UN High-Level Meeting puts NCDs on the map. Presentation 4 chapters 1. Who are/is behind is ? (stakeholders) – who is missing 2. What is at stake ? –

UN High-Level Meeting puts NCDs on the map

Presentation 4 chapters

1. Who are/is behind is ? (stakeholders)– who is missing

2. What is at stake ?– size of the needs– negative impact on

development in general– profits/attention– risks & threats

3. What was the result of the UN Meeting– UN Declaration– Review UN 2014

4. Opinions / Strategic directions

1. Who were behind this ? (stakeholders) who was missing ?

• Carribean initiative• NCD Alliance

Core Group: Diabetes, Cancer, Heart, LungOthers: left out of core group: Mental Health, Asthma

• wide & varied participation by others…– industry, anti-Nestlé lobby, WHO, Lancet, all except

tobacco• patients under-represented cf. HIV-AIDS• warm cloak of unity of purpose covered us all

2. What is at stake ?– size of the needs : “cause 2 out of 3 deaths”– Lost output EPIC measures Lost Output as 7 trillion $ in

LMIC 2011-2015: LMIC has 83% of NCD UMI 70% LMI 28% LI 4%

– negative impact on development in general• MDG• Tuberculosis

– opportunities• primary prevention cost effective

– risks & threats : cost/waste/ineffectiveness/capture

What was the result of the UN Meeting

UN Declaration: 13 pages with 64 articles•http://www.ncdalliance.org/sites/default/files/rfiles/UN%20HLM%20Political%20Declaration%20English.pdf

Comparison between desired outcome and outcome: •http://www.ncdalliance.org/sites/default/files/rfiles/NCD%20Alliance%20Language%20compared%20to%20Political%20Declaration.pdf

•Final Country Commitments at HLM plenaries and round tables.pdf

drive for accountability continues..!

2 examples of country recommendations Brazil President Dilma Rousseff: 1.Increased access to medication for patients with hypertension and diabetes 2.Reformulating public spaces for healthy lifestyles 3.Better eating habits through promoting breastfeeding, healthy eating in schools and food labeling 4.Voluntary agreements with food industry to eliminate transfats and reduce sodium in products 5.Raised tobacco taxes with national pricing legislation 6.Zero tolerance on drink driving 7.Access to preventative tests, mammograms and better treatment for breast and cervical cancer

USA: Sebelius:

Clinton Global Initiative to promote a smoke-free workplace around the world Initiatives: ‘healthy people 2020’ prevention strategy, targets and goals for prevention and public health with funding 2009 legislation giving government regulatory authority over tobacco products – e.g. 2012 have graphic warning in tobacco packs ‘Let’s Move Campaign’ – health in all policies approach Aim to introduce healthy food into schools and childcare settings Funding community efforts to combat tobacco and obesity – community transformation grants

Proposed Priority ActionsLancet’s Goal: reduce mortality 2% per year1.Leadership2.Prevention3.Treatment4.International Cooperation5.Monitoring progress & Accountability

$ 9 billion/year

WHO & WEF Best Buys1.Tobacco (tax+bans)2.Alcohol (tax+bans)3.Food intake + physical activity4.CVD+Diabetes (counsel+drugs)5.Cancer (HepB+Cervical)

$12 billion (=$ 2 Prim.Prev+ 10 Sec Prev)

Opinions / Strategic directions

Primary PreventionEmpowerment and community involvementMulti sector

Financing:taxing tobacco..alcohol..transfat…sugar“conflicts of interests”

• Secondary PreventionDiagonal approachPrimary care Details:Use Existing systems

reformed for Delivering services to include NCD

Who pays ?