GLOBAL BURDEN OF NCDs and HOW TO ADDRESS IT European Commission Conference on Global Health: Coherence in Response to Globalisation - PowerPoint PPT Presentation

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GLOBAL BURDEN OF NCDs and HOW TO ADDRESS IT European Commission Conference on Global Health: Coherence in Response to Globalisation

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Title: GLOBAL BURDEN OF NCDs and HOW TO ADDRESS IT European Commission Conference on Global Health: Coherence in Response to Globalisation


1
GLOBAL BURDEN OF NCDs and HOW TO ADDRESS
IT European Commission Conference on Global
Health Coherence in Response to Globalisation
  • C. James Hospedales
  • Pan American/World Health Organization

2
Noncommunicable Diseases and Conditions Adult
mortality rates (2004)
Launched October 2008
3
Magnitude
Total number of deaths
60 million
50 million
40 million
30 million
20 million
10 million
0
Group III - Injuries
Low-income countries
Group II Other deaths from noncommunicable
diseases
Group II Premature deaths from noncommunicable
diseases (below the age of 60), which are
preventable
Group I Communicable diseases, maternal,
perinatal and nutritional conditions
4
Noncommunicable Diseases (2006-2015)
2005 2005 2006-2015 (cumulative) 2006-2015 (cumulative) 2006-2015 (cumulative)
Geographical regions (WHO classification) Total deaths (millions) NCD deaths (millions) NCD deaths (millions) Trend Death from infectious disease Trend Death from NCD
Africa 10.8 2.5 28 6 27
Americas 6.2 4.8 53 -8 17
Eastern Mediterranean 4.3 2.2 25 -10 25
Europe 9.8 8.5 88 7 4
South-East Asia 14.7 8.0 89 -16 21
Western Pacific 12.4 9.7 105 1 20
Total 58.2 35.7 388 -3 17
(WHO, Chronic Disease Report, 2005)
5
Noncommunicable Diseases and Conditions Global
burden of disease attributable top 20 risk
factors (2002)
World Health Report, 2002)
High income
6
Co-existence of children with malnutrition and
mothers with overweight in same home
Fuente Garret, J, Ruel, Marie T. The coexistence
of child undernutricion and maternal overweight
7
Tobacco
Tobacco use is a risk factor for six of the eight
leading causes of death in the world
(WHO World Health Statistics, 2008)
8
How did we get here?
  • Low awareness public policy makers of problem
    or what can be done, espec to change environment
    vs. individual responsibility
  • Availability and affordability of real food,
    espec fruits and veg
  • Globalization food highly processed available
    high fat, TFAs, sugar, salt
  • Massive advertising special risk children
  • Trade and agriculture policies, e.g., insuff. use
    of tariff policy space
  • Fiscal policies, e.g., tobacco and alcohol taxes,
    pricing
  • Tobacco industry/control, advertising, smoke free
    spaces
  • Urbanisation, technology changes favor inactivity
  • Built environment favors cars not people safety
    concerns
  • Schools stress academics gt physical activity, few
    healthy food choices
  • Workplaces work-risks vs. life-risks
  • Public health training emphasizes dated agenda,
    not HP/DP and NCDs
  • Access to quality health services trained
    providers, info systems, self care

9
THE MALADIES OF AFFLUENCE
Globalisation and Health
The Economist, August 11th 2007
10
Cheap cars, traffic jams, global warming, hard to
walk/exercise, stress
11
Costs not sustainable
  • World Econ Forum Global Risk report 2010
  • CDC 2/3 of 2Trillion health care bill in USA
  • Diabetes alone estimated to cost gt65Billion in
    LAC/yr
  • Diabetes and HBP estimated to cost 5-8 of GDP in
    direct and indirect costs in Trinidad Tobago,
    Barbados, Jamaica
  • Renal dialysis bill in El Salvador is half the
    main hospital budget much due to diabetes,
    hypertension poorly managed

12
EVIDENCE OF PREVENTABILITY
  • In 23 low and middle income countries, which
    account for 80 NCD burden globally..
  • Measures to reduce salt intake by 15, tobacco
    use by 20, and scale up access to low cost
    treatment to 60 those at high risk could avert
    31 million deaths over 10 years and would cost
    on average 0.36 per person per year..
  • Lancet, December 2007
  • Special Issue on Chronic Diseases

13
A clear roadmap for Member States, partners and
WHO
  • Six objectives
  • 1. Raising the priority accorded to
    noncommunicable diseases in development work at
    global and national levels, and integrating
    prevention and control of non-communicable
    diseases into policies across all government
    departments
  • 2. Establishing and strengthening national
    policies and programmes
  • 3. Reducing and 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

14
??
Raising the priority of NCDs in development work
A/RES/64/265
  • Decides to convene a high-level meeting of the
    General Assembly in September 2011, with the
    participation of Heads of State and Government,
    on the prevention and control of non-communicable
    diseases
  • Also decides to hold consultations on the scope,
    modalities, format and organization of the
    high-level meeting of the General Assembly on the
    prevention and control of non-communicable
    diseases, with a view to concluding
    consultations, preferably before the end of 2010
  • Encourages Member States to include in their
    discussions at the High-level Plenary Meeting of
    the sixty-fifth session of the General Assembly
    on the review of the Millennium Development
    Goals, to be held in September 2010, the rising
    incidence and the socio-economic impact of the
    high prevalence of non-communicable diseases
    worldwide
  • Requests the Secretary-General to submit a report
    to the General Assembly at its sixty-fifth
    session in collaboration with Member States, the
    World Health Organization and the relevant funds,
    programmes and specialized agencies of the United
    Nations system, on the global status of
    non-communicable diseases, with a particular
    focus on the developmental challenges faced by
    developing countries.

15
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16
??
Establishing national NCD policies and plans
  • Strengthening health care for people with NCDs
  • WHO technical support package of essential
    interventions to integrate NCD prevention and
    control into primary care
  • MoH driven NCD scale up of PHC using the
    technical and policy guidance of package in 10
    countries.

17
??
Reducing NCD risk factors
  • Reducing the level of exposure of individuals
    and populations to tobacco use
  • Technical assistance package to implement the
    WHO FCTC demand reduction measures
  • Monitoring (surveillance and evaluation)
  • Protect (second hand smoke)
  • Offer help
  • Warn against dangers
  • Enforce legislation against tobacco promotion
  • Raise taxes
  • Bangladesh
  • Brazil
  • China
  • Egypt
  • India
  • Indonesia
  • Mexico
  • Pakistan
  • Philippines
  • Russia
  • Thailand
  • Turkey
  • Ukraine
  • Vietnam
  • Uruguay

18
??
Promoting NCD research
WHO Advisory Committee on Health Research
WHO Meeting on A Prioritized Research Agenda
Geneva, 25-26 August 2008)
Ministerial Forum on Research for Health, Bamako,
17-19 November 2008
Jan-July 2010 Consultations with international
partners and development of the first public
version
October 2009 Second draft
A Prioritized NCD Research Agenda
19
Strengthening Partnerships Global NCDnet
?5
2009
International Advisory Council
2010
WHO Secretariat
Funding Facility
Global/Regional Partners Forum
Partners Council Network (Virtual)
Working Group 1
Working Group 2
Working Group 3
Working Group 4
Working Group n
20
Regional Partners Forum for Action on Chronic
Disease
PUBLIC CARMEN Countries Sub regional
movements CDC NIH PHAC
PAHO/WHO Convener Catalyst WEF, IBLF,
PAHEF, PHAC
CIVIL SOCIETY IAHF, IDF, UICC Consumers
Intl Churches FBOs Academia Media Ciclovias EM
BARQ 5-A-DAY RAFA
PRIVATE FOOD NON ALCO MEDIA
TELECOM PHARMACEUTICALS SPORTS
FITNESS INSURANCE AUTO/TRUCK
Platform to engage public sector, businesses,
civil society To take joint, innovative action at
all levels
21
Meeting of Private Sector Companies on TF
elimination in PAHO, Washington
22
??
Surveillance, monitoring and evaluation
23
Conclusions
  • NCDs largest health burden in nearly all
    countries
  • Demographic change and risk factors
  • Interconnected to econ, social, environ issues
  • Impact on par with global fiscal crisis
  • Largely preventable through comprehensive
    prevention control programs at reasonable cost
  • We have a plan
  • Requires political will, all-of-society approach
    partnerships, resources
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