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