Transforming Health in the African Region Multi-Sectoral responses to Non- Communicable Diseases www.afro.who.int
THE WORLD S BIGGEST KILLER Non-communicable diseases (NCDs) leading cause of death in the world premature deaths occurring before the age of 70 Cardiovascular diseases account for most deaths, followed by cancer, respiratory diseases, and diabetes. These four groups of diseases account for 82% of all NCD deaths. NCDs grouped together because they share many of the same risk factors - smoking, physical inactivity, harmful use of alcohol and unhealthy diets.
AN UNFAIR BURDEN Almost three quarters of NCD deaths occur in LIMC burden falls most heavily on nations already grappling with communicable diseases, and with the least resources to fight back In the AFR region, the burden of NCDs will increase and by 2025 will become a major contributor to mortality if the current trend is unchecked. Double burden in ECSA Member States as most countries are faced with both Communicable and NCDs. Trends for NCDs on the raise hampering the socio-economic development of the countries.
AN UNFAIR BURDEN Projected Deaths from NCDs in the African Region in 2025 2010 40% of deaths in Africa from NCDs and injuries 2025 55% of deaths in Africa from NCDs and injuries 13% 7% 17% 8% 45% 20% 60% 30% Group I Communicable diseases, maternal, perinatal and nutritional conditions Group II Premature deaths from NCDs (below the age of 70), which are preventable Group III Other deaths from NCDs Group IV Injuries Group I Communicable diseases, maternal, perinatal and nutritional conditions Group II Premature deaths from NCDs (below the age of 70), which are preventable Group III Other deaths from NCDs Group IV Injuries
AN UNFAIR BURDEN 100 90 80 70 60 50 40 30 20 10 0 Proportional mortality (% of total deaths, all ages, both sexes) in ESA Total NCDs + Injuries Communicable, maternal, perinatal and nutritional conditions
40 35 30 25 20 15 10 5 0 Raised blood pressure (2008) Total alcohol per capita consumption, in litres of pure alcohol (2010) The Risk factors for NCDs are increasing in Africa 30 25 20 15 10 5 0 Obesity (2008) Raised blood Total alcohol per capita consumption, in litres of pure 6 Obesity
NCD AND POVERTY 3
NCD AND POVERTY Cost of inaction in middle- and lowcountries: US$ 7 trillion (2011-2025) Cost of action in middle- and low-countries: US$ 170 billion 3
THE OPPORTUNITY A 25% relative reduction in risk of premature mortality from cardiovascular disease, cancer, diabetes or chronic respiratory diseases At least a 10% relative reduction in the harmful use of alcohol A 10% relative reduction in prevalence of insufficient physical activity A 25% relative reduction in prevalence of raised blood pressure or contain the prevalence of raised blood pressure A 30% relative reduction in prevalence of current tobacco use Halt the rise in diabetes and obesity A 30% relative reduction in mean population intake of salt/sodium An 80% availability of the affordable basic technologies and essential medicines, incl. generics, required to treat NCDs At least 50% of eligible people receive drug therapy and counselling to prevent heart attacks and strokes
THE OPPORTUNITY Target 3.4 By 2030, reduce by one third premature mortality from NCDs through prevention and treatment and promote mental health and wellbeing. Target 3.5 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol. Target 3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents. Target 3.a Strengthen the implementation of the WHO FCTC in all countries, as appropriate. Target 3.b Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries.
THE RESPONSE Tobacco use Unhealthy diets Physical inactivity Harmful use of alcohol Heart disease and stroke Diabetes Cancer Chronic lung disease
THE RESPONSE Cardiovascular diseases Cancers Diabetes Chronic respiratory diseases Other NCDs
THE RESPONSE Health Agriculture Education Information Trade Finance Other relevant Government UN agencies WHO UNICEF UNFPA UN Women UNDP IAEA Others as relevant Private sector Civil societies National International NGOs CSO FBO Others
THE RESPONSE Sector Tobacco Physical inactivity Harmful use of alcohol Unhealthy diet Agriculture Communication Education Energy Environment Finance Food Health Housing Industry Justice/Security Legislature Transport Social/Welfare Sports Trade Urban planning
THE RESPONSE Five key elements that are integral to an effective Multisectoral coordination mechanism for NCDs High-level political leadership - authority and resources, monitors progress and ensures adherence to international commitments Clear scope and mandate for all the participating sectors. Strong secretariat and sectoral focal points. Costed joint work plan and earmarked funds required to ensure its seamless implementation. Robust accountability indicators. 3
THE RESPONSE Five key strategies to improve the involvement of relevant sectors Set the political agenda Generate evidence to make the business case Showcase benefits and share responsibilities Ensure joint accountability through process indicators Require periodic reporting to supra ministerial authority 3
THE RESPONSE 2018 3 rd HLM 2011 Moscow Declaration 2014 Outcome Document 2015 SDGs 2011 Political Declaration 2015 AAAA 3
THE RESPONSE By 2015: Set national NCD targets for 2025 or 2030 and monitor results By 2015: Develop a national multisectoral action plan By 2016: Implement the "best buy" interventions to reduce NCD risk factors By 2016: Implement the "best buy" interventions to strengthen health systems to address NCDs
THE RESPONSE Are countries making progress towards achieving the 9 voluntary targets and the four time-bound commitments? 3
THE RESPONSE Sign for optimism: o Realization of NCD epidemic Challenges of Multisectoral coordination o NCD unit/branch or department lack of high-level political commitment o o Growing interest for data Gradual multisectoral response Major bottlenecks: o o o o o EVD outbreak response Weak fiscal policies Interference of the industry Financial constraints Inadequate data & reporting mechanisms Divergent and occasionally conflicting mandates of stakeholder ministries. Insufficient involvement of civil society. Industry interference. Most countries in the region face multiple health and developmental challenges. NCDs tend to receive lesser political attention than to issues with visible and immediate ramifications such as epidemic outbreaks 3
THE RESPONSE Framing the Problem 1/Tackling NCDs helps to save lives 2/Tackling NCDs helps to reduce poverty 3/Tackling NCDs helps to save money 4/It is governments responsibility to lead the charge 5/Our greatest opportunity for impact is now As the world s number one killer, there is a critical imperative to fight NCDs, as well as reduce the morbidity and disability associated with them. Preventing and controlling NCDs fights poverty and unlocks citizens potential. It also helps governments to achieve the Sustainable Development Goals faster and more effectively. Tackling NCDs, especially through a Multisectoral approach to prevention, is a sound investment. It saves both lives and resources, allowing these resources to be allocated to other challenges. It s up to governments to create the healthy environments that protect people from tobacco, unhealthy food, harmful alcohol use and physical inactivity. With the nine targets agreed to, the SDGs in place, and countries everywhere proving the effectiveness of best buy policies, there has never been a better time to take on the NCDs. 3
THE WAY FORWARD Allocate commensurate resources Human and financial to NCD prevention and control Develop, implement, monitor & evaluate integrated National multisectoral NCDs prevention and control Action Plans Develop/scale up cost effective NCD prevention and control interventions ( best buys ) Implement/scale up cost effective health care (WHO PEN) to ensure Universal Health Coverage for NCDs at all levels. 3
THE WAY FORWARD Strengthen effective regulation of relevant industries e.g. banning advertising and marketing for tobacco, alcohol and sugar sweetened beverages Foster inter-sectoral and multisectoral collaboration/ coordination at country, regional and global levels Develop/strengthen comprehensive surveillance systems for NCDs and their risk factors (STEPS, GATS, GSHS, ) Engage/cooperate with non-health government sectors, non-state actors including UN organizations (UNDAF) to address NCDs and their RF 3
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