
TRENDS IN NCD RISK FACTORS
4. 4/15/2013
4
AdmissionstoMOHHospitalsdueto
CirculatoryDiseases&Cancer
7
y = 130995e0.0208x
R² = 0.7959
y = 53166e0.0523x
R² = 0.8716
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
200,000
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Circulatory diseases Malignant neoplasms Projected, Circulatory diseases Projected, Cancer
PrimaryRenalDiseases
8
y = 314.5x + 1735.7
R² = 0.9634
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
New dialysis patients
New dialysis patients Projected new dialysis patients
Since 2003, diabetes
accounted for > 50%
of the primary renal
disease of new dialysis
patients
5. 4/15/2013
5
9
2000
2003
2004
2008
Global Strategy for the Prevention and Control of
Noncommunicable Diseases
Global Strategy on Diet,
Physical Activity and Health
Action Plan on the Global Strategy for the
Prevention and Control of NCDs
2010
2009
2011
Global Strategy to
Reduce the Harmful
Use of Alcohol
WHO Global Status
Report on NCDs
Political Declaration on NCDs
WHO's global road map to prevent and
control NCDs
2012+ Realizing the commitments made in the Political Declaration
UNSecretary-General:
NCDsindevelopingcountriesarehidden,
misunderstoodandunder-recorded
A rapidly rising epidemic in developed and
developing countries…
… with serious socio-economic impacts,
particularly in developing countries.
Workable solutions exist to prevent most
premature deaths from NCDs and mitigate the
negative impact on development.
The way forward: These solutions need to be
mainstreamed into socio-economic development
programmes and poverty alleviation strategies.
10
6. 4/15/2013
6
11
UN High-levelMeeting on NCDs
(New York, 19-20 September 2011)
High-levelMeeting
113 Member States
34 Presidents & Prime
Ministers
3 Vice-Presidents and
Deputy Prime Ministers
51 Ministers of Foreign
Affairs & Health
11 Heads of UN
Agencies
100s of NGOs
PoliticalDeclaration
Establish multisectoral
national plans by 2013
Integrate NCDs into
health-planning
processes and the
national development
agenda
Promote multisectoral
action through health-
in-all policies and
whole-of-government
approaches
Build national capacity
WhatWHOisdoing
Develop a Global
Monitoring Framework
and targets
Develop a global
implementation plan
2013-2020
Provide technical
support to developing
countries
Identify options for
partnerships
Coordinate work with
other UN Agencies
Measure results
World Health Assembly in May 2012:
Decided to adopt a global target of a 25% reduction in premature mortality
from NCD by 2025
12
7. 4/15/2013
7
Highlights:UN PoliticalDeclaration
Heads of States and Governments and representatives committed to:
• Establish/strengthen, by 2013, national multisectoral policies and
plans for NCDs, taking into account the Global Strategy for NCDs and
its Action Plan;
• Integrate NCDs policies and programmes into health-planning
processes and the national development agenda of each Member
State;
• Develop national targets and indicators based on guidance provide
by WHO and give greater priority on surveillance;
• Accelerate implementation of the WHO FCTC, the Global Strategy on
Diet, Physical Activity and Health, and the Global Strategy to Reduce
the Harmful Use of Alcohol;
• Strengthen health systems that support primary care, prioritise early
detection and treatment, and improve access to affordable essential
medicines for NCDs.
13
What is Multi-SectoralApproach?
• Working together across sectors to improve health and
influence its determinant
• A number of other terms are used, often inter-changeably,
for engaging sectors outside of health. These include:
• Inter-sectoral action for health.
• Multi-stakeholder action.
• Whole-of-government.
• Health-in-all policies.
• Healthy public policies.
14
8. 4/15/2013
8
Why MSA?
• Governments can make substantial achievements in reducing
the burden of NCDs through MSA.
• Forging new collaborations and partnerships are critical in
making progress in addressing the NCD epidemic.
• Partnership occurs at different levels:
• Individuals, families and communities.
• Government, communities and NGOs.
• Government, development partners (within countries), civil
society and, as appropriate, the private sector.
15
‘Whole-of-Government’ and
‘Whole- of-Society’approach
• ‘Whole-of-Government’ denotes
public service agencies working
across portfolio boundaries to
achieve a shared goal and an
integrated government response
to particular issues
• Responsibility for health and its
social determinants rests with
the whole society, and health is
produced in new ways between
society and government.
16
9. 4/15/2013
9
Social Determinants of Health
17
Challengesin operationalising Multi-
sectoral Approach (MSA)
• No or ineffective multisectoral mechanism at national level;
• No high-level commitment and support for coordinated
operation;
• No or low level representation from different sectors in MSA
mechanisms;
• No mandate, agreed roles and responsibility of sectors;
• No joint plan with agreed target, indicator approach, and
inputs; and
• No auditing and valid reporting mechanism.
18
10. 4/15/2013
10
NCD Targets & MSA
• 25% relative reduction in NCD mortality (between 30-70
years) has been adopted as a global target during the 65th
World Health Assembly in May 2012.
• A set of global targets and indicators has been decided in a
Formal Meeting with Member States in November 2012, and
will be presented for adoption in the 66th World Health
Assembly (WHA in May 2013).
• The Global Monitoring Framework on NCDs consists of 25
indicators, with 9 voluntary global targets.
• Having targets and indicators will provide clear direction for
MSA and facilitate identifying the role and responsibility and
accountability for the different sectors. 19
What is new?
"Best buys" interventions to address NCDs
Population-
based
interventions
addressing
NCD
risk factors
Tobacco use - Excise tax increases
- Smoke-free indoor workplaces and public places
- Health information and warnings about tobacco
- Bans on advertising and promotion
Harmful use
of alcohol
- Excise tax increases on alcoholic beverages
- Comprehensive restrictions and bans on alcohol marketing
- Restrictions on the availability of retailed alcohol
Unhealthy
diet and
physical
inactivity
- Salt reduction through mass media campaigns and reduced salt
content in processed foods
- Replacement of trans-fats with polyunsaturated fats
- Public awareness programme about diet and physical activity
Individual-
based
interventions
addressing
NCDs in
primary care
Cancer - Prevention of liver cancer through hepatitis B immunization
- Prevention of cervical cancer through screening (visual
inspection with acetic acid [VIA]) and treatment of pre-
cancerous lesions
CVD and
diabetes
- Multi-drug therapy (including glycaemic control for diabetes
mellitus) for individuals who have had a heart attack or stroke,
and to persons at high risk (> 30%) of a cardiovascular event
within 10 years
- Providing aspirin to people having an acute heart attack
20
11. 4/15/2013
11
Tobacco
use
Harmful
use of
alcohol
• Excise tax increases
• Smoke-free indoor workplaces and public places
• Health warnings
• Bans on advertising and promotion
• Excise tax increases on alcoholic beverages
• Comprehensive restrictions and bans on alcohol
marketing
• Restrictions on the availability of retailed alcohol
• Salt reduction through mass media campaigns and
reduced salt content in processed foods
• Replacement of trans-fats with polyunsaturated
fats
• Public awareness programme about diet and
physical activity
HEALTHY CITIES AND ISLANDS SETTINGS SUCH AS SCHOOLS, WORKPLACES
ADVOCACY, HEALTH IMPACT ASSESSMENT HEALTH IN ALL POLICIES
MSA, ‘Best Buys’ and Sectors
MSA
Unhealthy
diet and
physical
inactivity
Ministries including
• Health
• Agriculture
• Finance
•Transport
• Trade and Industry
• Education
• Labour
• Urban planning
• Justice
Other stakeholders including
• Industry
• Civil society
• NGOs
• Academia
MINISTRIES
Health,
Agriculture,
Finance,
Transport,
Trade and Industry
Education,
Labour,
Urban planning,
Justice
OTHER STAKEHOLDERS
Civil society,
NGOs,
Academia,
Private sector,
Donor, development
partners
21
Examplesof bestpractices and
effectiveapproachesfor MSA
- Tobacco Control
• Tobacco taxation and Health
Promotion Foundations in
Australia, Lao PDR, Korea,
Malaysia, Mongolia, Tonga,
Viet Nam
• Plain packaging- a path
breaking approach in Australia
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12
Examples of best practices and effective
approaches for MSA
- Promoting Healthy Diet
• Healthier foods in Singapore-Hawker Fare
• Salt reduction in China and Mongolia
• Eat smart restaurants (700+), Hong Kong
(China)
• Eat smart @ school (400), Hong Kong
(China)
23
Examplesof best practices and
effectiveapproachesfor MSA
-Promoting Physical Activity
• Exercise equipment in public parks
in Lao PDR, China, Korea
• Walk paths, and cycling tracks in
Cambodia, Korea, China, Malaysia
• Community physical exercise groups
clubs in Seongbuk, Korea and Shanghai,
China
• Walking days in Dalin, Seongbuk, Xiamen
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13
Examples of best practices and effective
approaches for MSA
- Tobacco Control & Reducing Harm from
Alcohol
• The Mongolia’s President initiative in
alcohol control, non- alcohol in
government’s function and new alcohol
legislation.
• Development of legislation: drinking and
driving, use of helmet, blood testing:
China, Cambodia, Philippines, Vietnam.
• Regulating informal alcohol
control in Vietnam. 25
Examples of best practices and effective
approaches for MSA
-Healthy Cities
• Smoke-Free Cities:
• Harbin, QingDao, China.
• Makati and Marikina, Philippines.
• Luang Prabang, in Lao PDR.
• Siem Reap, Cambodia .
• Environmentally sustainable healthy urban
transport (ESHUT) in 5 Asian cities:
• Promote walking, cycling.
• Public transport system.
• Reduce use of private vehicles.
• Smoking ban.
• Promoting health and hygiene.
• Barrier-free transport environments.
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14
Examples of best practices and effective
approaches for MSA
-Healthy Settings: Health Promoting
Schools and Work Places
• Health Promoting schools for multiple
health interventions - Singapore, Hong
Kong, Macao (China).
• Healthy workplaces - Shanghai, Hong
Kong, China.
27
MSA-Entry Points
National multi-ministerial forumNational
• Effective only with commitment at the highest level,
need a good driver, Health in All Policies
City/District/Village levelSubnational
• More feasible, leverage local government, collective
voice of community, government closer to the
community, local ordinances
Tobacco/Alcohol/Physical ActivityRisk factor
• Facilitators-activism, pressure groups, champions,
international agreements (FCTC), global reporting,
more palpable interventions, common good /common
enemy
Inter
ministerial
Local
Government
Cross sector
working groups 28
15. 4/15/2013
15
MSA – Accountability and Reporting
• Experiences from MDG 4 and 5 in accountability framework.
• Agreed national targets and indicators.
• Sector-specific roles, responsibility, target, inputs and outputs.
• Joint statement and joint plan.
• Across sectors audit, evaluation.
• Public reporting.
29
Rio+20:
“NCDsconstituteoneofthemajorchallengesfor
sustainabledevelopment”
“We understand the goals of
sustainable development can only
be achieved in the absence of a
high prevalence of debilitating
communicable and NCDs, and
where populations can reach a
state of physical, mental and social
well-being.” [paragraph 138]
“We acknowledge that the global
burden and threat of NCDs
constitutes one of the major
challenges for sustainable
development in the 21st century.”
[paragraph 141]
30
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16
UNSystemTaskTeamonthepost-2015UN
DevelopmentAgenda:
NCDsisapriorityforsocialdevelopmentand
investmentsinpeople
“The MDGs did not adequately address
… increase in NCDs. ” [paragraph 19]
“Priorities for social development and
investments in people would include:
… NCDs. Access to sufficient nutritious
food and promotion of healthy life
styles with universal access to
preventive health services will be
essential to reduce the high incidence
of NCDs diseases in both developed
and developing countries.” [paragraph 67]
31
National Strategic Plan for
Non-Communicable Diseases
(NSP-NCD)2010-2014
• Presented and approved by the Cabinet on 17
December 2010
• Provides the framework for strengthening NCD
prevention & control program in Malaysia
• Adopts the “whole-of-government” and “whole-of-
society approach”
Seven Strategies:
1. Prevention and Promotion
2. Clinical Management
3. Increasing Patient
Compliance
4. Action with NGOs,
Professional Bodies & Other
Stakeholders
5. Monitoring, Research and
Surveillance
6. Capacity Building
7. Policy and Regulatory
interventions
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17
Strategy 7: Policy & Regulatory
Interventions
• Main thrust of NSP-NCD
• Health promotion and education will increase
awareness and knowledge
• However changes in behaviour is strongly influenced
by our living environment
Awareness Knowledge
Behavioural
Change
Supportive living
environment
Health promotion & educations
Policies & regulations
33
CabinetCommitteeforAHealthPromoting
Environment
• To support the implementation of NSP-NCD, the Cabinet on 17 December 2010
approved the establishment of a Cabinet-level committee, chaired by the Right
Honourable Deputy Prime Minister, and comprises of 10 members
1. Minister of Health
2. Minister of Education
3. Minister of Information, Communications, Arts & Culture
4. Minister of Rural & Regional Development
5. Minister of Agriculture and Agro-based Industry
6. Minister of Youth & Sports
7. Minister of Human Resource
8. Minister of Domestic Trade, Co-operatives and Consumerism
9. Minister of Housing and Local Governments
10. Minister of Women, Family and Social Affairs
Main TOR: To determine policies that creates a living
environment which supports positive behavioural changes
of the population towards healthy eating and active living
34
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18
Challengesfor Malaysia
• The main challenge in policy and regulatory interventions
remain that they are mostly under the responsibilities of
ministries and departments other than Ministry of Health
• Ministry of Health needs to take leadership role.
• Need to find a win-win solution – “mutuality of interest”.
• Economic and “political” consideration remains paramount
and needs to be acknowledged.
• For Malaysia, the establishment of the Cabinet Committee was
an important initial step to achieve the “whole-of-government
approach”.
• The health sector needs to play a strong advocacy role.
35
Summary
• Preventing and controlling NCD is an urgent priority for all
countries.
• Most of the drivers of NCDs and their risk factors lie outside
the control of the health sector.
• MSA is required to create enabling environments, so that
healthy choices are the easy choices.
• MSA is also required to break the cycle of poverty and NCDs.
• The prevention and control of NCDs and their risk factors
have a positive impact not only on health, but also on
productivity and economic and social development.
36