PHM-Exch> WHO Global Forum: Noncommunicable Diseases (NCDs) (6)

[Claudio Schuftan]

From: David Legge <D.Legge at latrobe.edu.au>


 The challenge is to redirect the NCDs juggernaut.  We need to encourage a
stronger focus on:

>
>    - the social determinants of various NCDs (moving away from solely
>    focusing on 'lifestyles' and treatment and towards a greater focus on how
>    TNCs under globalisation have freedom to cultivate NCDs),
>    - health system strengthening (including universal access, reasonable
>    drug pricing and primary health care and away from more vertical
>    disease-focused silos),
>    - rational use of medicines (and control of big pharma marketing
>    strategies, perhaps through a framework convention on RUM).
>
> It may be that one of the keys to achieving this redirection might be the
> NCD Alliance. While they have an individualised life style and
> treatm,ent approach they are not locked into this approach through
> shareholder obligations like big pharma is.  The challenge for the people's
> health movement might be to engage with the NCDs people and somehow
> problemetise their relationship with the 'patients' group' and big pharma so
> they might look afresh at the kind of redirections listed above. This might
> be a big naive, I am not sure.
>
> I think that a focus on agriculture (as per Alison Katz's contribution
> yesterday on PHM Exchange) would make a lot of sense in terms (a) of moving
> the debate towards the SDH; and (b) to build a platform for stronger north
> south solidarity around the need to regulate the TNCs (and globalisation)
> more effectively.  A lot of work would be needed to make this work; the
> links between the Carghill monopoly and NCDs will not be clear for all.  We
> do not have to reinvent this wheel; merely make the connections with Via
> Campesina, Food First, IATP and the TNI and other bodies who are working on
> agriculture, food and nutrition.
>
> At this time slogans regarding health systems strengthening (HSS) are
> almost as prominent as slogans around NCDs.  It is important to make it
> clear to the NCDs people that the vertical disease model is widely seen as
> dysfunctional and that it might be unwise to get on a train to nowhere.
> Rather we should be encouraging them to see how HSS will advance the cause
> to which they are committed.  A focus on HSS makes it clear that we are not
> denying the importance of NCDs, rather we are warning about big pharma's
> program of capturing yet another constituency in the interests of maximising
> executive bonus and shareholder return.
>
> Likewise a focus on the rational use of medicines could split the
> clinicians in the NCD movement from their big pharma funders and could
> perhaps open up new possibilties. We are arguing for a framework convention
> on the rational use of medicines with a view to exposing the hypocrisy of
> big pharma and perhaps delegitimising their claims to participate in the WHO
> Global Forum. Again there are expert NGOs working on these issues (TWN, HAI,
> Oxfam, MSF); our campaigning should be directed towards negotiating a
> broadly based movement towards a framework convention on RUM.  It would be a
> small recognition of Dr Bala's leadershiop and lifetime contribution in this
> field to re-energise the RUM movement.
>
> Likewise we need to build the links around the slogan 'access to medicines'
> to encompass access to communicable diseases medicines *and* NCD
> medicines.  This could have the effect of broadening the constituency
> demanding reform of IPRs, reasonable drug pricing and new approaches to
> innovation. It could also help to split the clinicians from big pharma.
> Again there are expert bodies working in this field (eg TWN, South Centre,
> KEI, MSF). We need a mass based global movement following their leadership.
>
>
> I look forward to further discussion on these issues.
>
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