Contribution to consultations on proposals for global monitoring framework and targets for NCDs
10 February 2012

Download the full PDF statement here.

Five months ago, 193 UN Member States unanimously adopted the Political Declaration on NCDs. The Declaration signals a new era for NCDs, providing consensus on what is causing the NCD epidemic and what must be done to reverse it, and when.

In three months from now, at the World Health Assembly (WHA), significant progress must be made on three short-term commitments that are critical to inspire and measure future action: a set of voluntary global targets, a global monitoring framework, and options for strengthening and facilitating multisectoral action through effective partnership.

Beyond WHA, we will have only seven months left in 2012 to complete these vital tasks. This timeline requires urgent and decisive action by Member States.

Yet we recognize that consultations have commenced with an incomplete set of proposals for the monitoring framework and ten “example” targets and associated indicators. In response to questions from Member States on 9 January, WHO has confirmed there will be “many” indicators in the monitoring framework, a prototype of which will be available on 22 March.

Member States also committed to “promote, establish or support and strengthen multisectoral national policies and plans” on NCDs by 2013; and “to strengthen … the development of population-based national registries”. How are these commitments being translated into action; and how will they feature in this monitoring and target-setting exercise? We need to know.

At this point in the consultations, we call on Member States to:

1. Adopt as an overarching goal, target to reduce preventable deaths from NCDs by 25% by 2025 at WHA in May 2012

This WHO suggested target should be accepted as the overarching goal to be achieved through successful attainment of the other agreed targets. For Health Ministers not to agree to this goal in May would be a major setback.

2. Agree targets on major risk factors and include physical inactivity

WHO’s suggested targets to reduce tobacco use, salt intake, harmful use of alcohol, blood pressure and to eliminate industrially-produced transfats must be accompanied by a target of a 10% relative reduction in the prevalence of insufficient physical activity in adults, as proposed by global experts on physical activity.

Indicators to monitor intake of free sugars and saturated fats will also help Member States to tackle unhealthy diet.

Alarming reports are reaching us of Member States coming under pressure from certain big alcohol producers to exclude a target to reduce alcohol consumption. This lobbying must be resisted and exposed.

We urge Member States to stand firm against interference with policy decisions by industry groups motivated purely by self-interest and not by public interest.

3. Develop and agree a target on increased access to affordable, essential NCD medicines and technologies

WHO’s suggested target on multi-drug therapy to prevent heart attack and stroke is vitally important and must be included.

The NCD Alliance also advocates for the addition of a broader target on access to quality-assured and affordable essential medicines supported by a range of indicators, examples of which could include access to insulin, vaccines, screening, radiotherapy and pain relief, as well as healthcare workers to provide services. This is in-keeping with the Declaration, which recognises the continuum of care from early detection and treatment, access to accurate diagnosis and care, including palliative care.

Considerable work has already been done by NCD experts on formulating precise wording and evidence to back up such a target, and will be available shortly. While such a target is being developed and consulted on, we urge Member States to call for work to start now on updating the WHO essential medicines list.

4. Demand that this monitoring initiative is fully integrated into broader health and development monitoring

The many millions that are invested into monitoring frameworks for communicable diseases and other health and development priorities should be put to use to include monitoring of the prevention and control of NCDs.

Similarly, the “larger number of indicators … related to process and policy” that WHO proposes for this framework should serve to integrate NCDs into health systems strengthening, maternal and child health, mental health, social determinants and preparations for the future global development framework, post-2015.