Who Global NCD Action Plan: Frameworks, priority actions and surveillance for effective and sustainable NCD prevention
Post on 15-Jun-2015
540 Views
Preview:
DESCRIPTION
Transcript
WHO GLOBAL NCD ACTION PLAN:Frameworks, priority actions and surveillance for effective and sustainable NCD prevention
China Healthy Lifestyle Conference
Beijing 19.8.2013
13.04.23 1
Pekka PuskaDirector General, National Institute for Health and Welfare (THL)President, Int. Association of National Public Health Institutes (IANPHI)Chair, Governing Council of WHO Cancer Research Agency (IARC)Past President, World Heart Federation (WHF)
Greetings from Finland
Pekka Puska, Director General13.04.23
10 million
15 million
20 million
25 million
High-income countries
Upper middle-income
Lower middle-income
Low-income countries
0.6M
0.5M
3.3M
2.3M
10.2M10.2M
3.3 M3.3 M3.0M
3.0M3.0M
3.0M
5.9M5.9M
2.3M
6.8 M6.8 M
3.7M13.6M
13.6M
1.1M0.9M
Low-income countriesGroup III - InjuriesGroup II – Other deaths from noncommunicable diseasesGroup II – Premature deaths from noncommunicable diseases (below the age of 60), which are preventableGroup I – Communicable diseases, maternal, perinatal and nutritional conditions
So
urce
:
Total number of deaths in the world
90% of premature deaths from NCDs occur in developing countries
13.04.23 3Pekka Puska, Director General
GLOBAL PUBLIC HEALTH CHANGING:
13.04.23 4
UN high-level summit on NCDsNew York Sept 2011
• Preceded by Ministerial Conference in Moscow (April 2011).
• Political declaration• Action on global NCD
prevention and control”• WHO’s leadership,
intersectoral support
13.04.23
RECENT POLITICAL SUPPORT
5Pekka Puska, Director General
WHO’s global NCD strategy, 2000
• NCD prevention and control is a global health priority
• Comprehensive action is needed, but from public health point of view population based prevention is the key (most cost-effective and sustainable)
• Integrated prevention: targeting common, lifestyle related risk factors (tobacco, diet, physical activity, alcohol)
13.04.23 6Pekka Puska, Director General
SurveillanceMapping the epidemic of
NCDs
ManagementStrengthen health care for people with NCDs
PreventionReducing the
level of exposure to risk factors
Key Components of the global strategy
Cornerstones of NCD prevention and control (WHO global strategy)• Attention to behavioural risk factors
– Tobacco use– Unhealthy diet– Physical inactivity– Harmful use of alcohol
• Monitoring and surveillance of – Risk factors and diseases– Preventive actions
• Redirection of health services– Prevention (esp. primary health care)– Chronic care model
13.04.23 8Pekka Puska, Director General
INTEGRATED PREVENTION
13.04.23 9Pekka Puska, Director General
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
The journey to scale up global action
2010
2009
2011
Global Strategy to Reduce the Harmful Use of Alcohol
WHO Global Status Report on NCDs
UN Political Declaration on NCDs13.04.23 10Pekka Puska, Director General
Key milestones: High-level Meeting on NCDs and beyond
High-level Meeting on NCDs (New York, September 2011)
Action Plan on the Global Strategy for the Prevention and Control of NCDs
Global Strategy for the Prevention and Control of Noncommunicable
Diseases
Global Strategy for the Prevention and Control of Noncommunicable
Diseases2000
2008
2013
2011
2011
8th Global Conference on Health Promotion,
10-14 June 2013, Helsinki, Finland
8th Global Conference on Health Promotion,
10-14 June 2013, Helsinki, Finland
World Conference on Social Determinants on Health, October 2011, Rio de Janeiro
World Conference on Social Determinants on Health, October 2011, Rio de Janeiro
13.04.23
Action Plan 2007-2012
#New Action Plan
for 2013-20endorsed by WHA 2013
12Pekka Puska, Director General
WHO global action plan 2013-201. International cooperation and advocacy
2. Strengthen national capacity, leadership, governance, multisectoral action and partnership
3. Reduce risk factors through health-promoting environments
4. Strengthen and reorient health systems for prevention and control of NCDs
5. Promote national capacity for research for prevention and control of NCDs
6. Monitor trends and determinants of NCD and evaluate progress
13.04.23 Pekka Puska, Director General 13
13.04.23 Pekka Puska, Director General 14
Global targets (2010-2025)1. 25 % reduction of avoidable mortality
2. 10 % reduction in harmful use of alcohol
3. 10 % reduction in insufficient physical activity
4. 30 % reduction in mean population salt intake
5. 30 % reduction in tobacco use
6. 25 % reduction in raised blood pressure
7. Halt the raise in diabetes and obesity
8. At least 50 % of eligible (=high risk) people receive drug treatment and councelling to prevent heart attack and stroke
9. In 80 % availability of affordable basic technologies and essential medicines for NCD
13.04.23 Pekka Puska, Director General 15
Ban Ki-Moon:”We should all work to meet the targets to reduce NCDs”
13.04.23 16Pekka Puska, Director General
Global indicators
• Indicators of targets
• Additional indicators–E.g. saturated fatty acids, fruits and
vegetables, blood cholesterol, cervical cancer screening, HPV vaccination, policies of narcotics, advertizing of foods and non-alcoholic beverages to children, national policies to limit saturated fats and eliminate trans fats in food supply
13.04.23 Pekka Puska, Director General 17
PRIORITY ACTIONS
• Should be feasible and affordable in low-cost settings
• Evidence and/or expert opinion to support
• Adapt to local conditions and stage of process
• Supported by many documents
13.04.23 Pekka Puska, Director General 18
1. International cooperation and advocacy
• Raise public and political awareness on NCDs
• Strengthen international collaboration for training
• Integrate NCDs into development strategies
13.04.23 Pekka Puska, Director General 19
13.04.23 20Pekka Puska, Director General
13.04.23 Pekka Puska, Director General 21
2. Strengthen national capacity, leadership etc.
• Increase budgetary allocations for NCD
• Strengthen national capacity, including institutional capacity for prevention and control of NCDs
• Develop national multisectoral policy and plan
13.04.23 Pekka Puska, Director General 22
Intersectoral work towards prevention- ”Health in all policies”
• People’s lifestyles are influenced by decisions in different sectors of society (much of them beyond the health sector)
• Health in general and NCD prevention in particular should be taken into account in decisions made by different sectors (health impact assessment)
• Social change process combining government policies, expert guidance, broad health promotion and mobilization of people
Pekka Puska, Director General13.04.23
8th Global WHO Conference on health promotion - “Health in all policies”
From Ottawa to Helsinki (June 2013)
13.04.23 24Pekka Puska, Director General
HELSINKI STATEMENT
Comprehensive action and partnership for national NCD prevention
• Health services
• Governments (national, local)
• Civil society (NGOs)
• Private sector
• Media
• International collaboration
13.04.23 25Pekka Puska, Director General
What are NPHIs?
Institution or network that provides leadership and coordination for public health systems at the national level
Often part of the government (usually under
MOH) or closely attached to it. Scope & size vary.
Promotes evidence-based decisions, policies, and programs
MEXICO INSP
MOROCCO
NETHERLANDS RIVM
U.S. CDC
ETHIOPIA EHNRI
CHINA CDC
Finland THL
3a Reduce risk factors: tobacco• Increase tobacco tax
• Completely smokefree indoor places by law
• Effective health warnings and media campaigns
• Ban all tobacco advertising, promotion and sponsorship
(all FCTC provisions should be implemented)
13.04.23 Pekka Puska, Director General 27
13.04.23 Pekka Puska, Director General 28
3b Reduce risk factors: alcohol
• Increase alcohol tax
• Comprehensive restrictions and bans on adventising and promotion
• Restrictions in the availability of retailed alcohol
13.04.23 Pekka Puska, Director General 29
13.04.23 Pekka Puska, Director General 30
3c Reduce risk factors: unhealthy diet and physical inactivity
• Salt reduction through industry and media campaigns
• Reduction of saturated fat and replacement of transfats
• Public awareness campaigns on diet and physical activity
13.04.23 Pekka Puska, Director General 31
13.04.23 Pekka Puska, Director General 32
4. Strengthen and reorient health systems• Integrate effective NCD interventions in universal
primary health care
• Explore innovative financing approaches to expand health coverage and prioritize very cost effective interventions
• Multidrug preventive therapy to high risk of CVD individuals
• Aspirin in acute heart attack
• Liver cancer prevention through hepatitis B immunization
• Cervical cancer prevention through screening
13.04.23 Pekka Puska, Director General 33
Redirection of health services
13.04.23 Pekka Puska, Director General 34
• Reorientation and strengthening of health systems• Primary health care:
”Now more than ever” (WHR 2008)
• Special emphasis for NCDs• Chronic care model• Preventive practices
5. Promote national reserch capacity
13.04.23 Pekka Puska, Director General 35
• Develop national research agenda• Strengthen national capacity
through national health and research institutes
13.04.23 Pekka Puska, Director General 36
6. Monitor and evaluate• Develop national targets and indicators
(based on the global ones)
• Develop national surveillance monitoring system–Cause of deaths register–Cancer register–Periodic population risk factor surveys–Monitoring of national actions
13.04.23 Pekka Puska, Director General 37
NCD FRAMEWORK FOR ACTION/MONITORING
13.04.23 38
GENETICS
Health promotion
Prevention Treatment
SOCIETAL RESPONSES(HiAP)
HEALTH SERVICES
Pekka Puska, Director General
International/global action
• United Nations: New York 2011 Political Declaration, Post 2015 targets
• UN agencies coordination
• WHO leadership–UN coordination– International collaborative mechanism–Global Action Plan 2013-20–Global monitoring and reporting (UN,
WHA)
13.04.23 Pekka Puska, Director General 39
13.04.23 Pekka Puska, Director General 40
NCD prevention is possible!
The potential is great• Quite rapid impact• Human impact on health and
wellbeing• Impact on health service costs and
socioeconomic developmentEXPERIENCE FROM FINLAND
13.04.23 41Pekka Puska, Director General
Change in age-adjusted mortality rates Finland, males aged 35–64 (per 100 000 population)
extension of the Project nationally
start of the North Karelia Project
North Karelia -85%
All Finland -80%
Rate per 100 000
1969-1971
2006 Change from 1969-1971 to 2006
All causes 1328 583 -56%
All cardiovascular
680 172 -75%
Coronary heart disease
489 103 -79%
All cancers 262 124 -53%
Coronary heart diseaseCoronary heart disease
Gain of some 10 healthy years in Finnish populationGain of some 10 healthy years in Finnish population
13.04.23 42Pekka Puska, Director General
The North Karelia/Finland experience• Supports and has interacted much with
the WHO NCD strategy:– Integrated prevention–FCTC, Diet & physical activity strategy
• Happy about the recent political support to upgrading of NCD prevention–UN NCD Summit in September 2011
in New York–Follow up work under WHO leadership
13.04.23 Pekka Puska, Director General
13.04.23 Pekka Puska, Director General
45
THE MAIN CHALLENGE FOR
SUCCESSFUL NCD
PREVENTION IS NOT WHAT
TO DO, BUT HOW TO
IMPLEMENT THE NEEDED
ACTIONS!
13.04.23 Pekka Puska, Director General
During the last few years a great number of strategies and plans for evidence-based, effective prevention and health promotion have been produced
13.04.23 Pekka Puska, Director General 46
Many important priorities have been identified
Pekka Puska, Director General
IDENTIFYINGIDENTIFYING IMPLEMENTINGIMPLEMENTING
PRIORITIESPRIORITIES THEMTHEM
FROM PRIORITIES TO IMPLEMENTATION
04/13/23
Implementation gap
The WHO Global NCD Action Plan and many other WHO and national strategies give clear quidance on what to do
- But to achieve good results a lot of practical work in the communities and in the country is needed!
13.04.23 Pekka Puska, Director General 48
Thank you
13.04.23 49Pekka Puska, Director General
top related