PHM-Exch> Spotlight on non-communicable diseases prevention and control

[Claudio Schuftan]

From: Sangeeta <ssangeeta at myjaring.net>
*From: *TWN News <news at twnnews.net>
Third World Network
www.twnside.org.sg

*WHO: Spotlight on non-communicable diseases prevention and control
Published in SUNS #7157 dated 25 May 2011
*
Geneva, 24 May (K. M. Gopakumar and Chiara Bodini*) -- Many developing
countries stress the importance of access to medicines and of addressing the
social determinants of health in order to prevent and control
non-communicable diseases.

This took place at the 64th World Health Assembly (WHA) meeting in Geneva on
16-24 May, during a discussion on the prevention and control of
non-communicable diseases (NCDs) that considered the WHO Secretariat report
on the matter and a draft resolution sponsored by 61 Member States including
EU member countries.

The Secretariat's report (document A64/21) deals with WHO's role in the
preparation, implementation and follow-up to the high-level meeting of the
United Nations General Assembly on the prevention and control of NCDs to be
held in September 2011.

The topic of NCDs has special prominence at this year's WHA because of the
high-level meeting (HLM) where Heads of State and Government are expected to
participate.

This flows from the UN General Assembly Resolution 64/265 adopted in May
2010 which in its preamble reaffirms "the need for international cooperation
in the area of public health through the exchange of best practices aimed at
building capacity at the public health system, providing financial
assistance, the production of and increased access to affordable, safe,
effective and high quality medicines, the training, recruitment and
retention of pubic health personnel, the development of infrastructure and
the transfer of technology".

Many Member States, in their interventions during the 21 May WHA discussion,
underscored the strong link between NCDs and development, and stressed the
need to address the social determinants of health (SDH) as well as to take
measures to improve access to affordable medicines, to effectively combat
NCDs. Interventions also called for more funding and political commitment,
better private sector regulation and policy-making free of conflict of
interests. Several Member States also supported the inclusion of mental
health in the context of NCDs.

A resolution was finally adopted by the WHA focusing on the role of WHO in
the preparation of the September HLM. This was agreed to by an informal
working group that met on the margins of the WHA to reshape the content of
the draft resolution submitted by some countries in January to the WHO
Executive Board.

The resolution endorses the Moscow Declaration (outcome of the First Global
Ministerial Conference on Healthy Lifestyles and Non-communicable Disease
Control held in Moscow on 28-29 April 2011), which is annexed to the
resolution, as a key input for the preparations leading to the HLM. It urges
Member States to continue to support the preparations at national, regional
and international levels for the HLM, including situation analyses of NCDs
and their risk factors as well as an assessment of national capacity and
health systems' response to address NCDs.

It also urges Member States to be represented at the level of Heads of State
and Government at the HLM and reiterates the UN General Assembly (UNGA) call
for action through an action-oriented outcome document. It also urges Member
States to consider as appropriate and relevant to include representatives of
civil society, non-governmental organisations, academia and networks working
on the control and prevention of NCDs.

The resolution requests the WHO Director-General (DG, Dr Margaret Chan) to
continue her existing lead role to coordinate UN specialised agencies, funds
and programmes, other relevant intergovernmental agencies to support Member
States. This would include undertaking concerted action and coordinating
responses in order to promptly and appropriately address the challenges
posed by NCDs, including further building up of situation analyses on NCDs
and risk factors as well as highlighting the social and economic impact of
NCDs, including financial challenges, in particular in developing countries.

It also requests the DG to prepare a report on the outcome of the Moscow
ministerial conference and the September HLM for the 65th WHA session in
2012; and to develop an implementation and follow-up plan for the outcomes
including the financial implications for submission to the 65th WHA.

The resolution also requests the UN Secretary-General to submit a global
status report on NCDs with a particular focus on the developmental
challenges faced by developing countries, to the GA at its 65th session in
collaboration with Member States, WHO and other relevant funds, programmes
and specialised agencies of the UN system.

Further to the May 2010 Resolution, the GA passed another resolution
(65/238) inviting the WHO to hold regional multi-sectoral consultations in
cooperation with regional commissions and other relevant agencies to provide
input to the preparatory process for the HLM.

Pursuant to this key role, WHO has organized regional consultations as well
as the Moscow ministerial conference.

The Moscow Declaration states that, in order to secure an ambitious and
sustainable outcome, "we commit to actively engage with all relevant sectors
of Government, on the basis of this Moscow Declaration, in the preparation
of and the follow-up to the United Nations General Assembly High-level
Meeting on the Prevention and Control of NCDs in September 2011 in New
York". The Declaration sets out actions at three levels: the whole
governmental, the ministry of health level and the international level.

Forty-seven Member States, 16 intergovernmental organisation and NGOs
participated in the NCDs discussion on 21 May. The Secretariat, in its
opening remarks, said that the role of WHO is to provide evidence-based
solutions and also to have a key role in implementation of outcomes of the
HLM.

Consumers International said that it is essential that while action is
stepped up to address NCDs, care is taken to increase consumer protection
and avoid giving the for-profit sector unprecedented opportunities to
influence policies. The effect of insufficient vigilance will be felt most
keenly in food-related NCDs - where Member States urgently need
encouragement to take effective legislative action to control harmful food
marketing. It also strongly urged that the critically important role of
marketing controls and the protection of breastfeeding and optimal
complementary feeding is recognized as an integral component of WHO's NCD
strategy.

Medicus Mundi International said that "it is disappointing that there is no
reference to the work of the Commission on Social Determinants of Health
(CSDH) in the Secretariat report. Unhealthy behaviors do play an important
role in determining NCDs, however there are structural determinants like
education, income, gender and ethnicity which are underlying causes of NCDs
and behavioral risk factors. It stressed the importance of equity dimensions
of NCDs as emphasized by CSDH and that these are closely linked to the
social and environmental factors; not just individual behaviors. Therefore,
if the UNGA is to provide an action-oriented outcome document preventive
measures for social and environmental factors must be included.

It also urged Member States to address the access to affordable treatment
for NCDs by clearly spelling out the response of the Member States and WHO
to initiate law and policy measures to ensure access to affordable
diagnostic tools and treatment, in particular the full use of the
flexibilities of TRIPS. It is also important to curb the practices of other
industries which contribute to the prevalence of NCDs such as food and
agricultural corporations. Therefore, it called for development of a code of
conduct to regulate their advertisement and promotion of products.

Corporate Accountability International asked Member States to apply the
safeguards in Article 5.3 of the Framework Convention on Tobacco Control
creating clear and enforceable standards in relation to water, public health
and nutrition. These measures must go beyond individual conflicts of
interest, and address institutional conflicts of interest.

The Secretariat, in reply to the discussion, stated that mental health is a
major issue and lacks appropriate intervention in many countries. It
stressed the need to address the five building blocks of health systems and
hoped that such an approach would in turn also help to address mental
health. It also recalled that mental health is highlighted in the global
status report on NCDs.

Regarding conflict of interest, the Secretariat stated that the WHO
Guideline on working with the private sector would guide its work. Further,
the DG called upon Member States to take a stand against the pressurising
tactics of tobacco companies against the implementation of the framework
convention.

(* K. M. Gopakumar is a senior researcher with Third World Network and Dr.
Chiara Bodini is a public health expert from the Centre for International
Health, University of Bologna.) +
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