<div dir="ltr"><div class="gmail_default" style="font-size:large"><br></div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">---------- Forwarded message ---------<br>From: <span dir="auto"><<a href="mailto:dlegge@phmovement.org">dlegge@phmovement.org</a>></span><br>Date: Fri, Jan 19, 2024 at 1:58 PM<br></div><br><div class="msg-8640053892685079152"><div bgcolor="#FAFAFA" link="blue" vlink="purple" style="word-wrap:break-word" lang="EN-AU"><div class="m_-8640053892685079152WordSection1"><div align="center"><table style="width:154.62%;background:#fafafa;border-collapse:collapse" width="154%" cellspacing="0" cellpadding="0" border="0"><tbody><tr><td style="width:100.0%;padding:7.5pt 7.5pt 7.5pt 7.5pt" width="100%" valign="top"><div align="center"><table style="width:450.0pt;border-collapse:collapse" width="600" cellspacing="0" cellpadding="0" border="0"><tbody><tr><td style="width:450.0pt;padding:0cm 0cm 0cm 0cm" width="600" valign="top"><div align="center"><table 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width="564" height="308" border="0"><u></u><u></u></p></td></tr></tbody></table></td></tr></tbody></table></td></tr><tr><td style="border:none;border-bottom:solid #eaeaea 1.5pt;background:white;padding:0cm 0cm 6.75pt 0cm;background:cover;background-size:cover" id="m_-8640053892685079152templateBody" valign="top"><table style="width:100.0%;border-collapse:collapse;min-width:100%" width="100%" cellspacing="0" cellpadding="0" border="0"><tbody><tr><td style="padding:6.75pt 0cm 0cm 0cm;min-width:100%" valign="top"><table style="width:100.0%;border-collapse:collapse" width="100%" cellspacing="0" cellpadding="0" border="0" align="left"><tbody><tr><td style="width:450.0pt;padding:0cm 0cm 0cm 0cm;max-width:100%;min-width:100%" width="600" valign="top"><table style="width:100.0%;border-collapse:collapse;word-break:break-word" width="100%" cellspacing="0" cellpadding="0" border="0" align="left"><tbody><tr><td style="padding:0cm 13.5pt 6.75pt 13.5pt" valign="top"><h1 style="text-align:center" align="center">Progress on NCDs lags: WHO must address the drivers, overcome the barriers<u></u><u></u></h1><p class="MsoNormal" style="margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm"><span style="font-size:9.0pt;font-family:"Tahoma",sans-serif;color:#202020">At its forthcoming Executive Board meeting WHO will confront the reality that progress on NCDs is either way off track or that the disease burden is worsening (reported in detail in <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=983a5a7297&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">EB154/7</span></a>).<br><br>WHO has not been sitting on its hands. <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=e8aecd3b3d&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">EB154/7</span></a> reports on a wide range of conferences and consultations, resolutions and reports, strategies, work plans and frameworks, and the adoption of technical guidance documents.<br><br>However, <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=95e8db06c3&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">EB154/7</span></a> does not adequately address the reasons for the limited progress, even a decade after the world had accepted NCDs as a major public health issue. Neither does it inquire deeply into the obstacles blocking the achievement of its many targets.<br><br>The three key challenges which need to be addressed are: health systems strengthening and the integration of disease strategies into comprehensive primary health care; intersectoral action at the domestic and international levels; and social and economic inequality<br><br>Health systems strengthening is critical to achieving every one of WHO’s NCD objectives. This boils down to resources (fiscal capacity and all the related issues), to the organization of service delivery, and to human resources policy. Health system strengthening also needs to address the values or ethics on which public services are organized and, as part of this, to build a different set of incentives, free of market pressures (including the pressure to focus solely on episodic sick care), in which health care practitioners can work. A key to health systems strengthening is to build the domestic political constituencies which care about comprehensiveness, quality, efficiency, resource allocation, evaluation in health care.<br><br>WHO’s focus on specific diseases and specific risk factors has encouraged a vertical and selective approach to health system development which contributes to the fragmentation of care. The challenge is to integrate the specific interventions being promoted into comprehensive health care services based on primary health care. <br>The intersectoral and international dimensions of NCDs control are critical, including the regulation of ultra-processed foods, unhealthy diets, tobacco, alcohol, air and water pollution, and occupational health. WHO has produced a great deal of policy advice here but has not confronted the task of building national constituencies which can insist on addressing the social, commercial and environmental determinants of health. Such constituencies are needed to drive domestic intersectoral action as well as foreign affairs engagement in the structures of global governance across sectors.<br><br>Health care personnel can play a major role in advocacy for health systems strengthening and for effective intersectoral/international action particularly in systems where the cultural norms are about public service rather than private profit. The dramatic upscaling of the CHWs workforce which WHO calls for in EB154/7 would strengthen such advocacy.<br><br>The report before the Executive Board is almost silent on the issue of social and economic inequity and its impacts on the causes, consequences and response to NCDs. The focus on particular diseases and specific risk factors has obscured the inequality dimension. This includes inequality in terms of accessing decent healthcare but also social and economic inequality and discrimination, which are associated with greater vulnerability and a greater exposure to all the specific risk factors described. It is time to name the structural drivers of deepening inequality; not just documenting their effects.<br><br>The full PHM Commentary on this agenda item explores these challenges in more detail and sets out key actions to address them.<u></u><u></u></span></p></td></tr></tbody></table></td></tr></tbody></table></td></tr></tbody></table><p class="MsoNormal"><u></u> <u></u></p><table style="width:100.0%;border-collapse:collapse;min-width:100%" width="100%" cellspacing="0" cellpadding="0" border="0"><tbody><tr><td style="padding:6.75pt 0cm 0cm 0cm" valign="top"><table style="width:100.0%;border-collapse:collapse" width="100%" cellspacing="0" cellpadding="0" border="0" align="left"><tbody><tr><td style="width:450.0pt;padding:0cm 0cm 0cm 0cm;max-width:100%;min-width:100%" width="600" valign="top"><table style="width:100.0%;border-collapse:collapse;word-break:break-word" width="100%" cellspacing="0" cellpadding="0" border="0" align="left"><tbody><tr><td style="padding:0cm 13.5pt 6.75pt 13.5pt" valign="top"><p class="MsoNormal" style="margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm"><span style="font-size:9.0pt;font-family:"Tahoma",sans-serif;color:#202020">The full <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=1ac190f0ff&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">PHM commentary on this item</span></a> provides a more detail and references. See also Tracker links to <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=926caa03bc&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">previous discussions of NCDs</span></a>.<u></u><u></u></span></p><p class="MsoNormal" style="margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm"><span style="font-size:9.0pt;font-family:"Tahoma",sans-serif;color:#202020">The WHO Tracker and PHM item commentaries are produced as part of <b><span style="font-family:"Tahoma",sans-serif">WHO Watch</span></b> which is a project of the <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=94c32157a4&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">People's Health Movement</span></a> in association with <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=a0bac19bdc&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">Medicus Mundi International</span></a>, <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=7e61ac6dfb&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">Third World Network</span></a> and a number of other civil society networks. WHO Watch contributes to democratising global health governance, through new alliances, new information flows and by broadening the policy discourse.<u></u><u></u></span></p><p class="MsoNormal" style="margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm"><span style="font-size:9.0pt;font-family:"Tahoma",sans-serif;color:#202020">See the WHO Tracker page for this EB154 session (<a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=b42eed2419&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">here</span></a>). See PHM’s <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=d9a9fa6190&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">integrated commentary</span></a> on the full agenda of EB154 (or read the <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=815128c501&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">flipbook version</span></a>). To ensure that you receive Update Alerts <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=80896e3297&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">subscribe</span></a> to the Updater. <br><br>You can support WHO Watch by forwarding this Item Alert, by publicising the <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=9741c5ae67&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">Tracker</span></a>, by inviting others to <a href="https://phmovement.us20.list-manage.com/track/click?u=559d715f58f654accf3de987e&id=916f056024&e=5f3cea0f3e" target="_blank"><span style="color:#007c89">subscribe to GHG Reports</span></a>; and by following us on social media via @PHMglobal and @WorldHealthWatch.<u></u><u></u></span></p><p class="MsoNormal" style="margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm"><span style="font-size:9.0pt;font-family:"Tahoma",sans-serif;color:#202020">To provide feedback 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