Transcript Roadmap

Update on noncommunicable diseases
Towards the UN High level
Meeting…
2000- 2010 - impressive number of high-level regional and global meetings,
organized by the WHO or by the UN General Assembly recognizing the
growing public-health burden imposed by NCDs:
– Resolution (53.17) of the World Health Assembly
– Action plan for the global strategy for the prevention and control of
NCDs endorsed by the WHA
– Resolution on the prevention and control of the NCDs by the 64th
session of the UN General Assembly.
– Resolution (65/238) on the scope, modalities, format and organization of
the high-level meeting on NCDs - UN General Assembly
– Global or regional meetings, ministerial meetings - Beijing, Doha,
Geneva, Port-of-Spain, Copenhagen, Teheran, Oslo, Nadi/Fiji, Mexico
City, Jakarta, Seoul, Brazzaville, Moscow, New York, Washington,
– WHO's Global status report on NCDs
– Wide consultations and discussions: 6 WHO Regional meetings; 5
informal consultations with civil society and the private sector
Global Ministerial Conference on Healthy Lifestyles and NCD Control
(Moscow, 28-29 April 2011)
•
First global ministerial conference focussing solely on NCDs: More
than 150 governments and 95 Ministers of Health attended.
•
Goals: To raise political awareness about the importance and
potential of NCD prevention and control, and to highlight the essential
need for intersectoral action.
•
High-level sessions to profile available instruments, strategies and
policies, and to foster international cooperation and coordination.
•
Interactive roundtable sessions to exchange successful approaches
and lessons learned.
•
Participants adopted the Moscow Declaration, which calls for the full
and effective implementation of the NCD Action Plan, and for
supporting WHO in developing a comprehensive global monitoring
framework for NCDs, particularly in preparation for the High-level
Meeting.
•
A summary report of the Conference will serve as an input to the
preparatory process leading towards the High-level Meeting on NCDs
in September 2011.
34 Presidents and PrimeMinisters
3 Vice-Presidents and
Deputy Prime-Ministers
51 Ministers of Foreign
Affairs and Health
11 Heads of UN Agencies
100s of NGOs
Establish multisectoral
national plans by 2013
Integrate NCDs into
health-planning
processes and the
national development
agenda
Promote multisectoral
action through health-inall policies and wholeof-government
approaches
Build national capacity
Increase domestic
resources
One-WHO work plan
113 Member States
Political Declaration
High-level Meeting
UN High-level Meeting on NCDs
(New York, 19-20 September 2011)
Set norms and
standards
Exercise a leading and
coordinating role within
the UN system
Develop a global
implementation plan
2013-2020
Expand technical
competence and
resources
Scale up technical
assistance
Work streams established by the WHO Secretariat
Technical assistance to developing countries
to support national efforts
Exercise WHO's leadership and coordination role
in relation to UN Agencies
Develop a global monitoring framework and
global voluntary targets for NCDs
Articulate options for multisectoral action for the prevention
and control of NCDs through effective partnership
Develop an updated global action plan for the development
and control of NCDs (2013-2020)
WHO-wide work plan 2012-2013 on NCDs
Technical assistance to
developing countries
to support national efforts
I. Scaling up technical assistance for the prevention and control of
NCDs to meet the demand from developing countries
Analysis of 144 Country Cooperation Strategies
Number
Promoting risk reduction, prevention, treatment and monitoring of
noncommunicable diseases, mental health, disability and injuries.
136
Strengthening the structure, organization and financing of health systems,
with a particular focus on achieving universal coverage, strengthening
human resources for health and increasing access to medical technologies
including medicines.
134
Supporting the achievement of the health-related Millennium Development 119
Goals (primarily Goals 4, 5 and 6) bringing together HIV/AIDS, tuberculosis,
malaria, and maternal and child health, with a focus on integrated service
delivery.
Surveillance of, and response to, disease outbreaks and acute public health
emergencies, and the effective management of humanitarian disasters.
119
The Bloomberg Initiative to
Reduce Tobacco Use
Objectives of the Bloomberg Initiative to
Reduce Tobacco Use
 Bloomberg Philanthropies’ $375 million, six-year investment aims to accelerate
the worldwide movement to combat tobacco use through a focused effort in
the countries with the highest tobacco burden.
 Specifically, the Bloomberg Initiative to Reduce Tobacco Use (BI) supports
work to promote the MPOWER package of six tobacco control interventions.
 5 core partner organizations:
– Campaign for Tobacco Free Kids
– US Centers for Disease Control and Prevention Foundation
– Johns Hopkins Bloomberg School of Public Health
– International Union Against Tuberculosis and Lunch Disease
– WHO
 Mayor Bloomberg announced in March the continuation of BI for at least the
next four years, with a USD 220 million commitment for 2013-2016
Exercise WHO's leadership and
coordination role
in relation to UN Agencies
Integrating NCDs into UNDAF processes
http://www.who.int/nmh/highlights/undaf/en/index.html
Development of a comprehensive
global monitoring system,
including indicators, and
voluntary global targets for the
prevention and control of NCDs
Political Declaration on NCDs (resolution A/RES/66/2)
61. Call upon WHO,…to develop before the end of 2012, a
comprehensive global monitoring framework, including a set of
indicators,……, to monitor trends and to assess progress made in
the implementation of national strategies and plans on NCDs.
62. Call upon WHO,.. to prepare recommendations for a set of
voluntary global targets for the prevention and control of
NCDs, before the end of 2012.
Process: Next steps
2012
2012
• 25 July 2012 – 19 October 2012: Relevant global NGOs and selected private sector entities
are invited to submit their views by email ([email protected]) on the revised WHO
Discussion Paper
• September – October 2012: Discussions at the WHO Regional Committees
2012
• End of October 2012: WHO Secretariat will publish a report summarizing the outcomes of
the discussions at the Regional Committees and the views received from relevant global
NGOs and selected private sector entities
2012
• 5-7 November 2012: Formal meeting with Member States and UN agencies to conclude the
work
2012
• January 2013: WHO Secretariat will submit a report on the final recommendations to the
Executive Board
2013
• May 2013: WHO Secretariat will submit a report with the final recommendations to the
World Health Assembly
Comprehensive Global Monitoring Framework for NCDs
Outcomes
Exposures
Health system response
• Cancer incidence,
by type
• Premature
mortality from
cardiovascular
disease, cancer,
diabetes, or chronic
respiratory disease
• Alcohol
• Fat intake
• Low fruit and vegetable intake
• Overweight and obesity
• Physical inactivity
• Raised blood glucose
• Raised Blood pressure
• Raised total cholesterol
• Salt/sodium intake
• Tobacco
• Cervical cancer screening
• Drug therapy to prevent heart attacks
and strokes
• Essential NCD medicines and
technologies
• Palliative care
• Policies to eliminate PHVOs from food
supply
• Policies to reduce marketing of foods to
children
• Vaccination against infectious cancers
11 voluntary global targets presented in the revised WHO Discussion Paper
Premature mortality from NCDs
25% reduction
Raised blood
pressure
25%
Obesity
0%
Salt/
sodium intake
30%
Tobacco smoking
30%
Fat intake
15%
Alcohol
10%
Raised
cholesterol
20%
Physical inactivity
10%
Generic
medicines and
technologies
Drug therapy
and
counselling
80%
50%
Target adopted by the World Health Assembly
Targets with wide support
Targets with support for further development
Articulating options for
strengthening multisectoral
action for the prevention
and control of NCDs through
effective partnerships
WHO's input into the Secretary-General's report
Note by the SG transmitting the report of the WHO DG:
Global partnership options for the prevention and control of NCDs
Option 1 – Aligned independent efforts
 Organic model: Activities to evolve without coordination or shared strategy
 WHO to host a forum (or series of fora) to invite interested parties to express commitment and to
seek partnerships
Option 2 – Social movement:
 Multistakeholder model: governments, NGOs, private sector, people living with NCDs
 WHO to forge a social movement to direct national and global efforts towards national
multisectoral policies and plans for the prevention and control of NCDs
Option 3 – Coordinated network
 Networked model: Cultivate a hub-and-spoke of coordinated collaborative arrangements
 WHO to establish a small Secretariat (based on UN Road Safety Collaboration)
Option 4 – Merger (a loose coordinated network around a social movement for NCDs)
 A merger of options 1, 2 and 3
Option 5 – Centralized, formal partnerships
 Vertical model: Large, centralized organization with a limited-time response and instigating
parallel structures in countries
 WHO to establish a single centralized partnership
Development of a
global action plan for the
prevention and control of NCDs
covering the period 2013-2020
The World Health Assembly has requested WHO to develop a
'WHO Action Plan for the Prevention and Control of NCDs for 2013-2020'
2000
2003
2004
2008
Global Strategy for the Prevention and
Control of Noncommunicable Diseases
Global Strategy on Diet,
Physical Activity and Health
Action Plan 2008-2013 on the Global Strategy for the
Prevention and Control of NCDs
Global Strategy to Reduce
the Harmful Use of Alcohol
2009
WHO Global Status
Report on NCDs
2010
2011
Political Declaration on NCDs
2013
2020
WHO Action Plan for the Prevention and Control of NCDs for 2013-2020
World Health Assembly resolution WHA64.11
REQUESTS THE DIRECTOR-GENERAL TO:
(4) to report to the Sixty-fifth World Health Assembly,
through the Executive Board, on the outcomes of the
first Global Ministerial Conference on Healthy Lifestyles
and NCD Control and the high-level meeting, and to
develop, together with relevant United Nations
agencies and entities, an implementation and followup plan for the outcomes, including its financial
implications, for submission to the Sixty-sixth World
Health Assembly, through the Executive Board.
(24 May 2011)
WHO Executive Board resolution EB130.R7
2. REQUESTS the Director-General:
(4) to develop, in a consultative manner, a WHO action plan for the
prevention and control of NCDs for 2013–2020, building on
lessons learnt from the 2008–2013 action plan and taking into
account the outcomes of the High-level Meeting of the United
Nations General Assembly on the Prevention and Control of
NCDs, the Moscow Declaration on Healthy Lifestyles and NCD
Control, the Rio Declaration on Social Determinants of Health,
building on and being consistent with existing WHO strategies
and tools on tobacco use, harmful use of alcohol, unhealthy diet
and physical inactivity;
(20 January 2012)
Process: Next steps
2012
• 26 July 2012 – 7 September 2012: Web-based consultation for Member States,
UN Agencies, NGOs and private sector entities (WHO Discussion Paper)
2012
• 16-17 August 2012: First informal consultation with Member States and UN
Agencies (WHO Discussion Paper)
2012
• 1 November 2012: Second informal consultation with Member States and UN
Agencies ('Annotated Zero Draft' Action Plan)
2013
2013
2013
• January 2013: Executive Board (Annotated Draft Action Plan)
• February 2013: Third informal consultation with Member States and UN
Agencies (Draft Action Plan)
• May 2013: World Health Assembly (Final Draft Action Plan)
2008-2013 Action Plan for the Global Strategy for the
Prevention and Control of NCDs
1. Integrating NCD prevention into
the development agenda, and
into policies across all
government departments
2. Establishing/strengthening
national policies and programmes
3. Reducing/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
Development of the 2013-2020 Action Plan:
Possible structure
Vision
To reduce the avoidable global NCD burden and its impact so that people can
reach the highest achievable levels of health and productivity
Goal
To reduce the toll of morbidity, disability and premature mortality from NCDs
Overarching Global Target
12.5% reduction in premature mortality from noncommunicable diseases by
2020
Cross-cutting principles
• Human rights
• Universal coverage and equity
• Life course approach
• Evidence-based practice
• Empowerment of people
Development of the 2013-2020 Action Plan:
Possible structure
Objectives
1. To raise priority accorded to prevention and control of NCDs in
the development agenda
2. To strengthen capacity, leadership, governance, and
accountability to accelerate country response for prevention
and control of NCDs
3. To promote a whole-of-Government approach and
multisectoral action for NCD prevention and control
4. To reduce modifiable risk factors for NCDs and create health
promoting environments
5. To strengthen and reorient health systems to address NCD
prevention and control through people- centered primary care
and universal coverage
6. To monitor and evaluate progress of prevention and control of
NCDs
Timelines to complete
the work under way in
the area of NCDs
Timelines
Formal consultation with Member States
to conclude the work on a global
monitoring framework and targets
16-17 Aug
1st informal consultation on action plan
1 Nov
2nd informal consultation on action plan
WHO's input into SG's report on
options for strengthening and
facilitating multisectoral action for the
prevention and control of NCDs
through effective partnership
Options and a time line for
multisectoral action through
partnerships
Development of a global
monitoring framework and
targets for NCDs
SG's report on options for
strengthening and facilitating
multisectoral action for the
prevention and control of NCDs
through effective partnership
SG's report on the progress
achieved in realizing the
commitments made in the
Political Declaration
Global monitoring framework,
indicators and and targets for
NCDs
WHO Global Status Report
on NCDs (2013)
WHO Action Plan for the
prevention and control of NCDs
for 2013-2020
3rd informal
consultation
on action plan
Comprehensive review and
assessment of the progress
achieved in the prevention and
control of NCDs
Final progress report on
implementing the 2008-2013
action plan
WHO's input into SG's report
on the progress achieved in
realizing the commitments
made in the Political
Declaration
Nov/
Dec 2013
Dec 2012
2014
Feb/Mar 2013
Sep 2013
5-7 Nov 2012
Jan-May 2014
WHA
27 August 2012
Jan-May 2013
Political Declaration of the High-level Meeting of the
General Assembly on the Prevention and Control of NCDs
EB/WHA
Jan-May 2012
EB/WHA
(resolution A/RES/66/2)
2014
GA
NCD Action Plan
Planning and
oversight
Health in all
policies
Healthy
settings
Secondary
prevention
Workplaces and
schools
Cardio-metabolic
risk assessment
and
management
Active mobility
Early detection
of cancer
Fiscal policies
National plan
Marketing
Health
information
system with
social
determinants
disaggregation
Salt
Trans-fat
Thank you