The hearing was split into a series of three roundtables, which effectively were panel discussions followed by statements made from the floor. The moderator for the day was Morgan Binswanger from LIVESTRONG, an NCD Alliance partner. The first Roundtable discussion considered the scale of the challenge being faced globally due to NCDs. The second Roundtable was titled “National and local issues”. The third roundtable was titled “What is needed to enhance global cooperation”.
Although the hearing was supposed to be interactive, the time available for genuine discussion was somewhat limited, given there were so many planned speakers. In summary, George Alleyne, who thanked Ashley Bloomfield of WHO for his help, addressed the common themes from the day, noting:
1. The universal value of health. All persons have the right to those sanitary and social measures necessary to protect and preserve their health. To deny them such in the context of NCD is a manifestation of social injustice
2. The current macroeconomic impact of NCD is already significant and the projections are staggering. The burden will be borne disproportionately by the poor. In this as in other areas there is need for further research.
3. The issue of the prevention and control of NCD has to be elevated to the political level and interest there maintained.
4. NCD are categorically a development issue and attention to them should be included in the country’s development agenda. The Paris Declaration speaks to the alignment of development assistance to national development priorities. There is need for ideas and strategies to attract the philanthropic community to funding for NCD.
5. There are effective interventions for the prevention and control of NCD, and WHO has provided a list of “best buys”. A holistic approach is needed, but countries are counseled to look at a “start here” list. It behooves all countries to invest as a priority in the interventions that are of proven value, notably in the area of tobacco and salt.
6. There may be a need for a “clearing house “to facilitate knowledge transfer. But in addition, use of modern social marketing technology is critical. Health is one such approach. The world needs some type of global forum as an enabling mechanism to facilitate global cooperation.
7. Collective action is essential to make the “game-changing” steps required for the optimal approach to the prevention and control of NCD. A crucial aspect of this collective action is multi-sectoral cooperation. The sectors within government as well as the sectors within the State (public sector, private sector, civil society) must be brought together.
8. Primary and secondary prevention are both essential and in the context of the former, interventions across the life course are critical. The particular case of nutrition must be addressed.
9. Strengthened health systems are crucial for the response and there were three critical aspects mentioned-human resources, universal access and information systems which are essential for the monitoring, evaluation and accountability mechanisms that are necessary. At the level of the health systems there are opportunities to work with the communicable disease community-the maternal and child health community. This brings into focus the need for the various UN agencies such as UNICEF, FAO and others to be involved. There are other groups which must be involved-women’s groups, those concerned with environmental issues such as climate change and those addressing occupational and work place issues.
10. Some industrial influences may be in conflict with the health goals. The appropriate regulation of these industries which drive risk factors for NCD is a sign of good governance.
11. There are lessons to be learned from the HIV experience.
12. Many of the MDGs are directly related to NCD, so there is no need for an either/or approach. The UN Resolution called for the HLM to deal primarily with four NCD that share four common risk factors.
13. Unlike the weather, we can control NCD. The best way to predict the future is to control it.