WHO is to be congratulated for going out of its comfort zone. This week in Moscow, they demonstrated an uncharacteristic inclusiveness, bringing together multiple stakeholders from beyond the member states, including civil society, academics, industry etc. so that all could participate in shaping the Declaration, the key output, to be released at the end of the meeting.
The main Moscow Meeting, the Russian Ministerial Meeting on Healthy Lifestyles and Noncommunicable Disease, brought together ministers and official delegations from more than 100 countrie, to deliberate on the different issues related to NCDs and how they should be tackled globally.
In addition to robust discussions, passionate engagement and incredible opportunities for learning by interested people even beyond those assembled in Moscow (thanks to the WHO for webcasting the events), the most enduring outputs from Moscow this week are two documents – the Moscow Declaration and WHO’s Global Status Report on Noncommunicable Disease.
With grateful thanks to the 60 people from 30 countries who worked tirelessly in advance and for more than 10 hours intensively during the conference to negotiate the wording of the document, the attendees at the Russian Ministerial Meeting endorsed the Moscow Declaration, a historic milestone in the world’s NCD journey. The document acknowledges the NCD crisis, the double burden in many countries from both NCDs and infectious diseases, and that NCDs are a development issue. It emphasizes both prevention and control and calls on members states to take immediate action to address NCDs while calling for international co-operation.
Key additional points:
- Dr. Margaret Chan, WHO’s Director-General, in her own inimitable style, called for “transformational leadership” from all levels in all sectors, a “whole of government” and “whole of society” approach, in order to convince leaders in New York that they should give NCDs the political leadership these serious diseases deserve.
- WHO also highlighted the need for good data and good measurement as they are needed for both policy and investment decisions. Of note, WHO committed to developing a global monitoring framework for NCDs by July 2011. In addition they stressed that countries must invest significantly in national surveillance and research on NCDs.
- While acknowledging the need for increased capacity and resources, WHO urged member states to examine what can be done now with the resources at hand. And urged Ministers of Health, the champions of NCDs, not to wait for additional money to begin action.
This report, the release of which was timed to coincide with this meeting in Moscow, is an authoritative resource for the size of the NCD problem.
Some key points include:
- NCDs cause 36 million deaths each year, 63% of the deaths in the world, with 4 out of 5 of them occurring in developing countries.
- 9 million of these deaths are premature (in people less than 60 years of age), and a vast majority, 8 out of 9, of these premature deaths occur in developing countries. Stated in a different way, in low- and middle-income countries, 29 percent of NCD deaths are premature, while in developed countries, 13 percent of the NCD deaths occur before age 60.
- NCDs are an enormous health and development problem affecting lower and middle-income countries disproportionately. While the mortality from NCDs is expected to increase in all countries (by 15% globally over 10 years), the rate of increase is expected to be the highest over the next 10 years in Africa (23%), followed by the Middle East and South East Asia.
- The report also summarizes the levels of NCD risk factors as well as the capacities within countries to address these serious diseases.
- And it lists “Best Buys” for intervention including tobacco control and salt reduction etc.
This Report will, we believe, be a reference for many students of public health, advocates and policy makers over the years. An updated report is expected in 2013, which will allow us to track the trends over time.
- See the Global Health Council’s story on this topic, with links to the WHO press release and the WHO Report.
Other key remarks resonated with us at Arogya World:
- NCDs represent a challenge of leadership – of governments, of NGOs, of the private sector, as well as individual people. We agree.We believe that policy makers and governments need to step up to the plate and make tough commitments, but so must other players.We believe the UN Summit this year gives industry an incredible opportunity to demonstrate responsiveness and responsibility. For example, industry can change marketing practices especially to children, invest in employee health and wellness, etc. In the words of Dr. Chan, “industry can earn trust by walking the talk”.We also think that NGOs like us must take a hard look at our own efforts and declare what more we can commit to doing this year in advance of the NCD Summit and beyond to help the world address NCDs.Furthermore, we also believe that we as individuals have a responsibility to make healthier lifestyle choices everyday.
- We need a social movement, which mobilizes all segments of society. Read our post: “An Opportunity We Cannot Afford to Miss.”
- That one avenue is to empower women to raise healthy children and families, and in turn impact their entire communities. We agree. We believe greatly in the central role women can play as a solution to the NCD crisis and are taking steps to take this message to women.
– See our op-ed “International Women’s Day: Catalyst for a Healthier Future”
– The Remarkable Women Speak Up Project
– Mothers Against Diabetes Campaign
- NCDs need all of us to think globally but act locally.This is something we at Arogya World truly believe in because we have declared a dual mission in our quest to change the course of chronic disease, one community at a time, for example global advocacy for NCDs and diabetes prevention through lifestyle changes in India.
- And we noted with interest the deliberations during the Food and Nutrition Roundtable, where Prof. Phllip James showed that public health interventions in schools and worksites, taxation, and regulated food advertising are among the best ways to address diabetes. Arogya World is engaged in school- and workplace-based diabetes prevention in India (see our framework for Healthy Schools and Healthy Workplaces ‘Seals of Approval’ and Our Work in India) and has plans for building on previous efforts asking for policy changes in India including those that clarify standards for advertising of junk foods on TV. And we also found remarkable Dr. Graham McGregor’s eloquent case for salt reduction similar to what has been followed in the UK.
The Moscow meetings lived up to their promise of putting NCDs on the world stage in a bigger way than ever before. We at Arogya World are pleased that prevention occupies a central spot in the Moscow Declaration. We sincerely believe that prevention is core to the way the world will address NCDs, and we believe that the final UN Outcomes Document will reflect that.