PHM-Exch> WHO Global Forum: Noncommunicable Diseases (NCDs) (4)

[Claudio Schuftan]

from David Legge <dglegge01 at gmail.com> :

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> I think that there are several key issues to note regarding this
> conference.
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> Of course there is an epidemic of NCDs and of course PHM is concerned about
> this.  However…
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> We, at PHM, are concerned that the focus on specific diseases should not
> take away from the focus on the social determinants of health which was the
> focus on the CSDH.  The conjunction of the large disease specific networks
> (cancer, diabetes, stroke, heart, lung) plus big pharma plus the pseudo
> ‘patients groups’ (largely puppets of big pharma) appears to be driving the
> agenda in a *very individualist direction*.  Note the reference to the
> Moscow conference as being about non-communicable diseases and *‘healthy
> lifestyles’*.
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> There were no mentions in the materials prepared for WHO's Executive Board
> in January of the findings of the Commission on *SDH* regarding NCDs.
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> The Bangladesh draft resolution brought NCDs within the scope of ‘health
> aid’; donor support for technology transfer, diagnostics, etc.  There is a
> logic to this, but also a risk of continuing the focus on individual illness
> to the neglect of political economy and the regulation of the transnational
> corporations (TNCs).
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> One of the strengths of the Bangla resolution is that it points towards the
> importance of an evidence-based approach to prevention and treatment.  I
> think that in this context the irresponsibility of big pharma in driving
> wherever possible over-prescribing should be a focus.  This leads to the
> idea of the need of a *global framework convention on the rational use of
> medicines (RUM).*  It would be great if we could get something about RUM
> in the final declaration in Moscow.
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> PHM should also be focusing attention on the *political economy of
> tobacco, junk food and urban planning.*  In particular we should argue for
> the *effective regulation of junk food TNCs* and more effective global
> control of big tobacco.
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> PHM should be concerned also about the possibility of more *vertical
> fragmentation* as a consequence of a focus of the interest on cancer,
> hypertension, stroke, heart and lung diseases.  Rather, we should be arguing
> for *a ‘health systems strengthening’ approach to NCDs,* including a *primary
> health care* focus and *universal health coverage*.
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> You have probably seen the arguments for inclusion of mental health in the
> agenda of NCDs. Whether or not you support this, the above considerations
> about SDH, RUM, regulation of the TNCs and adopting a health systems
> strengthening approach remain key for PHM.
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> There are many good people working in the disease specific sectors (cancer,
> heart, etc).  There may be some scope for building bridges between PHM and
> these folks.  It would be worth keeping an eye out for such possibilities
> before and during Moscow.
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> Hope this is helpful to our members in their discussions of and lobbying
> about this topic.  I look forward to other contributions to this discussion.
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> David Legge, Melbourne
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