Non-communicable diseases: taking action
Mirta Roses Periago, director, Pan American Health Organization
The damaging economic and social effects of non-communicable diseases on both developed and emerging countries have been recognised at international level, leading to agreement on a fresh set of policies for tackling this silent pandemic
From "The G20 Cannes Summit 2011: A New Way Forward," edited by John Kirton and Madeline Koch,
published by Newsdesk Media Group and the G20 Research Group, 2011
To download a low-resolution pdf, click here.
The economic toll of non-communicable diseases (NCDs) – namely, cancer, diabetes, heart disease and stroke, and chronic respiratory disease – will exceed $30 trillion over the next two decades in healthcare costs, lost productivity and personal medical expenses, revealed a recent study by the World Economic Forum and Harvard University. Such a burden roughly equals the gross domestic product (GDP) of the four biggest economies (United States, China, Japan and Germany) and represents almost 2.5 times the annual output of the BRIC countries (Brazil, Russia, India and China).
Global leaders duly recognised the devastating economic and social impact of NCDs at the United Nations High-Level Meeting on the Prevention and Control of NCDs (UN HLM-NCDs) held in New York on 19-20 September 2011. International commitments were reached to reduce the risk factors behind NCDs and to create more robust policies, programmes and strategies to prevent and control this foreseen calamity.
Now the challenge is to implement the right policies and follow-up mechanisms that will move the declarations into actions – and quickly – since some 36 million people die each year from NCDs, often prematurely, affecting productivity and stressing national healthcare budgets. At the same time, the number of people affected by NCDs is expected to rise substantially due to a rising and ageing population, placing further strains on fiscal results and risking setbacks in hard-fought health achievements.
Fortunately, however, there are several proven and successful ‘best buys’: low-cost and effective public health interventions are available to reduce the forecast NCD impact. In fact, for a small investment of $1-$3 per person per year, a core set of NCD strategies can be implemented, as shown in a recent report produced by the World Health Organization (WHO). These ‘best buys’ include tobacco control, salt reduction, cervical cancer screening and multi-drug therapy for people with a high risk of heart attacks and stroke, among others. These actions have a high value-for-money ratio, both from a public health perspective and from an economic standpoint.
Yet the underlying causes of this silent pandemic cannot be addressed solely by the health sector. Tobacco consumption, obesity, physical inactivity, unhealthy diets and harmful use of alcohol will only be reduced through public policies with concerted actions involving many government sectors – particularly agriculture, transportation, education and trade – acting in sync with the private sector, non-governmental organisations and civil society.
This is precisely why the UN has taken on NCDs, only the second health issue after HIV/AIDS to be addressed in such a high-level forum. Clearly, NCDs are a common priority for all countries regardless of size, geographic location, demographics or economic development. Together, countries have taken on a commitment to tackle this problem now, before it spirals out of control.
The political declaration, universally adopted, calls for WHO to develop a comprehensive global monitoring framework, including a set of indicators, and to recommend a set of voluntary global targets before the end of 2012, for member states to establish or strengthen national NCD policies and plans by 2013, and for the UN secretary-general to undertake a comprehensive review and assessment in 2014 of the progress achieved.
The G20 at the Cannes Summit should build upon the advances made at the UN HLM-NCDs and translate these into visible and concrete changes and actions within countries and communities, through the development or strengthening of public policies that transform physical and social environments into protective spaces that nurture and strengthen health and well-being. In particular, this summit should examine and discuss options to move forward on specific aspects of the political declaration, which call for strengthening international cooperation in support of national NCD plans; fulfilling official development assistance-related commitments that can be leveraged for NCD prevention and control, and engaging non-health actors, including the private sector and civil society, in collaborative partnerships to reduce NCD.
The G20 can significantly influence development initiatives and other forms of international cooperation, including ‘South-South’ partnerships, and leverage these to address NCDs prevention and control – especially to invest in the ‘best buys’ – such as increased taxation on tobacco and alcohol products.
Although global advocacy for NCDs was successfully achieved at the UN meeting, raising awareness in other global forums, to further incorporate the response to NCDs into the development agenda, will be necessary. With NCDs at the forefront of development discussions, the Pan American Health Organization (PAHO) and WHO will have the opportunity to enhance collaboration among UN agencies, such as the Food and Agriculture Organization, United Nations Population Fund, UN Women, UNAIDS, the United Nations Environment Programme, United Nations Industrial Development Organization, UNICEF and the United Nations Development Programme, as well as with the World Bank and other international organisations, thereby helping to synergise efforts and integrate NCDs into relevant global health initiatives.
Local-level advocacy and action are even more critical at this time, to create the positive energy needed to halt the NCD epidemic quickly. A social mobilisation movement for NCD prevention and control is necessary. The Wellness Week initiative, launched by PAHO and the World Economic Forum in association with mayors from 24 cities, the Get the Message Campaign by the Healthy Caribbean Coalition, the global call from the NCD Alliance and the Wellness in the Workplace initiatives adopted by many corporations are but a few examples of the growing social mobilisation in this realm.
The G20 is called on to take a leading role in the social movement against NCDs by promoting consideration of health in all policies. Current consumption and urban design patterns are unsustainable, but the know-how and the ability to change these for the better do exist. This is crucial to foster the well-being of populations, to alleviate fiscal pressures caused by rising healthcare costs, and to preserve and stimulate productivity. All of these are necessary conditions to spur widespread and sustained socioeconomic development.
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