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Meeting the Challenge of Non-Communicable Diseases


Meeting the Challenge of Non-Communicable Diseases Dr. Jeffrey L. Sturchio President & CEO Global Health Council Journalist to Journalist Training – PowerPoint PPT presentation

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Title: Meeting the Challenge of Non-Communicable Diseases

Meeting the Challenge of Non-Communicable
  • Dr. Jeffrey L. Sturchio
  • President CEO
  • Global Health Council
  • Journalist to Journalist Training
  • National Press Foundation
  • June 12, 2011

Globalization and health
  • In an age of globalization and growing
    insecurity, health is everybodys business
  • With the impact of global transportation and
    communications networks, a SARS outbreak in China
    can reverberated rapidly from Canada to Cairo
  • In an interconnected and interdependent world,
    bacteria and viruses travel almost as fast as
    e-mail messages and money flows.
  • Gro Harlem Brundtland, former Director-General,
    World Health Organization (2005)

Global health matters
  • Global health affects everyone disease knows no
  • Infectious diseases such as avian influenza,
    tuberculosis, SARS and West Nile Virus can spread
    from one country to another
  • Other health challenges such as HIV/AIDS have a
    major global political and economic impact
  •  Good health is the foundation for building a
    stable economy
  • Poor health hinders ones ability to take
    advantage of educational opportunities or hold a
  • Poor health undermines countries development and
    trade and can reinforce the cycle of poverty and
    political instability.

Impact of global crises on health
  • Equitable access to health care, and greater
    equity in health outcomes are fundamental to a
    well-functioning economy.Health had no say in
    the policies that led to the financial crisis or
    made climate change inevitable. But the health
    sector will bear the brunt of the
    consequences.....A world that is greatly out of
    balance in matters of health is neither stable
    nor secure.
  • Margaret Chan, The impact of global crises on
    health money, weather and microbes, Address at
    the 23rd Forum on Global Issues, Berlin, Germany,
    March 18, 2009. http//

Non-communicable diseases
  • Non-communicable diseases (NCDs) are the leading
    cause of death and disability worldwide they
    account for 60 percent of all deaths globally
  • People living in developing countries are more
    likely to develop and die prematurely from
    chronic disease
  • Have limited access to comprehensive health
    services for NCDs
  • Live in countries that do not have effective
    policies for NCDs (tobacco, alcohol, air
    pollution, etc.)
  • In addition to their devastating impact on
    health, NCDs have a major socio-economic impact
    on individuals, families, communities, and
  • There is an urgent need to raise the profile of
    NCDs on the international development agenda
  • The burden of chronic disease will account for
    over 75 percent of deaths by 2030

Ten leading causes of burden of disease, world,
2004 and 2030
The World Economic Forum named NCDs the third
largest economic risk facing the globe in 2010
Many of the risk factors associated with NCDs are
related to modifiable behaviors
SOURCE Geneau R, Stuckler D, McKee M, et al.
Raising the priority of preventing chronic
diseases a political process. Lancet 2010 376
Cardiovascular Diseases
  • The leading cause of death worldwide, accounting
    for 17 million deaths in 2005
  • Of these, 7.2 million were due to heart attacks
    and 5.7 million due to stroke
  • Include coronary heart disease (heart attacks),
    cerebrovascular disease, raised blood pressure
    (hypertension), peripheral artery disease,
    rheumatic heart disease, congenital heart
    disease, and heart failure
  • If current trends continue, WHO estimates that
    23.6 million people will dies from cardiovascular
    disease by 2030

Chronic respiratory diseases (CRDs)
  • Include asthma, respiratory allergies, chronic
    obstructive pulmonary disease (COPD),
    occupational lung diseases, sleep apnea syndrome
    and pulmonary hypertension
  • Collectively, CRDs account for 4 million deaths
    per year COPD is the fourth leading cause of
    death worldwide
  • Many CRDs are preventable, although they often
    fail to receive adequate attention from the
    health care system

  • A leading cause of death group worldwide,
    accounting for 7.4 million deaths in 2004
  • The global cancer burden has doubled in the past
    30 years by 2020, the cancer burden of 2000 is
    expected to double again
  • More that 70 percent of cancers occur in low- and
    middle-income countries
  • The leading type of cancer is lung cancer,
    accounting for 1.3 million deaths per year
  • In less developed countries, the leading type of
    cancer for men is lung cancer, followed by liver
    cancer the leading type for women is breast
    cancer followed by cervical cancer

  • Worldwide, over 220 people had diabetes in 2004
  • Nearly 80 percent of diabetes deaths occur in
    low- and middle-income countries
  • WHO estimates that diabetes deaths will double
    between 2005 and 2030
  • Causes kidney failure, diabetic retinopathy, and
    diabetic neuropathy increases the risk of heart
    disease and stroke
  • 43 million pre-school children worldwide are
    obese or overweight

60 per cent of the worlds total deaths are due
to non-communicable diseases, many of which are
90 per cent of people dying prematurely from NCDs
live in developing countries
NCDs are among the top ten causes of causes of
death in every income group
Without action, Africa will witness the largest
increase in deaths from NCDs in 2015 (compared to
2004). South East Asia and the Western Pacific
will have the highest absolute number of deaths.
Factors that contribute to the rise of NCDs
  • Rapid urbanization has led to changes in diet,
    physical activity, and environmental exposure
  • Decreases in the price of animal based products,
    sweeteners, and oils over the past two decades
    have contributed to dietary changes
  • Increasing availability of tobacco products as a
    result of expanding markets and lack of
    protective trade policies
  • Lack of knowledge about chronic disease and poor
    understanding of contributing risk factors
  • Shifting patterns of behavior due to
    globalization and increased media

Economic impact of NCDs
  • NCDs reduce the economic productivity of
    individuals and cause many families to fall into
  • The long-term nature of treatment and care for
    chronic disease results in significant household
    expenditures over prolonged periods of time and
    inability of the household to accumulate savings
  • Indian households that include a family member
    with a chronic disease are 40 percent more likely
    to fall into poverty
  • The expense of treatment often deters individuals
    from seeking treatment
  • In Nigeria, over 60 percent of cancer patients
    failed to complete their chemotherapy treatments
    because of the prohibitive cost of the drugs
  • NCDs also have a severe impact on the economies
    of countries
  • Over the next decade, China is estimated to lose
    over 550 billion in national income due to
    cardiovascular disease
  • In Central Asia, chronic diseases may reduce
    workers labor effort by 7 to 30 percent

Why have NCDs been neglected?
  • Common myths that surround NCDs that people
    knowingly choose to engage in unhealthy behaviors
    (smoking, drinking, diet), or that chronic
    diseases related to aging are inevitable may be
    detrimental to collective action
  • Policies that aim to regulate individual behavior
    (taxes on soft drinks, cigarettes) may be seen as
    impinging on individual agency
  • Weak health information systems prevent adequate
    surveillance of chronic disease in many
    developing countries without data, it is
    difficult to argue for the prioritization of NCDs
    based on the burden of disease
  • Although international advocacy for NCDs is
    growing, greater efforts are needed on the local
    level to raise the profile of NCDs on national
  • Another myth around NCDs is that low- and
    middle-income countries should give priority to
    infectious diseases. However, this approach does
    not align with the burden of disease in these

Interventions for NCDs
  • In 2007, a Lancet Series on NCDs identified three
    highly cost-effective interventions for
    preventing NCDs tobacco control, salt reduction,
    combined drug treatment for people at high risk
    of cardiovascular disease
  • Tobacco control and salt reduction could prevent
    almost 14 millions deaths over the next decade,
    at a cost of less than US 0.40 per person per
  • Aspirin and generic drugs to lower blood pressure
    and cholesterol could prevent 18 million deaths
    over the next decade, at a cost of approximately
    1.10 per person per year
  • National policies and legislation to limit the
    use of harmful substances, such as tobacco,
    alcohol, and unhealthy foods
  • Behavior change campaigns to educate about the
    risks of chronic disease and encourage positive,
    healthy behaviors
  • Strengthening of health systems and additional
    prevention, screening, treatment, and care
    services targeted to chronic disease

Funding for NCDs
  • Funding for NCDs is severely lacking in 2007,
    only 2.3 percent (503 million) of overall
    development assistance for health was dedicated
    to NCDs
  • Less than 15 percent of the WHOs agenda is
    allocated to chronic disease
  • Less than 2 percent of the total health budget of
    the Gates Foundation and the World Bank is
    allocated to chronic disease
  • Currently, there is no OECD/DAC Reporting System
    code to track funds for NCDs
  • In low- and middle-income countries, many
    governments are increasing domestic expenditures
    for health, but investment in chronic disease is
  • However, between 2001 and 2008 donor funding to
    developing countries for NCDs increased by over
    600 percent. This suggests a growing recognition
    and willingness to address the increasing burden
    of NCDs.

Next steps for NCDs
  • High-level Meeting of the United Nations General
    Assembly on the Prevention and Control of
    Non-communicable Diseases on September 19, 2011
  • UNGA will focus on three major themes related to
    chronic disease
  • The rising incidence, developmental and other
    challenges and the socioeconomic impact of NCDs
    and their risk factors
  • Strengthening national capacities, as well as
    appropriate policies, to address prevention and
    control of non-communicable diseases
  • Fostering international cooperation, as well as
    coordination, to address non-communicable

NCD Alliance
NCD Alliances 10 Asks for the UN NCDs Summit
  • 1. Commit to a whole-of-government response
    through costed national plans for NCD prevention
    and treatment 2. Establish an NCDs Partnership,
    linked to WHO, to coordinate follow up action
    with member states, other UN and multilateral
    agencies, foundations, NGOs and private sector 3.
    Increase national and international resources for
    NCD prevention and treatment 4. Include NCDs in
    future global health and development goals 5.
    Accelerate implementation of Framework Convention
    on Tobacco Control (FCTC) 6. Reduce dietary salt,
    sugar, saturated and trans-fats and harmful use
    of alcohol 7. Implement strategies to encourage
    physical activity and improve diet 8. Strengthen
    health systems through integration of NCD
    prevention and treatment 9. Increase access to
    affordable, quality-assured essential medicines
    and technologies to prevent and treat cancer,
    cardiovascular disease, chronic respiratory
    disease and diabetes, including vaccines and
    palliative care 10. Establish a high level
    Accountability Commission on NCDs with cross
    sector representation to monitor Summit

Key dates
  • WHO/ UNDESA Regional Summit Consultations
  • South-East Asia (14-17 Feb, Dhaka, Bangladesh)
  • Americas (24-25 February, Mexico City, Mexico)
  • Western Pacific (25-27 March, Seoul, South Korea)
  • Africa TBD
  • NCD Alliance Side Event 55th Session of the
    Commission on the Status of Women, 22 Feb4 Mar,
    New York
  • Partners in Health / NCD Alliance Conference on
    NCDs of the Bottom Billion, 2-3 March, Harvard
  • Oxford Health Alliance Annual Meeting on NCDs,
    14-15 April 2011, Oxford, UK
  • NCDnet Global Forum, 27 April, Moscow
  • Russia Ministerial Conference on NCDs, 28-29
    April, Moscow
  • 64th World Health Assembly, 16-25 May, Geneva
  • Global Health Council Annual Conference (Theme
    NCDs), 13-17 June, Washington, DC
  • UN civil society consultation, June 16
  • UN High-Level Meeting, 19-20 September 2011 in
    New York Three Roundtable Sessions

A role for public/private partnerships
  • Private sector companies can also make
    contributions to health and development by
    building partnerships to address these challenges
  • Working together, we can achieve more than any
    single organization or country can do on its own
  • Public/private partnerships offer an important
    mechanism that works to combine the complementary
    resources and expertise of the public and private
    sectors to achieve health goals

The value of collaboration
  • The marketplace is not the answer to all
    questions facing society. Likewise, the public
    sector cannot solve all social problems. But the
    combination of public and private efforts, when
    harnessed together, in an effort to achieve a
    clear and shared health objective, provides a
    powerful force that exceeds the sum of its
    separate efforts.
  • Dr. William H. Foege, in Ethics and the
    Pharmaceutical Industry (2005)

Framework for Corporate Pledges to Support NCD
Prevention Control
The way forward
  • We need to find the best solutions and scale them
    up -- across borders, across sectors, and through
    collaboration and cooperation among all
  • Progress is possible -- and there have been
    encouraging developments in the past several
    years with respect to dealing effectively with
    major global health issues
  • Continued partnerships in global health provide
    the best way to build on this momentum -- and
    offer the best hope for those living with both
    infectious and chronic diseases in the developing