The High-Level Meeting on the Prevention and Control of Noncommunicable Diseases (NCDs) was held in connection with the opening days of the UN General Assembly, on Monday and Tuesday, 19 to 20 September. The slogan that seemed to fit the occasion is the African proverb, “If you want to go fast, go alone; if you want to go far, go together”.
In anticipation of the High-Level event, New York City featured an array of initiatives for healthier lifestyles in the form of a “Wellness Week”. Sponsors included the New York Academy of Medicine, the City College of New York, the Pan American Health Organization, the World Economic Forum and Humana, a US-based health care company. It will be recalled that NCDs include diabetes, heart disease, lung cancer and other chronic diseases that are not only bringing about an increasing scourge of premature and painful death and disability throughout the world; they are also chronic diseases that can be prevented or controlled by better diet, regular physical activity, reducing alcohol consumption and stopping tobacco use. (It is worth noting that the persistent efforts of several NGOs to have mental health included among the NCDs has been successful – and it is included in the Political Declaration for the Summit.) The Wellness Week events included free bicycle riding in Central Park, health walks, exercise routines, systems for tracking fitness goals and healthy diets, information on stopping smoking and community-based support services.
The Political Declaration from the High-Level Meeting on the Prevention and Control of Non-Communicable Diseases was formally adopted by the UN General Assembly on 19 September 2011 at the beginning of the two-day meeting, with 34 heads of state in attendance. The time allotted for the plenary sessions had to be extended in order to accommodate more speakers than had been anticipated, and well over 40 side events were held throughout the city. We note that it was impossible to attend all of the sessions that covered sports and physical activity, nutrition and diet, anti-tobacco campaigns, changing demands on health care professionals, access to medicines and technologies, learning from the HIV/AIDS experience, impact of gender on NCDs, the impact of climate change on NCDs – the list goes on…. A continuing theme among these topics was the inter-action between government action and other stakeholders, and we learned a lot about the importance of public sector leadership and examples of cooperation involving civil society and private sector actors. A related theme was building from existing platforms on infectious diseases, child survival and maternal health to provide cancer screening or insulin to people with diabetes. Council member Herb Riband from Medtronic moderated one such panel for the Global Health Council.
In addition, numerous other side events provided platforms for the many interest groups that have mobilized around the NCD campaign. One especially interesting one was about the role of mobile phones and social media, a side event that highlighted the “Get the Message” campaign supported by the Healthy Caribbean Coalition in some 17 countries, working with mobile phone companies to get people to send text messages in support of the High-Level Meeting. Sir George Alleyne from Barbados and the “father” of the High-Level Meeting, wrapped up this session by noting the enthusiasm of the young people involved in the GTM campaign and of all who are working together to promote awareness and action. Sir George emphasized that the controversy raised by some NGOs about the role of the private sector was symptomatic of a very bad trend. While it is widely accepted that the tobacco industry is not a suitable partner in all of this, the diversity of the private sector merits our appreciation. The “marvelous role” of many in the private sector, as he described it, is fundamental to the goal of “going far”. None can claim to be perfect, but ALL are needed in this campaign.
Another advocate of multi-stakeholder cooperation was Julio Frenk, the former Mexican health minister and current dean of the Harvard School of Public Health who was a popular featured speaker at these side events. As he regularly pointed out, it was most important that the summit was happening at the UN and not the WHO, and thereby linking NCDs to the larger development and security environment. In fact, he argued, NCDs aren’t really non-communicable – since their dissemination is through risk factors associated with contemporary social networks (overeating, unhealthy foods, smoking, drinking too much and sedentary lifestyles). For that reason, we need a comprehensive response to health promotion, risk prevention and disease prevention; universal access to high quality services with financial protection; and innovation in health systems delivery. Mr. Frenk shared the view that we need to create mechanisms to make markets work to deliver this comprehensive response. While business groups will typically say that voluntary self-regulation is better than government regulation, Mr. Frenk emphasized that any regulatory framework should enable business to operate. Meanwhile, in the next phases of the NCD campaign, the tasks will be building a consensus on targets and indicators and on partnerships by the end of 2012, promote national action plans by 2013 and prepare for a review exercise at the UN in 2014.
Another feature of the side events surrounding the High-Level Meeting was the launching of specialized reports and publications on NCDs. The main event, to be sure, was the High-Level Meeting itself and the promulgation of the Political Declaration to define the contours of a global campaign. We are impressed with this achievement, since it is only the second health issue to be addressed by the UN General Assembly in this way (the first having been HIV/AIDS ten years ago). The “NCD Alliance” which came together just two years ago, bringing together the disease-specific international federations (diabetes, cancer, heart and lung diseases) to campaign for the convening of this High-Level meeting, has formed the core of the effort from civil society groups. From the NCD Alliance, new publications on access to essential medicines and technologies, priorities for health systems, NCDs as a rights-based movement and tobacco control, among others were announced at their all-day briefing on Saturday, 17 September. An important study sponsored by the World Economic Forum on the cost of inaction ($37 trillion over the next twenty years) came out at a Sunday event, along with a new WHO study on the modest costs of taking action to prevent and control NCDs ($11.4 billion per year, and averaging a sliding scale of small per capita costs even for the poorest of countries). The World Bank was also launching its report on the merits of prevention in developing countries and announcing its $10 billion portfolio on health, nutrition and population projects at another event during the week.
Earlier, it should be noted, the WHO had issued its survey of NCD prevalence by country as a baseline for the campaign. Numerous events throughout the week in New York were also scheduled to promote WHO recommendations for monitoring and performance indicators, universal coverage and the relationship to the campaign against HIV/AIDS. See details HERE. We encourage readers to take a look at these various publications.
We conclude by highlighting a few other pronouncements. First, the World Health Professionals Alliance has prepared the WHPA Health Improvement Card, a simple, universal educational tool to assess and record lifestyle/behavioural and biometric risk factors. It is part of the WHPA strategy to encourage a holistic approach and reform of health delivery systems worldwide to focus on prevention, treatment, rehabilitation and research. Another pronouncement pertains to the open consultation launched by the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) on a framework for action to tackle NCDs. The proposed framework itemizes commitments regarding innovation and research, access and affordability, prevention and health education and partnerships and solicits comments and suggestions online through Friday, 7 October 2011.
Click HERE to see the latest political declaration.