Translation of Research Findings for Prevention and Control of NCDs Shanthi Mendis Chronic Disease P

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Translation of Research Findings for Prevention
and Control of NCDs Shanthi MendisChronic
Disease Prevention and Management World Health
Organization
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Translation of Research Findings (Evidence) into
national NCD policies and programs in low- and-
middle- income countries

• Does evidence exist to inform NCD policies?
• How can evidence be translated into policies?

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Global mortality Major NCDs Heart disease,
Stroke, Cancer, Diabetes, asthma
Communicable maternal infant 30
Other NCDs, injuries mental health 18
Cancer 13
Diabetes 2
Asthma/COPD 7
Cardiovascular diseases
30
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What research findings do we have ?

• Research has found the causes of major NCDs.
• Research findings on effective interventions
  that
• protect the population from NCDs
• address people with NCDs or at high risk
• These interventions have been effectively
  implemented in developed countries to reverse
  NCD trends.

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What are the evidence informed NCD Policies ?

• Promote physical Activity
• Promote fruits/vegetables intake
• Reduce salt and fat intake
• Control tobacco
• Early detection and management

National NCD Policies
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Potential Impact of evidence based NCD policies

• Reduce recurrent heart attacks and strokes 75
• Reduce mortality from heart disease 50
• Reduce mortality from cancer, asthma, COPD
• Reduce health care costs
• Reduce social and macroeconomic costs

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Wider determinants of NCD
Housing
Employment
Environment For healthy living
Education health literacy
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Projected Mortality Trends 2000-2030
Cancers
Ischaemic HD
Stroke
Acute respiratoryinfections
Road trafficaccidents
Perinatal
HIV/AIDS
TB
Malaria
Projected global deaths (2004-2030) Global
Burden of Disease 2004 data
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Gap in Knowledge Translation

• What are the challenges for evidence informed
  policy making?
• What factors affect the policy environment ?
• How can policy making be made more open to the
  influence of evidence ?

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Challenges

• Intersectoral nature of NCD policies
• Associated with the pressures of globalization
• Constraints to knowledge translation
• control tobacco e.g. increase in tobacco tax
• reduce salt/fat intake e.g. agreement with food
  industry
• promote healthy eating e.g. regulate fast food
  chains
• increase fruits/vegetable intake e.g.
  agriculture subsidies

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Per capita expenditure on health (International
dollars )
Expenditure Number of countries
33 25 72 24 19 18
Less than 50 50 99 100-499 500-999 1000-1999
gt2000
LMIC lt 5 of GDP on health aim at 10-15

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Evidence informed policy making
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Political, Social, Economic and other Factors
that influence policy making
Governments that encourage policy debate
Governance Legislation, mandatory regulations
Partnerships Networks
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The Need for Partnerships and Governance
Food labelling

• Governance e.g. mandatory regulations or
  supervisory bodies

Partnership with industry to reduce salt in
processed food
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Partnerships are key

• Causes/solutions often outside health systems
• Need to look across society for the solutions
• Work intersectorally across ministries
• Alliances and coalitions, public/private

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Evidence informed NCD policies
Researchers
Technocrats and civil Servants
Need for Knowledge brokers
Evidence makers
Policy makers
e.g. Loose networks Lobbying NGO or civil society
groups Media Professional associations Community
organizations
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Empowerment of the community
New ways to engage people so that they can
influence policy

• Radio
• Internet
• Mobiles
• Interactive TV

Improve Health Literacy - Helping People to

• Support evidence informed policy making

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How can networks Influence policy process ?
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Need to Strengthen Country Capacity For
Broader Intersectoral Approaches to Research and
Knowledge Translation that goes beyond the health
sector
Source Potter and Brough (2004).
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World Health Organization Tools for translation
of evidence into policies

• Action Plan for Prevention and Control of NCD
• Framework Convention on Tobacco Control
• Global Strategy for Diet, Physical activity and
  Health Primary Care Package of Essential NCD
  interventions

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Conclusions

• Requirements for prevention and control of NCDs
  
• Broader intersectoral approaches to research
• Translation of research findings into policies
• Recognition of the widespread failure to
  implement evidence-based Health Interventions

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Conclusions

• For prevention and control of NCDs we need
• To find better ways for evidence informed policy
  making
• Partnerships to support intersectoral policies
• Networks to link researchers and technocrats
• Strong role of the State and better governance
• Knowledge translation that goes beyond the health
  sector

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Health in all Policies
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THANK YOU