WHO - Global and regional NCD commitments
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Transcript of WHO - Global and regional NCD commitments
WHO - Global and regional NCD commitments
Peter Sousa Hoejskov, Technical Officer Food Safety & NCDWHO Division of Pacific Technical Support (DPS)
55th PIHOA Board Meeting, Pohnpei, FSM 11-13 March 2014
*Surveillance*Mapping the epidemic of
NCDs and risk factors
*Management*Strengthen
health care for people with
NCDs
*Prevention*Reducing the
level of exposure to risk factors
World Health Assembly in 2000:There is a strategic vision on how to address NCDs
2000
2003
2004
2008
Global Strategy for the Prevention and Control of Noncommunicable Diseases
Global Strategy on Diet, Physical Activity and Health
Action Plan on the Global Strategy for the Prevention and Control of NCDs
2010
2009
2011
Global Strategy to Reduce the Harmful Use of Alcohol
WHO Global Status Report on NCDs
Political Declaration on NCDs
2012+ Realizing the commitments made in the Political Declaration
Setting the agenda:Vision and a global road map
Pacific political commitment Pacific Health Leaders Multisectoral leaders Pacific Forum Leaders
1995 Yanuca Island declaration: ‘Healthy Islands’
2003 Tonga Commitment to Healthy Lifestyle and Supportive Environment
2010 PIHOA: NCD as a medical emergency in USAPI
Pacific Food Summit : Agriculture, Health and Trade on Food Security
2011 Honiara Communique on NCD Crisis declaration
Ministers of Sports supporting NCD
NCD Crisis Declaration
UN High Level: Political Commitment on NCD
2013 Apia Communique on NCD Forum Trade and Economic Ministers : NCD Finance Roadmap
2014 Directors of Health: CRP endorsement
Ministers of Finance and Health Meeting
The UN High-level Meeting on NCDs was a defining moment for development cooperation: it sets a new global agenda that advances inclusive social and economic development.
UN
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eral
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y2011:Commitments from Heads of State and Government
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ld H
ealth
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y2012:Adopt a global target of a 25% reduction in premature mortality from NCDs by 2025
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ealth
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2013:WHO Global NCD Action Plan 2013-2020, including 9 global targets and 25 indicators
UN General Assembly NCD Review 2014:
Review and assessment of the United Nations General Assembly of the progress achieved in the prevention and control of NCDs
The WHO Global NCD Action Plan 2013-2020unites governments, international partners and WHO around a common agenda
Vision:A world free of the avoidable burden of NCDs
Goal:To reduce the preventable and avoidable burden of morbidity, mortality and disability due to NCDs by means of multisectoral collaboration and cooperation at national, regional and global levels
Objective 1To strengthen international
cooperation and advocacy to raise
the priority accorded to
prevention and control of NCDs
in the development agenda and in
internationally-agreed
development goals
Objective 4To strengthen
and orient health
systems to address the prevention
and control of NCDs through
people-centred
primary health care and universal
health coverage
Objective 5To promote and support
national capacity for high-quality research and development
for the prevention
and control of
NCDs
Objective 2To strengthen
national capacity,
leadership, governance, multisectoral
action and partnerships to
accelerate country response
for the prevention and control of NCDs
Objective 3To reduce
exposure to modifiable risk
factors for NCDs through creation
of health-promoting
environments
Objective 6To monitor the
trends and determinants of
NCDs and evaluate
progress in their prevention and control
The WHO Global NCD Action Plan 2013-2020 has six objectives with recommended actions for Member States, international partners and WHO
Targets for NCD prevention and control
TOBACCO FREE
PACIFIC
At the World Health Assembly in May 2013, Member States adopted the Comprehensive Global Monitoring Framework for the Prevention and Control of NCDs, including a set of 25 indicators
Action AreaGovernanceRisk factors
Health systems
Surveillance
Set national targets for 2025 in 2013, taking into account the 9 global targets
Develop national multisectoral NCD policies and plans to attain national targets for 2025, by addressing the three major components of the NCD strategy
Finalize and endorse Crisis Response Plans (CRP)
What is next?Immediate actions for Member States 2014-2015
What is next? Priority actions recommended for Member States to reduce the exposure of populations and individuals to risk factors for NCDs
Implement interventions identified by WHO as "best buys" using WHO tools: Tobacco use:
– Tax increases– Smoke-free indoor work places and public places– Health information and warnings about tobacco– Bans on adverting and promotion
Harmful use of alcohol:– Tax increases on alcoholic beverages– Comprehensive restrictions and bans on alcohol
marketing– Restrictions on the availability of alcohol
Unhealthy diet and physical inactivity:– Salt reduction through mass media campaigns and
reduced salt content in processed foods– Replacement of trans-fats with polyunsaturated fats– Public awareness programme about diet and physical
activity– Marketing of foods and non-alcoholic beverages to
children
Action AreaGovernanceRisk factors
Health systemsSurveillance
What is next? Priority actions recommended for Member States to enable health systems to respond more effectively and equitably to the health-care needs of people with NCDs
Implement interventions identified by WHO as "best buys" into the basic primary health care:
Health system strengthening is key:– Prevention of liver cancer through hepatitis
B immunization– Prevention of cervical cancer through
screening and treatment of pre-cancerous lesions
– Multidrug therapy to individuals who have had a heart attack or stroke and to persons with a high risk of a cardiovascular event in the next 10 years
Action AreaGovernanceRisk factors
Health systemsSurveillance
What is next? Priority actions recommended for Member States to quantify and track NCDs and their determinants (as it provides the foundation for advocacy, national policy and action)
Implement the WHO Framework for NCD Surveillance, covering – monitoring of risk factors and determinants, – outcomes (mortality and morbidity) and – health system response
Integrate into the national health information systems
Develop national targets and indicators, based on Pacific targets, the WHO recommendations and WHA Resolutions
Action AreaGovernanceRisk factors
Health systemsSurveillance
The WHO Framework for NCD Surveillance quantifies and tracks exposures, outcomes and health systems response
A WHO Framework for NCD Surveillance Exposures:
– Behavioural risk factors: tobacco use, physical inactivity, harmful use of alcohol and unhealthy diet
– Metabolic risk factors: overweight/obesity, raised blood pressure, glucose & cholesterol.
– Social determinants: education, material well being, access to health care
Outcomes:
– Mortality: NCD specific mortality– Morbidity: cancer incidence and type
Health System Response:– Interventions and health system capacity:
infrastructure, policies and plans, access to key health care interventions and treatments, partnerships.
Action AreaGovernanceRisk factors
Health systemsSurveillance
Indicators Vital Reg with COD
Cancer Registry
STEPS GSHS FFSurveys
GATS GYTS
Mortality from main NCDs Cancer incidence by type Harmful use of alcohol (3) Low fruit and veg intake Physical inactivity in adults Physical inactivity in adolescents Salt intake Saturated fat intake Tobacco use in adults Tobacco use in adolescents Raised blood glucose/diabetes Raised blood pressure Overweight and obesity in adults Overweight and obesity in adolescents Raised total cholesterol
Indicator VitalRegistration
Cancer Registry
STEPS FoodFreq Surveys
SARA/facility data
NCD Capacity survey
Cervical cancer screening Drug therapy and counseling Essential NCD meds and technologies
Hepatitis B vaccine HPV vaccine Marketing to children Access to palliative care Policies to limit saturated fats and eliminate trans fat
Set national targets and measure results
Member States are encouraged to adopt the global and Pacific voluntary targets as national targets
National adaptation should be guided by:o Current performance, o Current level of exposure o Programmes planned and in place
WHO is developing a Toolkit on NCD Surveillance, which will include a module on setting national targets and measuring results
• A framework to prioritize action in the short run (1-2 years)
• Based on very cost-effective interventions (“Best Buys”)
• Helps development partners focus support and technical assistance
• CRPs are not additional NCD plans!
Pacific Crisis Response Plans (CRP)
CRISIS RESPONSE PLANS (CRP) in PICs
Tobacco Control - Tobacco Free Pacific
Healthy Diet – Salt reduction & Fruits and Vegetables
CVD Risk Management & Counselling- Package of Essential NCD (PEN) Services
3 Areas; 15 Strategies and 15+ Milestones
Summary• NCD is not only a threat to public health, but also
to socio-economic development and prosperity • Targets and the way forward are clear –
Countries need to scale up action individually and collectively
• Surveillance, prevention and management of NCDs go hand-in-hand
• CRPs help countries prioritize and progress towards the long-term goal of 25x25
Thank you