Global NCD Prevention WHO Strategies and Implementation Plan. Dr Ruitai Shao Chronic Disease and Health Promotion

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1 Global NCD Prevention WHO Strategies and Implementation Plan Dr Ruitai Shao Chronic Disease and Health Promotion

2 Outline Main NCDs and Major risk factors Global Action Plan for implementing the strategy UN HLM Political Declaration on NCDs The way forward

3 communicable diseases, maternal, perinatal and nutritional conditions The NCD crisis (deaths in 2008) injuries 9% 28% NCDs after the age of 60 10% 31% 47% 42% Global 16% NCDs before the age of 60 Low- and middle-income countries only 17%

4 Sierra Leone Afghanistan Equatorial Guinea Nauru Papua New Guinea Gambia Angola Kiribati Ethiopia Women are dying too young from NCDs in developing countries Andorra Norway Spain Japan Germany Austria Switzerland San Marino Sweden Italy 0% 10% 20% 30% 40% 50% 60% 70%

5 New perspectives NCDs as a development issue Globalization Urbanization Population ageing Poverty Populations in low- and middle-income countries Increased exposure to common modifiable risk factors Loss of household income Noncommunicable diseases Limited access to effective and equitable health-care services Poverty at household level More than 8 million people die before the age of 60 in developing countries from noncommunicable diseases

6 Summary Major cause of death and threat is growing Underappreciated cause of poverty Solutions exist and are cost-effective and inexpensive to implement Comprehensive and integrated action, led by governments, is the key to success

7 Key Components of the global strategy Surveillance Mapping the epidemic of NCDs Prevention Reducing the level of exposure to risk factors Management Strengthen health care for people with NCDs

8 Vision and Road Map: the journey to scale up global action 2000 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 2008 Global Strategy to Reduce the Harmful Use of Alcohol WHO Global Status Report on NCDs 2011 UN Political Declaration on NCDs

9 World Health Assembly in 2008: Six objectives: 1. Raising the priority accorded to NCDs in development work 2. Strengthening national programmes 3. Reducing risk factors 4. Prioritizing research 5. Strengthening partnerships 6. Monitoring NCD trends

10 Prioritize most effective interventions' to reduce risk factors for NCDs Condition Tobacco use Alcohol use Unhealthy diet &physical inactivity Infections Interventions - Raise taxes on tobacco - Protect people from tobacco smoke - Warn about the dangers of tobacco - Enforce bans on tobacco advertising - Raise taxes on alcohol - Restrict access to retailed alcohol - Enforce bans on alcohol advertising - Reduce salt intake in food - Replace trans fat with polyunsaturated fat -Promote public awareness about diet and physical activity -Hepatitis B vaccination

11 How Member States can improve health care for NCDs Recommended action: Integrate NCDs into primary health care by expanding the package of PHC services to include NCD "best and good buys" identified in the Global Report Strengthen health systems and address the gaps in building blocks, particularly health financing, access to medicines, health information, and the health workforce

12 Prioritize most effective interventions to improve health care for NCDs Condition CVD & diabetes Cancer Interventions Provide counselling and multi-drug therapy (including blood sugar control for diabetes mellitus) for people with medium-high risk of developing heart attacks and strokes (including those who have established CVD) Treat heart attacks ( myocardial infarction) with aspirin Screening and treatment of pre-cancerous lesions to prevent cervical cancer

13 What is also new: High-level Meeting on NCDs (New York, September 2011): A BREAKTHROUGH!!!

14 Highlights of the High-level Meeting on NCDs Heads of State and Government 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 provided by WHO and give greater priority to 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, prioritize early detection and treatment, and improve access to affordable essential medicines for NCDs

15 Highlights of the High-level Meeting on NCDs Consensus and clear positions: NCDs as priority within the development agenda Whole-of-government approach to implement WHO's recommendations on surveillance, prevention and health care Leading role of WHO in coordinating global action on NCDs Expectations for WHO to strengthen internal capacity to support Member States Specific assignments that WHO has to deliver over the coming months and years

16 Specific assignments given to WHO To reaffirm WHO's leadership and coordinating role in promoting and monitoring global action against NCDs in relation to the work of other UN Agencies, development banks and international organizations ( 13) To intensify efforts to assist Member States in implementing, Global Strategy on NCDs and its Action Plan, WHO Framework Convention on Tobacco Control, Global Strategy on Diet, Physical Activity and Health, Global Strategy to Reduce the Harmful Use of Alcohol, and Set of recommendations on marketing ( 43) To work together with other UN Agencies in a coordinated manner to support national efforts ( 51) To continue to provide technical assistance and capacity building to developing countries to support national efforts ( 52) WHO Director-General

17 Specific assignments given to WHO To develop a comprehensive global monitoring framework for the prevention and control of NCDs, including a set of indicators ( 61) To prepare recommendations for a set of voluntary global targets for the prevention and control of NCDs ( 62) To provide guidance to Member States on the development of national targets and indicators based on national situations ( 63) To provide input to Secretary-General's report to the General Assembly on options for strengthening and facilitating multisectoral action for the prevention and control of NCDs through effective partnership ( 64) To provide input to the Secretary-General's report on the progress achieved ( 65) WHO Director-General

18 Lessons Learned Long time-frame and sustainable funding needed visible output requires visible input Preventive dose not achieved scaling up Focus mainly on community mobilization, public health - health care system not fully mobilized sustainability Link up with other targeted prevention initiatives and combine strategies whenever possible (CHHI, Diabetes, Canadian Strategy on Cancer Control )

19 Towards Integration - Challenges Need to create an Observatory function and database of best practices for integrated approaches Integrated evaluation framework Dissemination through effective usage of IT and other mechanisms (e.g. G-8 Heart Health Telematics Project) Intersectoral collaboration New alliances between public health and clinicians Comprehensive approach to chronic disease across the continuum of care Integrate in the population health agenda... A National Strategy for integrated chronic disease prevention

20 Thank you