Transcript Sustainable Development and NCDs
Sustainable Development and NCDs
George Alleyne April 18, 2012 Pan American Health Organization
Presentation
Concept of sustainable development
Sustainable Human Development (SHD)
What makes it sustainable?
The place of health
SHD and NCDs
NCDs in LAC
NCDs in Rio+ 20
Conclusions
Rachel Carson 1907-1964 Only within the moment of time represented by the present century has one species -- man -- acquired significant power to alter the nature of his world ( The Silent Spring, 1962
)
Gro Harlem Brundtland “ Our Common Future” The World Commission on Environment and Development (1987 ) Sustainable development : “ Development that meets the needs of the present without compromising the ability of future generations to meet their own needs”
Sustainable development
Our Common Future
“ The concept of sustainable development does imply limits –not absolute limits, but limitations imposed on environmental resources and by the ability of the biosphere to absorb the effects of human activities”
Rio-UNCED 1992
“The spirit of the conference was captured by the expression "Harmony with Nature", brought into the fore with the first principle of the Rio Declaration: "Human beings are at the centre of concerns for sustainable development. They are entitled to a healthy and productive life in harmony with nature".
Johannesburg 2002
The Johannesburg Declaration created “a collective responsibility to advance and strengthen the interdependent and mutually sustainable reinforcing pillars of development —economic development, social development and environmental protection —at local, national, regional and global levels.
”
Of what? Of whom?
view Development of what?
Development of whom?
“Development has a face, and that face is the face of man” Dr. Eric Williams (1973) PM Trinidad and Tobago
Other graphical representations
Human development
Social Economic Environment
Current basic concepts
Sustainable development is NOT only about the environment preservation of natural resources
The definition characterizes sustainability and NOT development
We must characterize development as Human Development
Mahbub Ul Haq “Human development is a process of enlarging people’s choices. The most critical ones are to lead a long and healthy life, to be educated and to enjoy a decent standard of living
.”
Development can be seen, it is argued here, as a process of expanding the real freedoms that people enjoy
Capabilities-what are persons able to be and do-their substantial freedoms
The most important things in life.
(% responses) Male Female Total Good health Happy family life 42 36 Employment 30 Live in a country without war 14 40 40 27 19 44 38 27 17 Source: Millennium Gallup Poll 1999
Health is an end of Human Development
Health is an instrument of Human Development
Health is one component of the social strand ( health, education, political freedom etc)
NCDs can make human development unsustainable through negative impact on health as well as on the three strands of the helix
Therefore: the control and prevention of NCDs must figure in any goal for sustainable human development
NCDs on sustainability strands
NCDs Social Economic Environment Note also the reverse causality
Impact on social strand
Equity unfair distribution of life chances-inequity disproportionate impact on the poor
Social cohesion stigma and discrimination-esp. cancer and diabetes chronic care –social fraction Gender
early male death-widowhood and poverty Education
Impact on economic strand
Effect on macroeconomy eg 37 $trillion dollars over next 2 decades( Bloom) impact on GDP
Effect on microeconomy poverty and preventing escape from poverty trap
Fiscal consequences Increased government expenditure in care, pensions etc; reduced government revenue
Impact on environmental strand
Difficult ? Impossible to show any direct impact of NCDs on the environment.
However, it is possible to show impact of the NCD risk factors on the environment e.g
-Tobacco production and climate change -Food production and climate change.
(livestock production responsible for 18% global GHG-more than transportation )
NCDs in the Americas
Total NCD Deaths 2009: 4.5 Million Source PAHO
In most countries of LAC
Almost half of those with diabetes and one third of those with hypertension are undiagnosed
More than half of those with diagnosed diabetes and one fourth of those with diagnosed hypertension are uncontrolled
Almost one third of those with diagnosed diabetes and half of those with diagnosed hypertension do not take appropriate medication Source: PAHO, population based surveys of NCD and risk factors
Strategies to address NCDs Society/environment Population based interventions; Primary prevention Clinical interventions Secondary prevention Individual
United Nations A/66/L.1
General Assembly
Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases 82 Countries 35 Heads of State Civil Society +++ Private Sector UN Agencies September 19-20, 2011
The Political Declaration Commitments:
Reduce risk factors
Strengthen policies and health systems
International cooperation
Partnerships
Research and development
Monitoring and evaluation
Follow-up
Earth Summit 2012
Objectives Themes
• • •
“Wish list” for Rio+ 20
Acknowledge NCDs as an “emerging challenge” Recognize the outcome of the New York UN HLM as one component for the objectives of Rio + 20 Incorporation into the Declaration the essentials of the commitments made in the UNHLM for NCDs
Conclusions
Our concern is sustainable human development
Health is an end as well as a means towards SHD
Human development is made sustainable by a helix of three strands-social, economic, environmental
NCDS impact adversely directly or indirectly on the three strands making HD unsustainable.
Thus the case for NCDs prevention and control figuring in sustainable human development