Transcript Slide 1

Raising the priority of noncommunicable diseases
in development work at global and national levels
Page 1
Presentation for discussion
(Not an official document)
Four types of noncommunicable diseases are largely preventable by means of
effective interventions that tackle shared modifiable risk factors
Causative risk factors
Noncommunicable diseases
Tobacco
use
Unhealthy
diets
Physical
inactivity
Harmful
use of
alcohol
Heart disease
and stroke
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


Diabetes




Cancer




Chronic lung
disease

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fact
60% of the world's annual deaths are due to noncommunicable diseases.
Approximately 25% of these deaths are premature and could be prevented
10%
70 million
60 million
5.8 M
26.0 M
50 million
(above the age of 60)
40 million
20 million
Source:
30 million
35 million
(60% of all deaths)
9.0 M
25% of 35 million
(below the age of 60)
18.0 M
10 million
0
Total number of deaths in the world (2004)
Group III - Injuries
Low-income countries
Group II – Other deaths from noncommunicable diseases
Group II – Premature deaths from noncommunicable diseases (below the age of 60), which are preventable
Group I – Communicable diseases, maternal, perinatal and nutritional conditions
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fact
More people die from heart diseases and strokes in the poorest developing countries
than in the richest industrialized countries
8.2 m
9.0 m
2030
2.6 m
3.8 m
6.1 m
7.3 m
2015
Source:
2.6 m
3.4 m
Low income countries
5.1 m
6.5 m
2004
2.4 m
2 million
Upper middle-income countries
High income countries
3.0 m
0
Lower middle-income countries
4 million
6 million
8 million
10 million
Estimated deaths from cardiovascular diseases (2004)
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In all developing countries, premature deaths from noncommunicable diseases account for a
large enough share of the disease burden to merit a serious policy response
fact
The top-10 leading causes of death
Low-income countries
Middle-income countries
High-income countries
•
•
•
•
•
• Stroke and other cerebrovascular disease
(14.2%)
• Coronary heart disease (13.9%)
• Chronic obstructionary pulmonary disease
(7.4%)
• Lower respiratory infection (3.8%)
• Trachea, bronchus, lung cancers (2.9%)
• Road traffic accidents (2.8%)
• Hypertensive heart disease (2.5%)
• Stomach cancer (2.2%)
• Tuberculosis (2.2%)
• Diabetes mellitus (2.1%)
• Coronary heart disease (16.3%)
• Stroke and other cerebrovascular diseases
(9.3%)
• Trachea, bronchus, lung cancers (5.9%)
• Chronic obstructive pulmonary disease
(3.5%)
• Alzheimer and other dementias (3.4%)
• Colon and rectum cancers (3.3%)
• Diabetes mellitus (2.8%)
• Breast cancer (2.0%)
• Stomach cancer (1.8%)
•
Source:
•
•
•
•
Lower respiratory infections (11.2%)
Coronary heart disease (9.4%)
Diarrhoeal diseases (6.9%)
HIV/AIDS (5.7%)
Stroke and other cerebrovascular diseases
(5.6%)
Chronic obstructive pulmonary disease
(3.6%)
Tuberculosis (3.5%)
Neonatal infections (3.4%)
Malaria (3.3%)
Premature and low birth weight (3.2%)
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2 million
1 million
3 million
4 million
5 million
0
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High blood pressure
Tobacco use
High blood glucose
Physical inactivity
Unsafe sex
Underweight
High cholesterol
Overweight and obesity
Alcohol use
Indoor smoke from solid fuels
Unsafe water, sanitation, hygiene
Low fruit and vegetable intake
Sub-optimal breastfeeding
Urban outdoor air pollution
Occupational risks
Vitamin A deficiency
Zinc deficiency
Unsafe health care injections
Iron deficiency
Illicit drug use
Unmet contraceptive need
Global climate change
Lead exposure
Child sexual abuse
fact
The risk of dying in developing countries from causes attributable to high-blood pressure,
tobacco use, high blood glucose or physical inactivity
Attributable deaths in developing countries by risk factor
7 million
6 million
Without action, Africa will witness the largest increase in deaths from
noncommunicable diseases in 2015 (vs 2004)
2.5 million
fact
30%
25%
2.0 million
20%
1.5 million
15%
1.0 million
10%
5%
0%
0
Africa Americas East.
Med
Europe South- Western
East Pacific
Asia
Africa Americas East. Europe South- Western
Med
East Pacific
Asia
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Noncommunicable diseases are among the leading causes of death among women in
developing countries, as well as high-income countries
10 leading causes of deaths in females (2004)
Source: WHO's report on "Women and Health: today's evidence, tomorrow's agenda"
fact
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At household level, noncommunicable diseases are affecting the
poorest people in developing countries disproportionally
Poverty at
household level
fact
Populations in low- and middle-income countries
Globalization
Urbanization
Population ageing
Increased exposure to common modifiable risk factors:
Unhealthy diets
Physical inactivity
Tobacco use
Harmful use of alcohol
Noncommunicable diseases:
Cardiovascular diseases
Cancers
Diabetes
Chronic respiratory diseases
Loss of household income
from unhealthy behaviours
Loss of household income
from poor physical status
Limited access to effective and equitable health-care services
which respond to the needs of people with noncommunicable diseases
Loss of household income
from high cost of health care
14 million people die prematurely each year
in developing countries from noncommunicable diseases
Poverty contributes to noncommunicable diseases and noncommunicable diseases contribute to poverty
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fact
Noncommunicable diseases are the third largest global risk in terms of likelihood and
the fourth largest global risk in terms of economic severity
Oil spikes
Retrenching from globalization
Asset price collapse
Noncommunicable diseases
Food price volatility
Financial crisis
"A problem neither the developed world
nor the developing world can afford"
"Declining development assistance has
already led to a significant reduction of
public spending on health in many
countries. When funds are limited,
governments tend to focus on basic health
services, in line with the MDGs, at the
expense of the prevention and treatment of
noncommunicable diseases."
(WEF Global Risk 2010 Report)
Infectious diseases
World Economic Forum:
Global Risk 2010 Report
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fact
In developing countries, more than 8 million premature deaths from
noncommunicable diseases per year are omitted from the MDGs
60 million
50 million
40 million
5.3 M
20.0 M
14.2 M
20 million
Source:
30 million
8.1 M
17.4 M
10 million
0 million
Not covered by the MDGs:
More than 8 million premature deaths from
noncommunicable diseases
Total number of deaths in low- and middle-income countries (2004)
Group III - Injuries
Low-income countries
Group II – Other deaths from noncommunicable diseases
Group II – Premature deaths from noncommunicable diseases (below the age of 60), which are preventable
Group I – Communicable diseases, maternal, perinatal and nutritional conditions
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fact
International development agencies have been slow in responding to the call
to raise the priority accorded to noncommunicable diseases in development work
Health ODA Commitments (2007) in US$ billions
HIV/AIDS & STDs
Health Policy & Admin. Management
Infectious Disease Control
Reproductive Health
Basic Health Care
Malaria Control
Family Planning
Tuberculosis Control
Basic Nutrition
Medical Services
Basic Health Infrastructure
Medical Research
Medical Education/Training
Health Education
Water Supply/Sanitation - Large Systems
Water resources policy/admin. mgmt
Basic Drinking Water Supply & Sanitation
Waste Management/Disposal
River Development
Water Resources Protection
Water Education/Training
$7.40
$1.65
$1.33
$1.16
$1.14
$0.80
$0.53
$0.45
$0.33
$0.24
$0.23
$0.22
$0.21
$0.06
• Total Health ODA: $22.1 billion
• Health ODA for noncommunicable
diseases: 503 million (~2%)
There is no OECD/DAC Creditor Reporting System code
yet to track health commitments for the prevention and
control of noncommunicable diseases
$3.90
$0.93
$0.92
$0.42
$0.10
$0.06
$0.01
Source: Kaiser Family Foundation (www.kff.org/globalhealth)
(Based on analysis of data obtained via online query of the OECD Development Assistance
Committee (DAC) Database and Creditor Reporting System (CRS) on 31 May 2009)
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fact
In May 2008, WHO Member States started to mobilize a global response to address
noncommunicable diseases, with a particular focus on developing countries
2000
Global Strategy for the Prevention
and Control of Noncommunicable
Diseases
Global Strategy on Infant and Young Child Feeding
WHO Framework Convention on Tobacco Control
2002
2003
2004
2008
Global Strategy on Diet, Physical Activity
and Health
Action Plan on the Global Strategy for the Prevention and Control of
Noncommunicable Diseases
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The 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of
Noncommunicable Diseases was endorsed by the World Health Assembly in May 2008
fact
Six objectives:
1. Raising the priority accorded to noncommunicable
diseases in development work at global and national
levels, and integrating prevention and control of noncommunicable diseases into policies across all
government departments
2. Establishing and strengthening national policies and
programmes
3. Reducing and preventing risk factors
4. Prioritizing research on prevention and health care
5. Strengthening partnerships
6. Monitoring NCD trends and assessing progress made at
country level
Under each of the six objectives, there are sets of actions
for Member States, the WHO Secretariat and international
partners
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fact
Many public health leaders are calling on global development initiatives to take into account the
prevention and control of noncommunicable diseases
• Regional Ministerial Meeting on Health Literacy
(Beijing, 29-30 April 2009)
• Regional Ministerial Meeting on Noncommunicable
Diseases and Injuries, Poverty and Development
(Qatar, 10-11 May 2009)
• ECOSOC High-level Segment on Global Health
(Geneva, 6-9 July 2009)
• ECOSOC Ministerial Roundtable Meeting on Noncommunicable Diseases and Injuries (Geneva, 8 July
2009)
Doha Declaration on
Noncommunicable
Diseases
ECOSOC Ministerial
Declaration
Continuing discussions at the
UN General Assembly
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High-level forums are starting to call for the inclusion of
noncommunicable diseases into discussions on development
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fact
fact
At the occasion of the 2009 ECOSOC High-level Segment, WHO launched
a new global network to combat noncommunicable diseases (NCDnet) on 8 July 2009
Mission of
NCDnet:
Help implement the Action Plan by catalyzing a multi-sectoral, multi-level
response, with a particular focus on developing countries
Goals of
NCDnet:
●
●
●
Increase focus on prevention and control of noncommunicable
diseases through collective advocacy
Increase resource availability (both financial and human capital)
Catalyze effective multi-stakeholder action with a focus on countrylevel implementation
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NCDnet is composed of the WHO Secretariat staff, an International Advisory Council,
NCDnet Global and Regional Forum meetings and functional Working Groups
WHO
International Advisory Council
Funding/Resourcing
Mechanisms
Global/Regional Forum Meetings
Working groups
Advocacy
and
Communications
Innovative
Resourcing
Mechanisms
Monitoring and
evaluation
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Partnership
capacity
building
fact