NCDnet - First Forum - FINAL DRAFT · 24/02/2010 · DRAFT. First NCDnet Global Forum (Geneva, 24 February 2010) 2 FOREWORD ... first NCDnet Global Forum conveyed a sense of urgency.

Report of the First Global Forum convened by the World Health Organization (Geneva, 24 February 2010)

Global Noncommunicable Disease Network (NCDnet)

Discussion paper(Not an official document)

DRAFT

First NCDnet Global Forum (Geneva, 24 February 2010)

2

FOREWORD Today, noncommunicable diseases (NCDs) represent a leading threat to global health and development. Cardiovascular diseases, cancers, diabetes and chronic respiratory diseases now cause 60 per cent of deaths globally. Around 80 per cent of these deaths occur in low- and middle-income countries, which can least afford the social and economic consequences they bring. It is estimated that more than 8 million deaths from NCDs occur every year in low- and middle-income countries before the age of 60. Most of these premature deaths are preventable if public policies involving all government departments are established and effectively implemented. There are new dimensions to the NCD problem in low- and middle-income countries. Many low- and middle-income countries are now beginning to suffer from a double burden of undernutrition and obesity. There is clear evidence that poor nutrition during pregnancy and the first two years of life predisposes individuals and populations to the development of cardiovascular disease and diabetes later in life. NCDs are also linked to the burden of HIV and TB, and recent analysis suggests that a significant reduction in the magnitude of NCDs would impact positively on the progress towards the achievement of Millennium Development Goal (MDG) 6. In order to address the global challenge posed by NCDs, the World Health Assembly endorsed the Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases in May 2008. The NCD Global Strategy Action Plan comprises a set of actions for Member States, international partners and WHO which, when performed collectively with the effective involvement of sectors outside health, will tackle the growing burden and socio-economic impact caused by NCDs. Prevention of NCDs is essential for sustainable development. International efforts in both health promotion and poverty reduction will be derailed if we fail to address the global challenge of cardiovascular diseases, cancers, diabetes and chronic respiratory diseases. Discussions at the 2009 ECOSOC High-level Segment (6-9 July 2009, Geneva) drew attention of the international community to the NCD gap in the global development agenda. Since then, a growing number of Member States have stressed that global development initiatives must take into account the prevention and control of NCDs and that instruments such as the MDGs provide opportunities for synergy. A number of low- and middle-income countries recently called on Member States of the United Nations General Assembly to undertake action. Their call has been supported by the Commonwealth Heads of Government, which have issued a 'Statement of Commonwealth Action to Combat NCDs1, which, inter alia, declares support for the call to integrate indicators to monitor the magnitude, trend and socio-economic impact of NCDs into the core MDG monitoring and evaluation system, and the call to convene a High-level Meeting on NCDs, to be held in September 2011, under the auspices of the UN General Assembly. 1 The Commonwealth Heads of Government Statement to Combat NCDs is available at: http://www.thecommonwealth.org/files/216911/FileName/StatementonCommonwealthActiontoCombatNon-CommunicableDiseases.pdf


3

In order to implement objective 5 of the Global Strategy Action Plan, which focuses on strengthening partnerships, WHO established the Global Noncommunicable Disease Network (NCDnet), which was launched during the ECOSOC High-level Segment in July 2009. The first meeting of the NCDnet Global Forum was convened in Geneva on 24 February 2010. It provided a timely opportunity to review the changing landscape and to focus on the key parameters to promote better health outcomes from NCDs in low- and middle-income countries: to raise awareness through collective advocacy, to improve resource availability, and scale up monitoring and evaluation. Improving health outcomes from NCDs is not just about investing more. Equally important are strengthening of partnerships and intersectoral action. Putting an end to premature deaths from NCDs will lay the foundation for improving the health and well-being of the present and future generations. The meeting of the first NCDnet Global Forum conveyed a sense of urgency. It is time to spread a broader awareness of the worldwide challenges of NCDs, and generate adequate resources that countries can use to support their prevention programmes. This report is written primarily for all partners concerned with action to prevent premature death and improve health outcomes from NCDs. We hope that the international development community will seriously consider the inclusion of NCD prevention initiatives as part of their priorities in bilateral and multilateral collaboration with low- and middle-income countries.

Dr Ala Alwan Assistant Director-General Noncommunicable Diseases and Mental Health World Health Organization


4


5

MEETING REPORT 1. INTRODUCTION The impetus for this meeting came from the World Health Assembly, which endorsed the Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases (NCDs) in May 20082. The NCD Global Strategy Action Plan has six objectives. Each objective has a set of proposed actions for Member States, international partners, as well as the WHO Secretariat. The fifth objective of the NCD Global Strategy Action Plan is to promote partnerships for the prevention and control of NCDs. It calls on the WHO Secretariat to facilitate a global network for NCD prevention and control. To this end, WHO convened the first Global Forum of a newly established Noncommunicable Disease Network3 (NCDnet) on 24 February 2010 in Geneva. The first NCDnet Global Forum brought together over 150 participants from all regions, representing a wide range of stakeholder groups with an interest in addressing NCDs in low- and middle-income countries, including global advocates, Member States, United Nations Agencies, the World Bank, NGOs, WHO Collaborating Centres, academia, research centres and the business community. The meeting provided an opportunity for participants to increase their understanding of the NCD Global Strategy Action Plan and to join and support NCDnet. 2. OBJECTIVES OF THE MEETING The purpose of the meeting was to mobilize a broad base of stakeholders in support of the implementation of the NCD Global Strategy Action Plan, enabling them to share knowledge and experience and to commence building and coordinating results-oriented collaborative efforts and alliances to achieve the three NCDnet goals of (1) increasing focus on NCDs through collective advocacy; (2) increasing resource availability (both financial and human capital) and (3) catalysing country-level action, with a particular focus on low- and middle-income countries. The meeting was conducted as an awareness building event, encouraging strategic dialogue, identifying key issues and charting a way forward that will widen the circle of stakeholders, and ultimately foster collaborative work.

2 http://whqlibdoc.who.int/publications/2009/9789241597418_eng.pdf 3 NCDnet, a new network to combat noncommunicable diseases, was established by WHO on 8 July 2009. The conceptual framework of NCDnet is available at http://www.who.int/nmh/ncdnet_20090826_en.pdf


6

3. WELCOME, OPENING REMARKS AND KEYNOTE ADDRESSES The first session included opening remarks by the WHO Director-General, Dr Margaret Chan, key note addresses by UN Messenger of Peace, HRH Princess Haya Al Hussein of Jordan and UNAIDS/UNICEF Goodwill Ambassador, HRH Princess Mathilde of Belgium, Duchess of Brabant, as well as a presentation by WHO Assistant Director-General, Dr Ala Alwan. The purpose of the opening remarks, the key note addresses and the presentation was to provide initial reflections and to highlight elements of consensus on what should be done in the face of a crowded environment for health and development and an unpredictable global financial crisis. The Director-General focused in her introduction on the greater burden of NCDs on low- and middle-income countries and the links with poverty4. A common theme across the key note address by HRH Princess Haya Al Hussein of Jordan was the increasing burden of over- and under-nutrition in low- and middle-income countries, as well as the declining trends in physical activity, which particularly affects women and youth in her region5. Her Royal Highness conveyed a sense of urgency when she called on the UN General Assembly for a broader discussion on the prevention and control of NCDs in low- and middle-income countries. HRH Princess Mathilde of Belgium referred to the close links between NCDs and HIV/AIDS, child health and maternal health and stressed that the international community now stands on the brink of success in raising the priority accorded to addressing NCDs in low- and middle-income countries6. Her Royal Highness called on the international community to double its efforts in providing support to low- and middle-income countries based on the NCD Global Strategy Action Plan. WHO Assistant Director-General, Dr Ala Alwan, reviewed the global magnitude of NCDs and their impact on socio-economic development, summarizing the progress achieved during the first 21 months in implementing the NCD Global Strategy Action Plan, and highlighting the opportunities and constraints in moving forward 7 . He emphasized that the meeting should be seen as an opportunity to exchange views and frame issues on collective advocacy, resourcing and country action, taking advantage of the wide range of experience around the table. The opening remarks, key note addresses and presentation concluded with two key messages. One is the urgent need to meet the demand of low- and middle-income countries for technical support (through aid and expertise) in order to strengthen national capacity-building for public-health and socio-economic aspects of the major NCDs. The other is that there are three new developments to the NCD problem in 4 The opening remarks of the WHO Director-General are available as follows: http://www.who.int/dg/speeches/2010/ncdnet_forum_20100224/en/index.html 5 The key note address of HRH Princess Haya Al Hussein of Jordan is available as follows: http://www.who.int/ncdnet/events/hrhprincess_hussein_20100224.pdf 6 They key note address of HRH Princess Mathilde of Belgium is available as follows: http://www.who.int/ncdnet/events/hrhprincess_hussein_20100224.pdf 7 The presentation of the WHO Assistant Director-General for Noncommunicable Diseases and Mental Health is available as follows: http://www.who.int/ncdnet/events/alwan_20100224.pdf


7

low- and middle-income countries which the international development community must take into account. The first development is the growing awareness that many international efforts to improve health and reduce poverty in low- and middle-income countries may not be reached unless NCDs are tackled. The second development is the growing political momentum within the United Nations to incorporate NCD prevention into the global development agenda. The third development is the strengthened evidence of the availability of feasible and cost-effective solutions to the NCD problem in low- and middle-income countries, which represent excellent economic investments. 4. THE PRIORITY ACCORDED TO NCDS IN DEVELOPMENT The first panel was chaired by the Minister of Health of Guyana, HE Dr Leslie Ramsammy. Panelists included the Vice Prime-Minister and Minister of Social Affairs and Public Health of Belgium, HE Ms Laurette Onkelinx; the Founder and Executive Chairman of the World Economic Forum, Professor Klaus Schwab; the Acting Vice-President for Nutrition, Health and Population at the World Bank, Mr Julian Schweitzer; and the Deputy Director of the Department of Cooperation and Public Relations of the Russian Federation's Ministry of Health and Social Development, Dr Oleg Chestnov. The purpose of the first panel was to identify opportunities to include NCDs in global discussions on development and chart a way forward in order that global development initiatives will take into account the prevention and control of NCDs. There was agreement on the call to add NCDs prevention to global public health goals, as well as the Millennium Development Goals (MDGs)8. The Vice Prime-Minister and Minister of Social Affairs and Public Health of Belgium stressed the need to increase the priority accorded to the prevention and treatment of NCDs in low- and middle-income countries. The Founder and Executive Chairman of the World Economic Forum referred to the World Economic Forum Global Risks Report 20109, which highlights NCDs as one of the leading macro-economic risks in terms of likelihood and severity. The Vice-President of the World Bank identified the need for a holistic approach to health development, going beyond the predominant focus on HIV/Malaria and TB to strengthening health systems and building national sustainable institutional capacities to address the leading causes of ill health, including NCDs. The Deputy Director of the Department of Cooperation and Public Relations of the Russian Federation's Ministry of Health and Social Development expressed concern regarding the current lack of investment and funding available through international development agencies, UN Agencies and the World Bank to support low- and middle-income countries in establishing and strengthening national policies and plans to prevent and control NCDs, as well as the limited financing available within country budgets. Questions were raised about the extent and nature of engagement of international development agencies in addressing NCDs. The first panel concluded with two key messages. One is the need for global development initiatives to take into account the prevention and control of NCDs, in 8 http://www.who.int/mediacentre/events/2008/wha61/leslie_ramsammy_speech/en/index.html 9 http://www.weforum.org/pdf/globalrisk/globalrisks2010.pdf


8

line with objective 1 of the NCD Global Strategy Action Plan. The other is a concurrent need to recognize that the burden of NCDs in low- and middle-income countries will increase rapidly because of globalization, rapid urbanization and population ageing, and that technical support is key in addressing the pressures that this will impose on international efforts in health and in poverty reduction. 5. ACCELERATING THE ACHIEVEMENT OF NCDNET GOALS The second panel was chaired by the WHO Assistant Director-General, Dr Ala Alwan. Panelists included the Director for Global Health Programmes of Bloomberg Philanthropies, Dr Kelly Henning; the President of the International Diabetes Federation, Dr Jean-Claude Mbanya; the Deputy Director of the Department of Cooperation and Public Relations of the Russian Federation's Ministry of Health and Social Development, Dr Oleg Chestnov; the Associate Director for Global Health at the US Centers for Disease Control and Prevention, Dr David McQueen; the Deputy Director-General of the Netherlands' Ministry of Health, Welfare and Sports, Ms Annemiek van Bolhuis; the Deputy Chief Executive Officer of the Thai Health Promotion Foundation, Dr Supreda Adulyanon; the representative of the Health Ministers' Council Executive Office of the Gulf Cooperation Council, Dr Yousef Alnesef; the Director-General of Canada's Public Health Institute, Dr Kim Elmslie; and Acting Vice-President for Nutrition, Health and Population at the World Bank, Mr Julian Schweitzer. The purpose of the second panel was to provide an opportunity for stakeholders to pledge specific support to the implementation of the NCD Global Strategy Action Plan and link their plans to the implementation of strategic interventions. Panelists spoke of their support to low- and middle-income countries and WHO in implementing interventions projects, exchanges of experience among stakeholders and capacity-building programmes, including: - Bloomberg Philanthropies spoke of their combined investment of US$500 million,

together with the Bill and Melinda Gates Foundation, to help governments in low- and middle-income countries implement proven policies and increase funding for tobacco control;

- International Diabetes Federation, World Heart Federation and the International Union against Cancer announced that they have formed an alliance of NGOs through which more than 730 national member organizations have been mobilized to support countries in mobilizing resources, building effective national programmes and strengthening health systems, in line with the NCD Global Strategy Action Plan, so that they can meet the growing challenges posed by NCDs;

- The Russian Federation committed to hosting a high-level international conference on NCDs in 2011 to raise the priority given to the prevention and control of NCDs on the agendas of meetings of international leaders and strengthen the global response to the NCD challenge;

- The US Centres for Disease Control and Prevention reiterated their longstanding commitment to working with WHO on promoting the implementation of interventions to reduce risk factors for NCDs, in particular tobacco control, unhealthy diets and physical inactivity, as well as on strengthening surveillance


9

systems and standardized data collection on risk factors in low- and middle-income countries;

- The Netherlands Ministry of Health Welfare and Sports, announced that it will closely collaborate with WHO, through financial support and secondments, in implementing the various components of the NCD Global Strategy Action Plan in low- and middle-income countries. Particular priority would be given to NCDs in international and regional initiatives to strengthen health systems based on primary health care;

- The Thai Health Promotion Foundation has successfully implemented a sustainable funding model to support NCD prevention, based on a 2 per cent surcharge on alcohol and tobacco. Thai Health committed to lend full support to low- and middle-income countries and WHO to develop mechanisms for sustainable health financing, through earmarking of alcohol and tobacco taxes, in order to reduce scale up prevention efforts and reduce inequities in accessing health care.

- The Gulf Cooperation Council will support its Member States in integrating the prevention and control of NCDs into the national health development plans, and provide technical support to countries in integrating cost-effective interventions against the major NCDs in their health systems;

- The Public Health Agency of Canada committed to working closely with WHO, through financial support and providing short-term consultancies, to ensure that NCDnet is placed at the forefront of efforts to facilitate the implementation of the NCD Global Strategy Action Plan. Canada particularly focused on providing support to a system for monitoring and evaluation of progress in achieving the three objectives set out for NCDnet.

- The World Bank committed to supporting countries, through its resources, to conduct country-level needs and constraints assessments, and to work closely with WHO on developing models for sustainable health financing, including reviewing the Thai Health Promotion Foundation's model to access the feasibility of adapting this model to a wide range of national contexts. The World Bank also committed to working closely with IHP+ countries to ensure that greater attention is paid to NCDs in low-income countries and to help gather indicators to better measure the impact of NCDs on poverty and the quality of the response.

The second panel concluded with two key messages. One is the importance of accelerating progress in implementing the NCD Global Strategy Action Plan through a coordinated set of actions. The second is the need to strengthen partnerships and joint work between Member States and international partners. A growing number of international development partners have started to support countries in building effective national programmes. This first group of innovative international development partners should encourage and influence other international development partners to put NCDs higher on the agenda wherever it is holding back the achievement of better health outcomes, poverty reduction and human capital formation. 6. MAKING PROGRESS AT COUNTRY LEVEL The third panel was chaired by the Director of the WHO Collaborating Centre for Research and Community-based Prevention of Cardiovascular Diseases at the University of Lausanne, Dr Fred Paccaud. Panelists included the Minister of Health of Guyana, HE Dr Leslie Ramsammy; the Ambassador and Permanent Representative of the Permanent Mission of Mauritius to the UN and other international organizations in Geneva, HE Mr Shree Baboo Chekitan Servansing; the Ambassador of the Permanent


10

Mission of Kenya to the UN and other international organizations in Geneva, HE Dr Tom Okeyo Mboya; and the Deputy CEO of the Thai Health Promotion Foundation, Dr Supreda Adulyanon. The purpose of the third panel was to provide an opportunity for stakeholders to recommend successful approaches for intersectoral action at national levels against NCDs. Panelists highlighted examples of successful interventions implemented in low- and middle-income countries to address specific aspects of the NCD challenge, including establishing and monitoring national programmes. Guyana has developed a national plan to prevent and control NCDs, which is currently being implemented. As a first result, Guyana witnessed a 43 per cent reduction in amputations due to the implementation of cost-effective policy interventions for diabetes care. Mauritius spoke of the rapidly changing disease burden: more than 83 per cent of annual deaths were due to NCDs. At the outset of the epidemic in Mauritius, there was no shared vision and consensus on political and programmatic actions. As a result, NCDs started to dominate health care needs in Mauritius. Cost pressures at national and household levels arising from multiple contacts with health systems over long periods of time, and productivity losses associated with NCD illness and foregone income of both the patient and the caregiver, were the main drivers in Mauritius to unite politicians and policy makers around a common agenda to halt and begin to reverse the national NCD epidemic. With technical support from WHO, a national strategy to prevent and control NCDs was developed. Kenya called on international leaders to raise the priority given to the prevention and control of NCDs in low- and middle-income countries on the agendas of relevant high-level forums and meetings. The Thai Health Promotion Foundation spoke of the progress achieved in reducing tobacco use and the harmful use of alcohol and highlighted mechanisms it had developed for sustainable health financing. The third panel concluded with three key messages. One is the pressing need for advocacy to integrate NCD prevention into the global and national development agendas. Instruments such as the Millennium Development Goals provide opportunities for synergy, as do strategies for poverty alleviation. The second is the importance of strengthening national health promotion and primary prevention action to reduce the main shared modifiable risk factors for NCDs. The third is the need to conduct an international review of mechanisms for sustainable health financing. The successful approach of Thailand in earmarking tobacco and alcohol taxes to strengthen health promotion should be included in the review. 7. WORKING TOGETHER The final panel was chaired by the Director of Global Health Programmes at Bloomberg Philanthropies, Dr Kelly Henning. A first breakout session of the 'NCDnet Working Group on Advocacy and Communications' was moderated by the Director, of the United Nations Information Centre for Bahrain, Qatar and the United Arab Emirates, Mr Nejib Friji. A verbal report summarizing the outcome of the discussions during this session was provided by the CEO of the World Heart Federation, Ms Helen Alderson. A breakout session of the 'NCDnet Working Group on Innovative Resourcing Mechanisms' was moderated by WHO Partnership Adviser for


11

Noncommunicable Diseases and Mental Health, Ms Janet Voûte. A verbal report summarizing the outcome of the discussions during this session was provided by the Senior Health Specialist from the World Bank, Dr Montserrat Meiro-Lorenzo. A breakout session of the 'NCDnet Working Group on Monitoring and Evaluation' was moderated by the President of the International Association for the Study of Obesity, Dr Philip James. A verbal report summarizing the outcome of the discussions during this session was provided by the Acting Deputy Director-General of the New Zealand Ministry of Health, Dr Ashley Bloomfield. The purpose of the final panel was to review three preliminary reports which had been prepared by the corresponding NCDnet Working Groups and which contained concrete proposals on ways to build and coordinate results-oriented collaborative efforts in the areas of advocacy and communications, innovative resourcing mechanisms and monitoring and evaluation. A list of five priorities for collaborative action on advocacy and communications was proposed by participants, as follows: - Develop a strategy to collectively raise the awareness among national and

international leaders of the growing burden of NCDs in low- and middle-income countries and its socio-economic impact. A key message is that development initiatives must take into account the prevention and control of NCDs if low- and middle-income countries are to have a real chance of achieving sustainable economic growth and reducing poverty.

- Develop a strategy to collectively raise the priority given to the prevention and control of NCDs on the agendas of selected relevant high-level forums and meetings. The meeting distinguished between global development agendas and the global and regional public health agendas. Here the issue is one of clarity: what does it mean for the remaining five years up to 2015 and for the shaping of the global development agenda beyond 2015? International development resources for health have increased significantly, but understanding the incentives that determine the structure and functioning of the international system is essential.

- Develop a strategy to collectively mobilize NGOs in low- and middle-income countries to support the development of effective national NCD programmes and strengthening health systems. To focus the debate, participants recognized that there was added-value in moving beyond narrow focus areas to a wider NCD focus.

- Assess existing models of social mobilization approaches10 used to engage people's participation in achieving better health outcomes from NCDs, and, based on the assessment, develop a strategy to collectively disseminate successful approaches to people with NCDs, with a special focus on populations with low health awareness and/or literacy. It also requires that a voice is given to people living with NCDs in low- and middle-income countries. The challenge is also to learn from social mobilization approaches to address HIV/AIDS, including in the frame of human rights.

- Establish an internet-based 'community of practice' as a tool for capacity building, under the aegis of WHO. It would comprise policy makers, programme managers

10 Social mobilization is a term used by the United Nations Agencies to describe a comprehensive planning approach that emphasizes political coalition building and community action. It is the process of bringing together all feasible and practical intersectoral allies to raise people's awareness of and demand for a particular development programme, to assist in the delivery of resources and services and to strengthen community participation for sustainability and self-reliance.


12

and international partners and share knowledge on the practical adaptation, application and impact of international experience in the prevention and control of NCDs, including community-based programmes and successful approaches for intersectoral action against NCDs.

Similarly, a list of five priorities for collaborative action on innovative resourcing mechanisms was proposed by participants, as follows: - Under the aegis of the World Bank and WHO, develop a project proposal to

support low- and middle-income countries in mobilizing resources to conduct national needs and constraints assessments (also referred to a situation and response analyses) to address political, systemic and technical readiness. Better codifying the framework of these assessments was also suggested.

- Under the aegis of the World Bank and WHO, develop two "best buys" project proposals to support low- and middle-income countries in mobilizing resources to establish capacity-building programmes aimed at (1) developing mechanisms for sustainable health financing (e.g. by earmarking alcohol and tobacco taxes); and (2) implementing and monitoring a package of essential, cost-effective, primary care interventions for the early detection and management of NCDs (so-called "PEN" package). Regarding the first, more knowledge must be generated about aspects of "sin tax" models. Regarding the latter, precision is required in defining which interventions will be included in the PEN package. Calculations on the cost-effectiveness must also build on the ongoing WHO-CHOICE work11. Lessons learned from the recent development of a package of six cost-effective policy interventions to reduce tobacco use must also be considered.

- Under the aegis of WHO, and building on international experience in the areas of polio12 and malaria13, draw up a financial resources requirements document ("global price tag"), outlining the range of activities and funding that will be required to meet the growing challenges posed by NCDs in low- and middle-income countries.

- Develop a proposal for discussion, outlining possible appropriate global financing mechanisms to support low- and middle-income countries in building and implementing effective national programmes and strengthening health systems. One view holds that it is feasible to tap into existing global financing mechanisms, as creating another vertical programme in a crowded environment for health and development risks greater fragmentation. At the same time, the feasibility of establishing domestic resourcing mechanisms must also be taken into account.

- Establish a baseline of the amount of Official Development Assistance allocated to addressing NCDs. Requesting OECD/DAC to establish a Creditor Reporting System code to track health commitments for the prevention and control of NCDs was also suggested.

The 'NCDnet Working Group on Monitoring and Evaluation' distinguished between the monitoring and evaluation of the NCD Global Strategy Action Plan and NCDnet. Concerning the first, and in line with paragraph 39(d) of the NCD Global Strategy Action Plan, a representative group of stakeholders will be convened by the International Advisory Council of NCDnet to evaluate progress on the implementation 11 WHO-CHOICE: WHO project on Choosing Interventions that are Cost-Effective http://www.who.int/choice/en/ 12 Financial Resource Requirements for the Global Polio Eradication Initiative (2010-2012): http://www.polioeradication.org/content/publications/FRR2010-2012.ENG.pdf 13 Malaria Funding and Resource Utilization: http://www.rollbackmalaria.org/ProgressImpactSeries/docs/RBMMalariaFinancingReport-en.pdf


13

of this action plan. Concerning the status of implementation of the three objectives of NCDnet, a 'NCDnet Performance Assessment' will be conducted periodically. To this end, one view is that it is equally important to measure the quality and impact of the NCDnet activities, as well as quantity. On a separate note, it was also recommended to support countries in establishing effective national partnerships for the prevention and control of NCDs, involving key stakeholders, as appropriate. The final panel concluded with three key messages. One is that partnership with international partners is key to all aspects of the implementation of the NCD Global Strategy Action Plan. There was general agreement that NCDnet has clearly defined its core business in terms of international public health advocacy, innovative resourcing and monitoring and evaluation. The second is that changing the situation at global and national levels has proven to be possible, given the growing evidence of political appetite for including NCDs in global and national discussions on development. The third is that if the implementation at country level of the NCD Global Strategy Action Plan is to be scaled up, financing for these activities must be secured. A coordinated approach among international partners, with defined specific outcomes and deliverables, needs to be further developed in ways that make it possible to demonstrate NCDnet's effectiveness. 8. CLOSING REMARKS AND THE WAY FORWARD The closing session was chaired by WHO Assistant Director-General, Dr Ala Alwan. It was agreed that the strategic dialogue at this meeting represents the beginning of a wider process to mobilize stakeholders in supporting capacity-building programmes for the prevention and control of NCDs in low- and middle-income countries. In summarizing the way forward, the WHO Assistant Director-General for Noncommunicable Diseases and Mental Health agreed that one of the next steps was to inform Member States about the outcome of the first Global Forum and the progress made so far in implementing the NCD Global Strategy Action Plan. This topic will be discussed as one of the agenda items of the Sixty-third World Health Assembly in May 201014. An informal report of the first Global Forum will be posted on WHO NCDnet's internet home page as a discussion paper (www.who.int/ncdnet). The second NCDnet Global Forum is envisaged to take place in 2011. 9. POST-CONFERENCE EVALUATION A preliminary analysis of evaluation questionnaires completed by participants indicate that 92 per cent of respondents agreed that the meeting met their expectations, that the objectives were clear and that the NCD Global Strategy Action Plan is clearly understood. Furthermore, 92 per cent of respondents support the mission and goals of NCDnet and envisage continued participation in this informal collaborative network.

14 http://apps.who.int/gb/e/e_wha63.html


14

ANNEX: LIST OF PARTICIPANTS Member States and international partners (in alphabetical order): - Mr Dominic Aboraah, Counsellor, Permanent Mission of Ghana, Geneva - Dr Supreda Adulyanon, Deputy Chief Executive Officer, Thai Health Promotion

Foundation, Thailand - Ms Helen Alderson, Chief Executive Officer, World Heart Federation - Dr Yousef Alnesef, Health Ministers Council Executive Office, Gulf Cooperation

Council - Dr Nick Banatvala, Head of Global Affairs, Department of Health, UK - Mr Olivier Belle, Diplomatic Counsellor, Ministry of Social Affairs and Public

Health, Belgium - Dr Ashley Bloomfield, Acting Deputy Director-General, Sector Capability and

Innovation Directorate, Ministry of Health, New Zealand - Her Royal Highness Princess Haya Al Hussein of Jordan - H.E. Mr Yahya Salim Al Wahaibi, Ambassador, Permanent Representative,

Permanent Mission of Oman, Geneva - Dr Sabine Beckmann, Senior Programme Advisor, Global Fund/Global Health

Partnerships, HIV/AIDS Group, United Nations Development Programme (UNDP)

- Mr Morgan Binswanger, Chief of Staff, Lance Armstrong Foundation - Ms Annemiek van Bolhuis, Deputy Director-General, Ministry of Health, Welfare

and Sports, the Netherlands - Ms Géraldine Bonnin, WHO Programme Officer, Ministry of Health and Sports,

France - Dr Bettina Borisch, Institute of Social and Preventive Medicine, University of

Geneva - Dr Jean Bousquet, Chairman, WHO Global Alliance against Chronic Respiratory

Diseases (GARD) - Mr Hugo Brauwers, Deputy Permanent Representative, Permanent Mission of the

Netherlands, Geneva - Dr Donna Brown, Senior Evaluation Consultant and Practice Leader, Paragon

Review and Consulting Inc., Canada - Dr Werner Burkart, Deputy Director General, Head, Department of Nuclear

Sciences and Applications, International Atomic Energy Agency (IAEA) - Dr Rolando Camacho-Rodriguez, Programme of Action for Cancer Therapy,

Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA)

- Ms IIaria Cameli, European Commission, Permanent Delegation, Geneva - Ms Genevieve Chedeville-Murray, Health Counselor, Permanent Mission of France,

Geneva - Dr Xuanhao Chan, Manager, Professional and Scientific Affairs, International

Pharmaceutical Federation (FIP)


15

- Dr Oleg Chestnov, Deputy Director, Department of Cooperation and Public Relations, Ministry of Health and Social Development, Russian Federation

- Dr Rethy Chhem, Director, Division of Human Health, International Atomic Energy Agency (IAEA)

- Ms Ruth Colagiuri, Vice-President, International Diabetes Federation (IDF) - Mr Sanjeev Commar, Minister-Counsellor (Health), Permanent Mission of Australia,

Geneva - Ms Alison Cox, Project Director, Framework Convention Alliance (FCA) - Ms Maggie Davies, Executive Director, Health Action Partnership International

(HAPI) - Ms Michèle Deneffe, Counsellor, Permanenent Mission of Belgium, Geneva - Dr Sylvie Desjardins, Scientific Director, Senior Health Economist, WHO

Collaborating Centre on NCD Disease Policy Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada

- Ms Jelisaveta Djurickovic-Tuvic, Deputy Permanent Representative, Permanent Mission of Serbia, Geneva

- Mr Roland Driece, Counsellor, Permanent Mission of the Netherlands, Geneva - Ms Andrea Dubidad-Dixon, First Secretary, Permanent Mission of Jamaica, Geneva - Dr Ibrahim Elmadfa, President, International Union of Nutritional Sciences - Ms Kimberly Elmslie, Director-General, Centre for Chronic Disease Prevention

and Control, Public Health Agency of Canada - Ms Thea Emmerling, First Counsellor, Health and Food, Permanent Delegation of

the European Union, Geneva - Dr Igor Fedotov, Safework Representative, International Labour Organization

(ILO) - Ms Anne-Marie Felton, Vice President, International Diabetes Federation (IDF),

Chair, Task Force on International Advocacy for Diabetes - Ms Grace Lo Yuen Fong, Unit Manager, Community Health and Social Services

Unit, Health and Social Services Department, International Federation of Red Cross (IFRC)

- Ms Masthead Fostier, Chief of Cabinet (HRH Princess Mathilde), Belgium - HE Mr Dennis Francis, Ambassador, Permanent Representative, Permanent

Mission of Trinidad and Tobago, Geneva - Ms Maria Friis Hansen, Permanent Mission of Denmark, Geneva - Mr Nejib Friji, Director, UN Information Centre (UNIC) - Mr Mohamed Gad, First Secretary, Permanent Mission of Egypt, Geneva - Dr Sibel Gogen, Cardiovascular Diseases Unit, General Directorate of Primary

Health Care, Turkey - Ms Danielle Green, Director of Global Activities, Kidney Disease Prevention

Network, National Kidney Foundation - Mr Nathan Grey, Chief Executive Officer, American Cancer Society - Dr Pauline Guimet, Director Technical Resources, Handicap International - Dr Kelly Henning, Director, International Health Programmes, Bloomberg

Philanthropies - Ms Wendy Hinton, Deputy Permanent Representative, Permanent Mission of New

Zealand, Geneva


16

- Mr Paul Holmes, Senior Regional Health Advisor, Bureau for Europe and Eurasia, U.S. Agency for International Development (USAID)

- Mr Laurent Huber, Director, Framework Convention Alliance (FCA) - Dr A. Refik Imamegioglu, Diabetes and Metabolic Disease Unit, General

Directorate of Primary Health Care, Ministry of Health, Turkey - Mr Nobuo Ito, Adviser, International Kidney Evaluation Association, Japan - Dr Charanjit Jagait, Director of Communications, World Heart Federation (WHF) - Ms Rozmin Jamal, Director, Clinical Research Unit, Aga Khan University, Pakistan - Dr Philip T. James, President, International Association for the Study Obesity - Ms Christel Jansen, Attaché, Permanent Mission of the Netherlands, Geneva - Ms Gillian Javetski, Global Fund/Global Health Partnerships, HIV/AIDS Group,

United Nations Development Programme (UNDP) - Mr Akhshid Javid, Third Secretary, Permanent Mission of Afghanistan, Geneva - Ms Ann Keeling, Chief Executive Officer, International Diabetes Federation (IDF) - Dr Ekaterina Kissimova-Sharbek, Health Economist, International Diabetes

Federation (IDF) - Mr Masaki Kitamura, Director, International Kidney Evaluation Association

(IKEAJ), Japan - Mr Eero Lahtinen, Counsellor (Health), Permanent Mission of Finland, Geneva - Ms Carole Lanteri, Deputy Permanent Representative, Permanent Mission of

Monaco, Geneva - Mr Thor Erik Lindgren, Counsellor, Permanent Mission of Norway, Geneva - Mr Mark Lodge, Executive Director, International Network for Cancer Treatment

and Research (INCTR) - Mr Jose Ramon Lorenzo, First Secretary, Permanent Mission of Mexico, Geneva - Mr Nart Mamser, Health Care Advisor to HRH Princess Haya Al Hussein of

Jordan, Dubai, United Arab Emirates - Her Royal Highness Princess Mathilde of Belgium, Duchess of Brabant - Dr Jean Claude Mbanya, President, International Diabetes Federation (IDF) - HE Dr Tom Okeyo Mboya, Ambassador, Permanent Representative, Permanent

Mission of Kenya, Geneva - Dr David McQueen, National Centers for Chronic Disease Prevention and Health

Promotion, Centers for Disease Control and Prevention, USA - HE Mr Alex van Meeuwen, Ambassador, Permanent Representative, Permanent

Mission of Belgium, Geneva - Dr Montserrat Meiro-Lorenzo, Senior Health Specialist, Health, Nutrition and

Population Group, Human Development Network, World Bank - Ms Leen Meulenbergs, Director, International Relations Department, FPS Health,

Food Chain Safety and Environment, Ministry of Health, Belgium - Mr Ahsan Nabeel, Third Secretary, Permanent Mission of Pakistan, Geneva - Dr Yvonne Njage, Programme Officer, Fogarty International Center, National

Institutes of Health, USA - Dr Gregorio Obrador, Dean, Universidad Panamericana School of Medicine,

Mexico - HE Ms Laurette Onkelinx, Vice- Prime Minister and Minister of Social Affairs and

Public Health, Belgium


17

- Dr Fred Paccaud, Director of the WHO Collaborating Centre for Research and Community-based Prevention of Cardiovascular Diseases at the University of Lausanne, Switzerland

- Mr Greg Paton, Policy and Governance Coordinator, International Diabetes Federation (IDF)

- Mr Anatoly Pavlov, Counsellor, Permanent Mission of the Russian Federation, Geneva

- Ms Awilo Ochieng Pernet, Scientific Adviser, Global Health, Federal Ministry of Public Health, Switzerland

- Mr Ariel Pino, Project Manager, International Social Security Association (ISSA) - Mr Eduardo Pisani, Director-General, International Federation of Pharmaceutical

Manufacturers & Associations (IFPMA) - Mr Ammar Rajab, Third Secretary, Permanent Mission of Bahrain, Geneva - Ms Johanna Ralston, Vice-President, Global Strategies and Managing Director of

International Affairs, American Cancer Society, USA - HE Dr Leslie Ramsammy, Minister of Health, Guyana - Dr Scott Ratzen, Chairman, NCD Taskforce, International Federation of

Pharmaceutical Manufacturers & Associations (IFPMA) - Dr Salman Rawaf, Professor of Public Health, Director, WHO Centre, Department

of Primary Care and Social Medicine, Imperial College, London, UK - Dr Olivier Raynaud, Senior Director, Head of Healthcare Initiatives and Healthcare,

World Economic Forum (WEF) - Dr Farhad Riahi, Partner, McKinsey & Company - Ms Patti Rundall, Policy Director, Baby Milk Action - Dr Seah Seow Chen, Second Secretary, Permanent Mission of Singapore, Geneva - Ms Stella de Sabata, Head of Programmes, International Union Against Cancer

(UICC) - Dr Massoud Samiei, Programme Director, Programme of Action for Cancer

Therapy, Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA)

- Dr Frédérique S. Santerre, Director, Health Care Systems, International Federation of Pharmaceutical Manufacturers & Associations (IFPMA)

- Professor Klaus Schwab, Founder and Executive Chairman, World Economic Forum (WEF)

- Mr Julian Schweitzer, Acting Vice President, Human Development Network, World Bank

- Dr Julia Seyer, Medical Advisor, World Medical Association - HE Mr Shree Baboo Chekitan Servansing, Ambassador, Permanent Representative,

Permanent Mission of Mauritius, Geneva - Dr Sylvie Stachenko, Vice-President of Partnership, International Union for Health

Promotion and Education (IUHPE) - Mr Marc Stefanello, Graphi 4, France - Mr Yumi Suzuki, Secretary General, International Kidney Evaluation Association

(IKEAJ), Japan - Prof Susumu Takahashi, President, International Kidney Evaluation Association

(IKEAJ), Japan - HE Mr Tan York Chor, Ambassador, Permanent Representative, Permanent

Mission of Singapore, Geneva


18

- Ms Susanne Terstal, Deputy Permanent Representative, Permanent Mission of the Kingdom, Geneva

- Mr Kenji Toda, Deputy Director General, International Federation of Pharmaceutical Manufacturers & Associations (IFPMA)

- Dr Julie Torode, Deputy Chief Executive Officer, Programmes Directors, International Union Against Cancer (UICC)

- HE Mr John Ukec Lueth Ukec, Ambassador, Permanent Representative, Permanent Mission of Sudan, Geneva

- Mr Rahul Venkit, Multimedia Officer, International Diabetes Federation (IDF) - Ms Annaïk de Voghel, Spokesperson of H.E. Ms Laurette Onkelinx, Ministry of

Social Affairs and Public Health, Belgium - Ms Gerda Vrielink, First Secretary, Permanent Mission of the Netherlands, Geneva - Dr Judith Watt, Consultant, Framework Convention Alliance (FCA) WHO Secretariat (in alphabetical order): - Dr Dele Olawale Abegunde, Health Economist, Medicines Access and Rational

Use - Ms Loubna Al Atlassi, Technical Officer, Partnerships and UN Reform - Dr Ala Alwan, Assistant Director-General, Noncommunicable Diseases and Mental

Health - Dr Timothy Armstrong, Coordinator, Surveillance and Population-based

Prevention, Chronic Diseases and Health Promotion - Ms Gini Arnold, Project Officer, Tobacco Free Initiative - Dr Douglas Bettcher, Director, Tobacco Free Initiative - Dr Francesco Branca, Director, Nutrition for Health and Development - Dr Nathalie Jeanne Nicole Broutet, Medical Officer, Control of Sexually

Transmitted and Reproductive Tract Infections, Reproductive Health and Research - Ms Alexandra Cameron, Technical Officer, Medicines Access and Rational Use,

Essential Medicines and Pharmaceutical Policies - Ms Vanessa Candeias, Technical Officer, Surveillance and Population-based

Prevention, Chronic Diseases and Health Promotion - Dr Margaret Chan, Director-General - Ms Avis Chehab, Assistant to Dr Ala Alwan, Noncommunicable Disease and

Mental Health - Dr Daniel Hugh Chisholm, Health Economist, Costs, Effectiveness, Expenditure

and Priority Setting, Health Systems Financing - Ms Clare Courtney, Communications Officer, Noncommunicable Diseases and

Mental Health - Ms Katherine Eden Deland, Project Officer, Tobacco Free Initiative - Dr Carissa Etienne, Assistant Director-General, Health Systems and Services - Dr David Evans, Director, Health Systems Financing, Health Systems and Services - Ms Christy Feig, Director, Department of Communications - Dr Tieru Han, Director, Building Healthy Communities & Populations, Regional

Office for the Western Pacific (WPRO) - Mr Menno van Hilten, External Relations Officer, Noncommunicable Diseases and

Mental Health


19

- Dr Hans Hogerzeil, Director, Essential Medicines and Pharmaceutical Policies, Health Systems and Services

- Dr James Hospedales, Senior Adviser, Prevention & Control of Chronic Diseases, Regional Office for the Americas (AMRO/PAHO)

- Dr Ivo Kocur, Team Leader, Prevention of Blindness & Deafness - Dr Etienne Krug, Director, Violence and Injury Prevention and Disability - Dr Jerzy Leowski, Regional Adviser, Noncommunicable Diseases and Mental

Health, Regional Office for South-East Asia (SEARO) - Dr Wim van Lerberghe, Director, Health Policy, Development and Services, Health

Systems and Services - Dr Elizabeth Mason, Director, Child and Adolescent Health and Development

Family and Community Health - Mr Issa Matta, Senior Legal Officer, Commercial and Contractual Matters, Office

of Legal Council - Dr Shanthi Mendis, Coordinator, Chronic Diseases Prevention and Management

Chronic Diseases and Health Promotion - Dr Maria Neira, Director, Protection of the Human Environment, Health Security

and Environment - Dr Haik Nikogosian, Head of Convention Secretariat, WHO Framework

Convention Tobacco Control - Ms Alana Officer, Coordinator, Disability and Rehabilitation, Violence and Injury

Prevention and Disability - Dr Mercedes de Onis, Coordinator, Growth Assessment and Surveillance,

Nutrition for Health and Development - Dr Juan Pablo Peña-Rosas, Coordinator, Reduction of Micronutrient Malnutrition,

Nutrition for Health and Development - Ms Anne-Marie Perucic, Health Economist, Tobacco Free Initiative - Dr Armando Peruga, Coordinator, National Capacity, Tobacco Free Initiative - Dr Vladimir Poznyak, Coordinator, Management of Substance Abuse, Mental

Health and Substance Abuse - Dr Vinayak Prasad, Senior Adviser, Tobacco Free Initiative - Dr Gojka Roglic, Medical Officer, Chronic Diseases Prevention and Management,

Chronic Diseases and Health Promotion - Mr Alex Ross, Director, Partnerships and UN Reform - Ms Randa Saadeh, Scientist, Country Focused Nutrition Policy and Programme,

Nutrition for Health and Development - Dr Boureima Sambo, Programme Manager, Prevention & Control of Non-

Communicable Diseases, Regional Office for Africa (AFRO) - Dr Shekhar Saxena, Programme Manager and Coordinator, Evidence, Reserch and

Action on Mental and Brain Disorder, Mental Health and Substance Abuse - Dr Benedetto Saraceno, Director, Mental Health and Substance Abuse - Ms Silvia Scopelliti, Partnership Manager, The Partners Forum for Action on

Chronic Disease, Regional Office for the Americas (PAHO/WHO) - Dr Cecilia Sepulveda Bermedo, Senior Adviser, Chronic Diseases Prevention and

Management, Chronic Diseases and Health Promotion - Dr Ruitai Shao, Programme Management Adviser, Chronic Diseases and Health

Promotion


20

- Dr Sally Stansfield, Executive Secretary, Health Metrics Network Department, Information, Evidence and Research

- Dr KC Tang, Scientist, Health Promotion, Chronic Diseases and Health Promotion - Dr Phyllida Travis, Health Systems Adviser, Organization and Management of

Health Services, Health System Governance and Service Delivery - Dr Edouard Tursan D'Espaignet, Coordinator, Comprehensive Information

Systems for Tobacco Control, Tobacco Free Initiative - Dr Andreas Ullrich, Medical Officer, Chronic Diseases Prevention and

Management, Chronic Diseases and Health Promotion - Ms Gemma Vestal, Legal Officer, Regulation, Legislation and Enforcement,

Tobacco Free Initiative - Ms Janet Voûte, Partnerships Adviser, Noncommunicable Diseases and Mental

Health - Dr Anne-Marie Worning, Executive Director, Office of the Director-General - Dr Ayda Yurekli, Coordinator, Tobacco Free Initiative


21

For more information: www.who.int/ncdnet

© World Health Organization, 2010. All rights reserved.

The following copyright notice applies: www.who.int/about/copyright

This discussion paper does not represent an official position of the World Health Organization. It is a tool to explore the views of interested parties on the subject matter. References to international partners are suggestions only and do not constitute or imply any endorsement whatsoever of this discussion paper.

The World Health Organization does not warrant that the information contained in this discussion paper is complete and correct and shall not be liable for any damages incurred as a result of its use.

The designations employed and the presentation of the material in this discussion paper do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.

The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

All reasonable precautions have been taken by the World Health Organization to verify the information contained in this discussion paper. However, this discussion paper is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the presentation lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

Unless specified otherwise, the data contained in this discussion paper is based on the 2004 update on the 'Global burden of disease'. Additional information is available at www.who.int/healthinfo/global_burden_disease .


22

NCDnet - First Forum - FINAL DRAFT · 24/02/2010 · DRAFT. First NCDnet Global Forum (Geneva, 24 February 2010) 2 FOREWORD ... first NCDnet Global Forum conveyed a sense of urgency.

Documents