Second presentation: Ms Leanne Riley Team Leader Surveillance and Population-based Prevention Department of Chronic Diseases and Health Promotion

Transcription

1 Second presentation: Ms Leanne Riley Team Leader Surveillance and Population-based Prevention Department of Chronic Diseases and Health Promotion World Health Organization

2 Targets presented in the first WHO Discussion Paper

3 Outcome targets Indicator Data Source(s) Criteria 1 Mortality from NCDs 25% relative reduction in overall mortality from cardiovascular disease, cancer, diabetes, or chronic respiratory disease 2 Diabetes 10% relative reduction in prevalence of diabetes Unconditional probability of dying between ages from, cardiovascular disease, cancer, diabetes, or chronic respiratory disease Age-standardized prevalence of diabetes among persons aged 25+ years Civil registration system, with medical certification of cause of death, or survey with verbal autopsy National survey (with measurement) Exposure targets Indicator Data Source(s) Criteria 3 Tobacco smoking 40% relative reduction in prevalence of current tobacco smoking 4 Alcohol 10% relative reduction in persons aged 15+ alcohol per capita consumption (APC) 5 Dietary salt intake Mean population intake of salt less than 5 grams per day Age-standardized prevalence of current tobacco smoking among persons aged 15+ years Per capita consumption of litres of pure alcohol among persons aged 15+ years Age-standardized mean population intake of salt per day National survey Official statistics and reporting systems for production, import, export, and sales or taxation data; and national survey National survey (with measurement) * * * *

4 Exposure targets Indicator Data Source(s) Criteria 6 Blood pressure/hypertension 25% relative reduction in prevalence of raised blood pressure 7 Obesity No increase in obesity prevalence 8 Prevention of heart attack and stroke 80% coverage of multidrug therapy (including glycaemic control) for people aged 30+ years with a 10 year risk of heart attack or stroke 30%, or existing cardiovascular disease 9 Cervical cancer screening 80% of women between ages screened for cervical cancer at least once 1 0 Elimination of industrially produced trans-fats from the food supply Elimination of industrially produced trans-fats (PHVO)) from the food supply Age-standardized prevalence of raised blood pressure among persons aged 25+ years Age-standardized prevalence of obesity among persons aged 25+ years; Percentage of estimated people aged 30+ years with a 10 year risk of heart attack or stroke 30%, or existing cardiovascular disease who are currently on multiple drug therapy (including glycaemic control). Prevalence of women between ages screened for cervical cancer at least once Adoption of national policies that eliminate partially hydrogenated vegetable oils (PHVO) in the food supply National survey (with measurement) National survey (with measurement) National survey (with measurement) National survey; health facility data Policy review * *

5 Feedback on the first WHO Discussion Paper 22 Member States submitted written comments and 43 Member States attended the January 2012 informal consultation to give their views. Member States requested a more detailed outline of the GMF and set of indicators. There was reasonable support for the targets related to mortality, hypertension and tobacco. Member States raised concerns on feasibility and measurability of some of the suggested targets - salt, diabetes, alcohol, multi drug therapy, cervical cancer, obesity and trans-fats. Member States highlighted some gaps including indicators and/or targets related to physical inactivity, additional dietary risk factors, access to medicines and diagnostics. A detailed summary of Member States feedback from the consultative processes is available on the WHO website.

6 Targets presented in the second WHO Discussion Paper

7 Global monitoring framework, including indicators (paragraph 61) and voluntary global targets (paragraph 62) Indicators with targets Raised Blood Pressure 25% relative reduction Mortality between ages 30 and 70 due to CVD, cancer, diabetes, or chronic respiratory disease 25% relative reduction Tobacco 30% relative reduction Salt/sodium 30% relative reduction until 5gm/day Physical inactivity 10% relative reduction Other WHO core indicators Overweight/obesity (adult, child, adolescent) Raised total cholesterol Raised blood glucose/diabetes Adult per capita consumption of alcohol and heavy episodic drinking Low fruit and vegetable intake Cancer incidence, by type Policies to virtually eliminate trans fats and to reduce marketing of unhealthy foods to children Cervical cancer screening Vaccination: HPV, Hepatitis B Availability of basic technologies and medicines Access to palliative care Multidrug therapy for CVD risk reduction Other country-specific indicators of NCD and related issues including social determinants of health

8 Outcomes Exposures Health systems response Cancer incidence by type Mortality between ages due to CVD, cancer, diabetes, or CRD Adult alcohol per capita consumption Heavy drinking occasions Insufficient physical activity Low fruit and vegetable consumption Overweight/obesity Raised blood glucose/diabetes Raised blood pressure/hypertension Raised total cholesterol Salt/sodium intake Tobacco smoking Access to palliative care Availability of basic diagnostics and medicines Cervical cancer screening Multidrug therapy for CVD risk reduction Policies to eliminate trans fats Policies to reduce marketing of unhealthy foods to children Vaccination for Hepatitis B Vaccination for HPV * All indicators should be disaggregated by gender, age, socioeconomic position, and other relevant stratifies

9 Outcomes Exposures Health systems response Cancer incidence by type Mortality between ages due to CVD, cancer, diabetes, or CRD (25% relative reduction) Adult alcohol per capita consumption Heavy drinking occasions Insufficient physical activity (10% relative reduction) Low fruit and vegetable consumption Overweight/obesity Raised blood glucose/diabetes Raised blood pressure/hypertension. (25% relative reduction) Raised total cholesterol Salt/sodium intake. (30% relative reduction) Tobacco smoking. (30% relative reduction) Access to palliative care Availability of basic diagnostics and medicines Cervical cancer screening Multidrug therapy for CVD risk reduction Policies to eliminate trans fats Policies to reduce marketing of unhealthy foods to children Vaccination for Hepatitis B Vaccination for HPV * All indicators should be disaggregated by gender, age, socioeconomic position, and other relevant stratifies

10 Feedback from Member States on second WHO Discussion Paper 25 Member States submitted written comments. Member States supported the more detailed Global Monitoring Framework and indicators. There was good support for the targets related to mortality, hypertension, tobacco, physical inactivity. Member States raised concerns on feasibility and measurability of some of the suggested targets and indicators, particularly salt. Member States highlighted some gaps including indicators and/or targets related to alcohol and health systems response such as access to medicines. A detailed summary of Member States feedback from the consultative processes will be made available on the WHO website.

11 Feedback from UN agencies and funds on second WHO Discussion Paper 2 UN agencies provided written comments UNWRA and UNAIDS. Comments were in general supportive of the suggested targets and indicators. There was support to promote an indicator on health systems to be a target, with a preference for this to be on access to medicines to treat NCDs. There was also support for a focus on equity and gender issues and women's cancers.

12 Feedback from NGOs on second WHO Discussion Paper 19 relevant NGOs submitted written comments. There was good support for the package of 5 targets. There was strong support to reinstate alcohol as a target, with APC as the indicator. There was good support for reinstating the obesity target, and suggestions this be expanded to include a focus on children. There was some support for reinstating the multi-drug therapy target, or a target on availability of essential medicines and diagnostics. There was good support to reinstate the target on trans fats elimination.

13 Feedback from NGOs on second WHO Discussion Paper, cont. NGOs supported many of the indicators including in the Global Monitoring Framework. There was strong support for the indicators on cancer incidence, cervical cancer, vaccination for Hep B and HPV, and palliative care. NGOs supported having a longer list of indicators, and suggestions for additional indicators were made. New indicators on the following were proposed: breast cancer, stroke, asthma, saturated fats, and added sugars. A detailed summary of NGOs feedback from the consultative processes will be made available on the WHO website.

14 Feedback from Private Sector on the second WHO Discussion Paper 1 selected private sector entity submitted written comments. The comments related to their area of interest food and non-alcoholic beverages. They indicated support for the salt target and trans fats and marketing of unhealthy foods to children indicators.

15 Thank you