WHO Global Forum on NCD Prevention and Control Working Together for a Healthy Future

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Dr Pekka PuskaDirectorDepartment of NCD
Prevention and Health PromotionWorld Health
Organization, Geneva

• WHO Global Forum on NCD Prevention and Control
  Working Together for a Healthy Future
• Setting the Scene

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The World Health is in Transition
Epidemiological NCD overriding CD, double
burden of diseases in many developing
countries Demographic Population
ageing Lifestyles Diets are rapidly changing
Physical activity reducing Tobacco use
increasing Urbanization Growing cities
Globalisation Increasing global influences
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Death, by broad cause group 2000
Total deaths 55,694,000
Noncommunicable conditions (59.0)
Injuries (9.1)
Communicable diseases, maternal and perinatal
conditions and nutritional deficiencies (31.9)
Source WHO, World Health Report 2001
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Deaths, by broad cause group and WHO Region, 2000

75
50
25
Source WHO, World Health Report 2001
EMR
EUR
SEAR
WPR
AFR
AMR
Noncommunicable conditions
Communicable diseases, maternal and perinatal
conditions and nutritional deficiencies
Injuries
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World Deaths in 2000 attributable to selected
leading risk factors
Number of deaths (000s)
Source WHR 2002
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7 out of the 10 main risk factors relate to diet,
physical activity and tobacco

• Blood pressure
• Tobacco
• Cholesterol
• Fruit and vegetable intake
• Alcohol
• High BMI
• Physical Activity

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Lifestyle Transition

• Emerging epidemic of NCDs is to a great extent a
  consequence of rapid changes in the diets, of
  declining physical activity and of increase of
  tobacco use
• The determinants of these changes are
  urbanisation, changes in occupations and many
  global influences
• The transition concerns adults and children
• Risks are increasingly accumulating in lower
  socio-economic groups of the population

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NCDs are to a great extent preventable diseases

• Medical evidence for prevention exists
• Population-based prevention is the most
  cost-effective and the only affordable option for
  major public health improvement in NCD rates
• Major changes in population rates can take place
  in a surprisingly short time

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WHO Global Strategy on NCD Prevention and
Control, WHA 2000

• NCDs a priority
• Emphasis on prevention
• Integrated prevention targets risk factors
  common to several NCDs
• Tobacco
• Unhealthy diet
• Physical inactivity
• Endorses networks etc

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STRATEGIES TO REDUCE RISKWorld Health Report
2002 messages I

• Very substantial health gains can be made for
  relatively modest expenditures on interventions
• Changing population distributions of risk factors
  (like blood pressure, blood cholesterol) through
  general lifestyle changes
• CVD Population wide strategies to lower
  cholesterol (Quality of Fat) and blood pressure
  (Salt Reduction) key

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STRATEGIES TO REDUCE RISKWorld Health Report
2002 messages II

• Tobacco Higher taxes, comprehensive
  advertisement ban
• Mix of population wide, high risk and secondary
  prevention measures, in a cost effective balance
• Sustained policy action
• Strengthening of national institutions to
  implement and evaluate risk reduction programmes

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NCD PREVENTION AND HEALTH PROMOTION
NETWORKS Global Integrated NCD Prevention
Networks CINDI European network in 27
countries CARMEN Latin American network in 8
countries EMAN Initiative in Eastern
Mediterranean Region NANDI Initiative in
the African region (SEARO) South East Region
Plans are underway (MOANA) Western Pacific
Region Started informally Mega Country
Health Promotion Network 11 countries over
100 mil. people
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WHO Global Forum for NCD Prevention and Control
1 History

• Initiative from CINDI and CARMEN
• HQ preparations, meeting in North Karelia in 2000
• Endorsement by ROs

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WHO Global Forum for NCD Prevention and Control
2 Aims

• Share experiences between regional networks, HQ
  and many global partners
• Discuss and agree on joint activities

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WHO Global Forum on NCD Prevention and Control
Participants

• Representatives of networks
• WHO Secretariat (HQ, Ros)
• Global partners (UN agencies, CCS, other)

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WHO Global Forum on NCD Prevention and Control
Meetings

• 2001 Geneva
• 2002 Shanghai
• 2003 Rio de Janeiro
• 2004 ?

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WHO Global Forum on NCD Prevention and Control
Agenda

• Progress reports from networks
• Main strategies/lines of work
• Capacity building, partnership and collaboration

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General NCD Prevention and Control

• Global and regional strategies
• National strategies and policy development
• Capacity building and training
• Prevention across life course
• Advocacy

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Strategies on the main risk factors

• Tobacco FCTC
• Diet and Physical Activity Global Strategy

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Global Tobacco Control in the 21st CenturyThe
WHO Framework Convention on Tobacco Control
Process and Challenges
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Framework Convention of Tobacco Control (FCTC)

• FCTC is an international legal instrument that
  will curb the global spread of tobacco and
  tobacco products
• FCTC includes a series of measures for effective
  global and national tobacco control
• FCTC is WHO's first exercise of treaty making
  process
• FCTC is WHOs first

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Global Strategy on Diet, Physical Activity and
Healthour Mandate

• WHA resolution on a Global Strategy for
  prevention and control of NCDs (2000)
• WHA discussion paper on health promotion (2001)
• WHA resolution on diet, physical activity and
  health calls for preparation of Global
  Strategy(2002)

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The Big Picture
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57th World Health Assembly
May 2004
Incorporation of Member States comments,
suggestions
113th Executive Board Session
January 2004
Global Strategy provided to Member States within
EB agenda item on NCD Prevention
Middle or late November 2003
Preparation of all EB documents (WHO/GOV)
October 2003
Internal comments, and advice from Reference
Group, Regional Offices
August/ September 2003
Drafting the Global Strategy document
(secretariat)
Recommendations from Member States and other
stakeholders (Consultations of Spring 2003
http//www.who.int/hpr/gs.consultation.document.sh
tml)
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Global Strategy - content

• Introduction
• The challenge
• The opportunity
• Goals and Objectives
• Evidence for Action
• Principles for Action
• Obligations and Responsibilities for Action
  (WHO, Member States, International Partners,
  Civil Society/NGOs, Private Sector)
• Follow-up and Future Developments
• Conclusions

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Role of Health Services

• NCD management, innovative care
• Prevention in health services

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Surveillance, Evaluation, Info Base

• Surveillance
• Evaluation
• NCD Info base

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Community Based Programmes

• Community based demonstration projects (serving
  national prevention)
• Research on effectiveness joint study

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COMMUNITY BASED DEMONSTRATION PROJECT
LARGE SCALE PREVENTION
BASIC MEDICAL RESEARCH
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MEDICAL KNOWLEDGE
SOCIAL AND BEHAVIORAL THEORY
COMMUNITY PROGRAM
HARD, PRACTICAL WORK
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Joint Campaigns

• Tobacco Quit and Win
• Physical Activity Move for Health
• Diet Global Fruit and Vegetable Initiative

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International QuitWinPractical Collaboration
for Global Smoking Cessation
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Training

• CINDI Winter School, Evidence Course
• North Karelia Project International Visitors
  Programme
• Global Forum International Visitors Programme
• Training materials

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Partnerships, Collaboration

• NGOs
• CCs
• UN agencies

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Working Groups

• Group I Review the progress and comments
• Group II Implement the Strategy
• Group III Establish partnerships, capacity
  building and develop work plan

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Visibility and Resources

• Website
• Materials
• Activities
• Resource mobilization

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Next Meeting

• Location
• Preparations

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FINAL COMMENTS

• NCD prevention is the area where the greatest
  global health gains can be achieved
• Population based prevention, influencing
  population risk factor levels / risk related
  lifestyles is the cost effective, affordable way
  to achieve it
• The Regional NCD Networks and the Global Forum
  are instruments for interested Member Sates, WHO
  and other partners to work together to help
  effective national actions and supportive global
  efforts

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THANK YOU