"Without global goals or targets, this is not going to fly – what gets measured gets done." - Margaret Chan, Director-General, World Health Organization
- April 27th, Russia Ministerial Conference on NCDs
1. Governments around the world have agreed to hold a United Nations High Level Summit (the Summit) on 19-20th September 2011 in New York which will be attended by UN member state Heads of State and Heads of Government. This Summit has the potential to change the world for those living with NCDs, but only if the meeting results in measurable commitments to take action.
2. Governments will issue an action oriented Outcomes Document at the conclusion of the Summit which will address NCDs globally. The NCD Alliance, as the unique global voice representing those living with or affected by NCDs, has issued a Proposed Outcomes Document containing national and global targets for NCDs which we believe would represent a successful Summit which can be found here. The Alliance has also released a condensed Pocketbook Version of its Proposed Outcomes Document containing its 10 Priority Outcomes for the Summit which can be found here.
The NCD Alliance and The Lancet have also issued a complementary document outlining the priority cost-effective interventions they are asking governments to commit to implementing at the UN Summit which can be found here.
The world’s political leaders will meet at the Summit on NCDs in September to agree action against a global epidemic of four diseases that everywhere threaten social and economic development as well as security.
Urgent action is vital because the facts about NCDs are staggering. Together cancer, cardiovascular disease, chronic respiratory disease and diabetes are the world’s number one killer. They cause 60% of all global deaths with four out of five of these deaths in low- and middle-income countries where they strike people in their most productive years. 14 million of the 35 million NCD deaths each year could be prevented or delayed. Strong measures taken now can reverse this epidemic.
Last year when the Summit on NCDs was announced, the NCD Alliance called for commitments from governments that would result in six broad outcomes:
1) Governments to be accountable and measured on NCD plans
2) Framework Convention on Tobacco Control (FCTC) to be fully implemented
3) A global commitment to prevent the preventable
4) Globally agreed approaches to NCD treatment and care
5) Resources to deliver global NCD interventions
6) NCDs in the MDG successor goals
We now present the next, more detailed iteration of the six broad outcomes to continue the dialogue with the UN and its agencies and all member states.
The NCD Alliance Proposed Outcomes Document
The NCD Alliance and its global network of partners have brought together expert thinking and practical experience of NCDs and their common risk factors to draw up a detailed programme of action which we believe UN Member States should consider as a template for a strong Outcomes Document in September this year.
Our Proposed Outcomes Document contains 34 carefully considered recommendations that we believe should be the basis of the political response to NCDs. We have not ranked these in order of priority because the NCD crisis is complex and multi-faceted. However, we have grouped them under 8 headings: Leadership, Prevention, Diagnostics and Treatment, Health Systems, Resources, Research, Human Rights/Vulnerability and Monitoring/Follow Up.
We believe that global action should aim to reduce NCD deaths by at least 2 per cent a year.
Eight Focus Areas for Action
Combatting NCDs requires global leadership coordinated by the UN plus sustained activity over a decade of action during which the UN, national governments, the private sector and NGOs work together to implement the promises made at the Summit. NCDs must be included in future global development goals to ensure low and middle-income countries have the resources and expert support to tackle NCDs. Global commitments must then be translated into costed national NCD strategies and joined-up plans implemented, with specific targets, for the prevention, early detection, treatment and care of NCDs.
The majority of NCD cases can be prevented or delayed by confronting four major risk factors: tobacco use, unhealthy diet, physical inactivity and alcohol misuse. Control of tobacco is absolutely critical to reducing NCDs. Governments have agreed to take action through the Framework Convention on Tobacco Control; they must implement it effectively. In addition, where there are proven cost effective interventions available for specific diseases, these should be pursued immediately.
Diagnostics and Treatment
Early diagnosis and treatment stops NCDs progressing into costly, crippling complications and premature death. There are documented, cost effective means to diagnose and treat NCDs and these should be available to all.
The primary health care level is crucial for prevention, diagnosis and routine treatment of NCDs. New vertical NCD health programmes are not needed; NCDs should be integrated into existing health system programmes which should be strengthened to meet the scale of the problem.
At a time when resources are scarce, many may seek to limit investing in the NCD problem, but investing in NCDs now will save money, lives and misery later. More investment is needed through domestic health funding and Overseas Development Assistance for low and middle income countries. Development funding agencies must end the policy prohibition against funding NCDs. Innovative financing mechanisms and better procurement policies are also needed to fund NCD programmes.
Governments should invest in more research to enhance our common understanding of NCD causes, cures and control.
Poverty and malnutrition put people at high risk and need to be confronted. Certain social groups and peoples are more vulnerable to NCDs. Maternal health and nutrition must be safeguarded to reduce NCDs in mothers and children. We urge the UN to address the fact that people with NCDs often suffer discrimination and stigma – these must be ended to enable them to lead full and productive lives.
The NCD epidemic has grown in little more than one generation but will require a long-term commitment to resolve it. Implementation of the commitments made at the Summit will need to be closely monitored and we would propose that the UN convene a high level review of progress in 2016.
Download an introduction letter from the NCD Alliance here.
Read our Frequently Asked Questions about the NCDA Proposed Outcomes Document here.
Read more about the NCD Alliance and The Lancet's Priority Interventions for the UN High-Level Summit here.