<div class="gmail_quote"><div><div class="gmail_quote">from David Legge <span dir="ltr"><<a href="mailto:dglegge01@gmail.com" target="_blank">dglegge01@gmail.com</a>></span> :<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<p class="MsoNormal"><span class="Apple-style-span" style="color: rgb(31, 73, 125); font-size: 15px; "> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">I think that there are several key issues to note regarding this
conference. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">Of course there is an epidemic of NCDs and of course PHM is
concerned about this. However…</span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">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 <b>very individualist
direction</b>. Note the reference to the Moscow conference as being about
non-communicable diseases and <b>‘healthy lifestyles’</b>. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">There were no mentions in the materials prepared for WHO's Executive Board in
January of the findings of the Commission on <b>SDH</b> regarding NCDs. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">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). </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">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 <b>global framework convention on the rational use of medicines (RUM).</b>
It would be great if we could get something about RUM in the final declaration in Moscow.
</span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">PHM should also be focusing attention on the <b>political
economy of tobacco, junk food and urban planning.</b> In particular we should
argue for the <b>effective regulation of junk food TNCs</b> and more effective
global control of big tobacco. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">PHM should be concerned also about the possibility of more <b>vertical
fragmentation</b> as a consequence of a focus of the interest on cancer,
hypertension, stroke, heart and lung diseases. Rather, we should be arguing for <b>a
‘health systems strengthening’ approach to NCDs,</b> including a <b>primary
health care</b> focus and <b>universal health coverage</b>.</span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">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. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">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. </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D">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.</span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span class="Apple-style-span" style="color: rgb(31, 73, 125); font-size: 15px; ">David Legge, Melbourne</span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#1F497D"> </span></p>
<p class="MsoNormal"><font class="Apple-style-span" color="#1F497D"><span class="Apple-style-span" style="font-size: 15px;"><br></span></font></p></blockquote></div></div></div>