Update on noncommunicable diseases

Towards the UN High level Meeting…

2000- 2010 - impressive number of high-level regional and global meetings, organized by the WHO or by the UN General Assembly recognizing the growing public-health burden imposed by NCDs:

– Resolution (53.17) of the World Health Assembly – Action plan for the global strategy for the prevention and control of

NCDs endorsed by the WHA– Resolution on the prevention and control of the NCDs by the 64th

session of the UN General Assembly. – Resolution (65/238) on the scope, modalities, format and organization of

the high-level meeting on NCDs - UN General Assembly– Global or regional meetings, ministerial meetings - Beijing, Doha,

Geneva, Port-of-Spain, Copenhagen, Teheran, Oslo, Nadi/Fiji, Mexico City, Jakarta, Seoul, Brazzaville, Moscow, New York, Washington,

– WHO's Global status report on NCDs– Wide consultations and discussions: 6 WHO Regional meetings; 5

informal consultations with civil society and the private sector

• First global ministerial conference focussing solely on NCDs: More than 150 governments and 95 Ministers of Health attended.

• Goals: To raise political awareness about the importance and potential of NCD prevention and control, and to highlight the essential need for intersectoral action. 

• High-level sessions to profile available instruments, strategies and policies, and to foster international cooperation and coordination. 

• Interactive roundtable sessions to exchange successful approaches and lessons learned. 

• Participants adopted the Moscow Declaration, which calls for the full and effective implementation of the NCD Action Plan, and for supporting WHO in developing a comprehensive global monitoring framework for NCDs, particularly in preparation for the High-level Meeting.

• A summary report of the Conference will serve as an input to the preparatory process leading towards the High-level Meeting on NCDs in September 2011.

Global Ministerial Conference on Healthy Lifestyles and NCD Control(Moscow, 28-29 April 2011)

Hig

h-l

ev

el M

ee

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g 113 Member States34 Presidents and Prime-Ministers3 Vice-Presidents and Deputy Prime-Ministers51 Ministers of Foreign Affairs and Health11 Heads of UN Agencies100s of NGOs

Po

litic

al D

ec

lara

tio

n 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

Increase domestic resources

On

e-W

HO

wo

rk p

lan Set norms and

standards

Exercise a leading and coordinating role within the UN system

Develop a global implementation plan 2013-2020

Expand technical competence and resources

Scale up technical assistance

UN High-level Meeting on NCDs(New York, 19-20 September 2011)

Work streams established by the WHO Secretariat

Technical assistance to developing countries to support national efforts

Exercise WHO's leadership and coordination role in relation to UN Agencies

Develop a global monitoring framework and global voluntary targets for NCDs

Articulate options for multisectoral action for the prevention and control of NCDs through effective partnership

Develop an updated global action plan for the development and control of NCDs (2013-2020)

WHO-wide work plan 2012-2013 on NCDs

Technical assistance to developing countries

to support national efforts

Analysis of 144 Country Cooperation Strategies Number

Promoting risk reduction, prevention, treatment and monitoring of noncommunicable diseases, mental health, disability and injuries.

136

Strengthening the structure, organization and financing of health systems, with a particular focus on achieving universal coverage, strengthening human resources for health and increasing access to medical technologies including medicines.

134

Supporting the achievement of the health-related Millennium Development Goals (primarily Goals 4, 5 and 6) bringing together HIV/AIDS, tuberculosis, malaria, and maternal and child health, with a focus on integrated service delivery.

119

Surveillance of, and response to, disease outbreaks and acute public health emergencies, and the effective management of humanitarian disasters.

119

I. Scaling up technical assistance for the prevention and control of NCDs to meet the demand from developing countries

The Bloomberg Initiative to Reduce Tobacco Use

Objectives of the Bloomberg Initiative to Reduce Tobacco Use

Bloomberg Philanthropies’ $375 million, six-year investment aims to accelerate the worldwide movement to combat tobacco use through a focused effort in the countries with the highest tobacco burden.

Specifically, the Bloomberg Initiative to Reduce Tobacco Use (BI) supports work to promote the MPOWER package of six tobacco control interventions.

5 core partner organizations: – Campaign for Tobacco Free Kids– US Centers for Disease Control and Prevention Foundation– Johns Hopkins Bloomberg School of Public Health– International Union Against Tuberculosis and Lunch Disease– WHO

Mayor Bloomberg announced in March the continuation of BI for at least the next four years, with a USD 220 million commitment for 2013-2016

Exercise WHO's leadership and coordination role

in relation to UN Agencies

http://www.who.int/nmh/highlights/undaf/en/index.html

Integrating NCDs into UNDAF processes

Development of a comprehensive global monitoring system,

including indicators, and voluntary global targets for the prevention and control of NCDs

61. Call upon WHO,…to develop before the end of 2012, a comprehensive global monitoring framework, including a set of indicators,……, to monitor trends and to assess progress made in the implementation of national strategies and plans on NCDs.

62. Call upon WHO,.. to prepare recommendations for a set of voluntary global targets for the prevention and control of NCDs, before the end of 2012.

Political Declaration on NCDs (resolution A/RES/66/2)

2012

• 25 July 2012 – 19 October 2012: Relevant global NGOs and selected private sector entities are invited to submit their views by email (ncdpartnership@who.int) on the revised WHO Discussion Paper

2012

• September – October 2012: Discussions at the WHO Regional Committees

2012

• End of October 2012: WHO Secretariat will publish a report summarizing the outcomes of the discussions at the Regional Committees and the views received from relevant global NGOs and selected private sector entities

2012

• 5-7 November 2012: Formal meeting with Member States and UN agencies to conclude the work

2012

• January 2013: WHO Secretariat will submit a report on the final recommendations to the Executive Board

2013

• May 2013: WHO Secretariat will submit a report with the final recommendations to the World Health Assembly

Process: Next steps

Outcomes• Cancer incidence,

by type• Premature

mortality from cardiovascular disease, cancer, diabetes, or chronic respiratory disease

Exposures• Alcohol• Fat intake• Low fruit and vegetable intake• Overweight and obesity• Physical inactivity• Raised blood glucose• Raised Blood pressure• Raised total cholesterol• Salt/sodium intake• Tobacco

Health system response• Cervical cancer screening• Drug therapy to prevent heart attacks

and strokes• Essential NCD medicines and

technologies• Palliative care• Policies to eliminate PHVOs from food

supply• Policies to reduce marketing of foods to

children• Vaccination against infectious cancers

Comprehensive Global Monitoring Framework for NCDs

Raised blood pressure

25%

Salt/sodium intake

30%

Tobacco smoking30%

Physical inactivity10%

Obesity0%

Fat intake15%

Alcohol10%

Raised cholesterol

20%

Generic medicines and technologies

80%

Drug therapy and

counselling50%

Premature mortality from NCDs25% reduction

Target adopted by the World Health Assembly

Targets with wide support Targets with support for further development

11 voluntary global targets presented in the revised WHO Discussion Paper

Articulating options for strengthening multisectoral

action for the prevention and control of NCDs through

effective partnerships

WHO's input into the Secretary-General's report

Option 1 – Aligned independent efforts Organic model: Activities to evolve without coordination or shared strategy WHO to host a forum (or series of fora) to invite interested parties to express commitment and to

seek partnerships

Option 2 – Social movement: Multistakeholder model: governments, NGOs, private sector, people living with NCDs WHO to forge a social movement to direct national and global efforts towards national

multisectoral policies and plans for the prevention and control of NCDs

Option 3 – Coordinated network Networked model: Cultivate a hub-and-spoke of coordinated collaborative arrangements WHO to establish a small Secretariat (based on UN Road Safety Collaboration)

Option 4 – Merger (a loose coordinated network around a social movement for NCDs) A merger of options 1, 2 and 3

Option 5 – Centralized, formal partnerships Vertical model: Large, centralized organization with a limited-time response and instigating

parallel structures in countries WHO to establish a single centralized partnership

Note by the SG transmitting the report of the WHO DG:Global partnership options for the prevention and control of NCDs

Development of a global action plan for the

prevention and control of NCDs covering the period 2013-2020

2000

2003

2004

2008

Global Strategy for the Prevention and Control of Noncommunicable Diseases

Global Strategy on Diet, Physical Activity and Health

Action Plan 2008-2013 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

20132020

The World Health Assembly has requested WHO to develop a'WHO Action Plan for the Prevention and Control of NCDs for 2013-2020'

WHO Action Plan for the Prevention and Control of NCDs for 2013-2020

World Health Assembly resolution WHA64.11

REQUESTS THE DIRECTOR-GENERAL TO:

(4) to report to the Sixty-fifth World Health Assembly, through the Executive Board, on the outcomes of the first Global Ministerial Conference on Healthy Lifestyles and NCD Control and the high-level meeting, and to develop, together with relevant United Nations agencies and entities, an implementation and follow-up plan for the outcomes, including its financial implications, for submission to the Sixty-sixth World Health Assembly, through the Executive Board.

(24 May 2011)

2. REQUESTS the Director-General:

(4) to develop, in a consultative manner, a WHO action plan for the prevention and control of NCDs for 2013–2020, building on lessons learnt from the 2008–2013 action plan and taking into account the outcomes of the High-level Meeting of the United Nations General Assembly on the Prevention and Control of NCDs, the Moscow Declaration on Healthy Lifestyles and NCD Control, the Rio Declaration on Social Determinants of Health, building on and being consistent with existing WHO strategies and tools on tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity;

(20 January 2012)

WHO Executive Board resolution EB130.R7

2012

• 26 July 2012 – 7 September 2012: Web-based consultation for Member States, UN Agencies, NGOs and private sector entities (WHO Discussion Paper)

2012

• 16-17 August 2012: First informal consultation with Member States and UN Agencies (WHO Discussion Paper)

2012

• 1 November 2012: Second informal consultation with Member States and UN Agencies ('Annotated Zero Draft' Action Plan)

2013

• January 2013: Executive Board (Annotated Draft Action Plan)

2013

• February 2013: Third informal consultation with Member States and UN Agencies (Draft Action Plan)

2013

• May 2013: World Health Assembly (Final Draft Action Plan)

Process: Next steps

1. Integrating NCD prevention into the development agenda, and into policies across all government departments

2. Establishing/strengthening national policies and programmes

3. Reducing/preventing risk factors 4. Prioritizing research on

prevention and health care5. Strengthening partnerships6. Monitoring NCD trends and

assessing progress made at country levelSet

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2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs

Vision To reduce the avoidable global NCD burden and its impact so that people can reach the highest achievable levels of health and productivity Goal To reduce the toll of morbidity, disability and premature mortality from NCDs

Overarching Global Target12.5% reduction in premature mortality from noncommunicable diseases by 2020

Cross-cutting principles• Human rights• Universal coverage and equity• Life course approach• Evidence-based practice• Empowerment of people

Development of the 2013-2020 Action Plan:Possible structure

Objectives 1. To raise priority accorded to prevention and control of NCDs in

the development agenda 2. To strengthen capacity, leadership, governance, and

accountability to accelerate country response for prevention and control of NCDs

3. To promote a whole-of-Government approach and multisectoral action for NCD prevention and control

4. To reduce modifiable risk factors for NCDs and create health promoting environments

5. To strengthen and reorient health systems to address NCD prevention and control through people- centered primary care and universal coverage

6. To monitor and evaluate progress of prevention and control of NCDs

Development of the 2013-2020 Action Plan:Possible structure

Timelines to complete the work under way in

the area of NCDs

Jan-May 2012EB/WHA

27 August 2012

WHO Action Plan for the prevention and control of NCDs

for 2013-2020

Jan-May 2013EB/WHA

WHO's input into SG's report on options for strengthening and

facilitating multisectoral action for the prevention and control of NCDs through effective partnership

Sep 2013

2014GA

Comprehensive review and assessment of the progress

achieved in the prevention and control of NCDs

Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of NCDs(resolution A/RES/66/2)

WHO's input into SG's report on the progress achieved in realizing the commitments

made in the Political Declaration

Final progress report on implementing the 2008-2013

action plan

Jan-May 2014WHA

Development of a global monitoring framework and

targets for NCDs

Options and a time line for multisectoral action through

partnerships

Global monitoring framework, indicators and and targets for

NCDs

WHO Global Status Report on NCDs (2013)

2014

SG's report on options for strengthening and facilitating multisectoral action for the

prevention and control of NCDs through effective partnership

Nov/Dec 2012

Formal consultation with Member States to conclude the work on a global

monitoring framework and targets

5-7 Nov 2012

SG's report on the progress achieved in realizing the

commitments made in the Political Declaration

Dec 2013

1st informal consultation on action plan

2nd informal consultation on action plan

Timelines

3rd informal consultation

on action plan

16-17 Aug

1 Nov

Feb/Mar 2013

Health2020

Health Equity

Health

Governance

Economics of

Prevention

Public Health

NCD Action Plan

Planning and oversight

National plan

Health information system with

social determinants

disaggregation

Health in all policies

Fiscal policies

Marketing

Salt

Trans-fat

Healthy settings

Workplaces and schools

Active mobility

Secondary prevention

Cardio-metabolic risk assessment

and management

Early detection of cancer

Thank you