NCD and Mental Health Oleg Chestnov ADG/NMH Gauden Galea DNP
NCD and Mental Health
Oleg Chestnov ADG/NMHGauden Galea DNP
Global Process
World Health Assembly resolution WHA64.11
REQUESTS THE DIRECTOR-GENERAL TO:
(4) to report to the Sixty-fifth World Health Assembly, through the Executive Board, on the outcomes of the first Global Ministerial Conference on Healthy Lifestyles and NCD Control and the high-level meeting, and to develop, together with relevant United Nations agencies and entities, an implementation and follow-up plan for the outcomes, including its financial implications, for submission to the Sixty-sixth World Health Assembly, through the Executive Board.
(24 May 2011)
2000
2003
2004
2008
Global Strategy for the Prevention and Control of Noncommunicable Diseases
Global Strategy on Diet, Physical Activity and Health
Action Plan 2008-2013 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
20132020
The World Health Assembly has requested WHO to develop a'WHO Action Plan for the Prevention and Control of NCDs for 2013-2020'
WHO Action Plan for the Prevention and Control of NCDs for 2013-2020
South-East Asia
24-26 April 2012
Yangon, Myanmar
Americas
7-8 May 2012
Brasilia, Brazil
Eastern Mediterranean
30 June – 2 July 2012
Cairo, Egypt
Western Pacific
11-14 June 2012
Kuala Lumpur, Malaysia
Europe
28-29 June 2012
Astana, Kazakhstan
Africa
September 2012
Nairobi, Kenya
Process: Steps to dateRegional consultations based on a WHO Discussion Paper
2012• 26 July 2012 – 7 September 2012: Web-based consultation for Member States,
UN Agencies, NGOs and private sector entities (WHO Discussion Paper)
2012• 16-17 August 2012: First informal consultation with Member States and UN
Agencies (WHO Discussion Paper)
2012• 1 November 2012: Second informal consultation with Member States and UN
Agencies ('Annotated Zero Draft' Action Plan)
2013• January 2013: Executive Board (Annotated Draft Action Plan)
2013• February 2013: Third informal consultation with Member States and UN
Agencies (Draft Action Plan)
2013• May 2013: World Health Assembly (Final Draft Action Plan)
Process: Next steps
Regional Action
Reduction of Circulatory Mortality
Determinants• “Causes of the causes”:• Income• Education• Early Childhood
• Globalization• Demography
Risk Factors• Modifiable• Behavioral• Biological
• Non-modifiable• Genetics
Diseases / Conditions• CVD• DM• Cancer• CRD
Outcomes• Mortality• Morbidity• Poverty: cause
and consequence of NCDs
NCD Framework for Action
Health Promotion
Prevention Treatment
Whole of Society
Health Services
Workflow: ToolsetBest Buys and instructions for use
Each Tool• Evidence base• Basis for selection• “Instructions for
adaptation and use”
Activation Threshold. Project formally initiated only after national prerequisites fulfilled.
Workflow: Process1
• Integrated Needs Assessment
2• Tool Selection• Prerequisites
3• National
Investment
4• Initiation &
Capacity Building
5• Results
Comprehensive situation analysis. Baselines set. Targets agreed by WHO and country teams
Specific tools selected. Plan for adaptation.Country action PRIOR to initiation agreed
WHO and other partners invest in capacity and support implementation in agreed time.
Results are specific PRODUCTS defined in terms of OUTCOMES and IMPACT
Determinants Risk Factors Diseases Outcomes
Results: Example Product Areas
↑ Legislation↑ Communication↑ Capacity
↑ Service access↑ Service quality↑ Capacity
↑ Measurement
↓ Risky behaviour↓ Biologic risk
↓ Incidence↓ Complications↑ Survival
↓ Mortality↓ Poverty↑ Equity
Outcomes of joint action
Impact of joint action
Capacity [1] National Health Reporting
EUR B+C
NCD mortality 100%
NCD morbidity 100%
NCD risk factors 68%
Capacity to Disaggregate: Medium to Low
Capacity [2] Behavioural Risk factors
EUR B+C
Tobacco 88%
Alcohol 76%
Diet 76%
Physical inactivity 76%
Capacity [3] Biological Risk factors
EUR B+C
Overweight & obesity 76%
Blood pressure 84%
Blood glucose 68%
Blood lipids 44%
For discussion
Participation
How can CIS countries maximize their participation in the global consultation process?
Capacity
How can we build the NCD surveillance capacity of CIS countries?
Mental Health Consultation:Global and Regional Action PlansOslo, Norway, 3-5 September 2012
Global Mental Health Action Plan
Resolution WHA 65.4 in May 2012: global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level.
Challenges:• 13% of global burden of disease.• 40-60% higher risk of premature death.• Estimated lost economic output next 20 years:
$16trillion (World Economic Forum).
Objectives Global Mental Health Action Plan1. Effective leadership and governance.2. Mental health and social care services in community
based settings.3. Mental health promotion and protection that span the
life course.4. Strengthen information systems, evidence and
research.
Each with global targets.
European Mental health Action Plan
Requested by Member States, builds on and customises the Global Action Plan, addressing European needs and priorities:
1. Optimize wellbeing at times of economic distress, particularly those most at risk.
2. Focus on empowerment and social inclusion.3. Provide accessible and affordable services.4. Guarantee respectful and effective treatments.
Targets being developed.
Process
Sep• Joint Political consultation, Oslo, Norway
Nov• Global Consultation
May• WHA: Global Mental Health Action Plan
Sep• RCM: European Mental Health Action Plan
Thank You!