NCDs: Right Time For The World To Be in Control

 

The best approach to tackle a disease is prevention. The best time to treat a diseases is when it is controllable. The method to treat a disease is scientifically proven methodolgy.

In the above context, faced with the growing incidence of non-communicable diseases(NCDs) and their health and economic impact on all countries, in particular on the developing world, the world has to tackle the issues of targets now, considering it to be the best and only opportune time, probably the last best opportunity to tackle the future health and economic impact of NCDs.

It is a matter of great concern, as rightly raused by the 'NCD Alliance' in its release of 18th May, the progress on a set of global targets to tackle non-communicable diseases (NCDs) is likely to be inadequate during the 65th World Health Assembly in Geneva.

 

NCD Alliance is a global advocacy organization representing hundreds of global and national groups, believes this inadequacy in approach could cripple the momentum that has been built, following the last September’s historic UN Summit on NCDs in New York,  in which UN member states committed to a range of actions to tackle the NCD epidemic.

It is no small measure that NCDs are responsible for 60% of all global deaths.  They are the leading cause of death in most high-income countries (80%-90%), and also in most low-income and middle-income countries. In all settings, the burden of these conditions is growing.

The NCD Alliance's 18 May release quotes Ann Keeling, Chair of the NCD Alliance and CEO of the International Diabetes Federation, having commented, “In the run-up to the UN Summit on NCDs, we urged Member States to include meaningful targets to prevent and control NCDs. We particularly called for the adoption of an overarching goal to reduce preventable deaths from NCDs by 25% by 2025. Member States deferred decisions about targets to 2012. Eight months on from the UN Summit, there can be no excuse for the world’s Health Ministers not to adopt at least this global goal, and supporting targets.”

In accordance with the Political Declaration agreed at the UN Summit, the World Health Organization (WHO) released a discussion paper in December 2011, in which 10 targets were presented: an overarching target of reducing preventable NCD deaths by 25% by 2025, and nine other targets covering tobacco, salt, alcohol, and a range of other contributors to the NCD epidemic.

But following the input  from only  21 Member States (when the UN has 194 members), the second discussion paper, released in March, had reduced the proposed targets to just five.  While the mortality and blood pressure targets remained – both 25% relative reductions by 2025, the tobacco and salt targets had been watered down. The other targets had been dropped, including the target on alcohol (a relative reduction of 10% adult per capita consumption)—after intense lobbying from the alcohol industry, which objected strongly to any attempt to reduce overall consumption worldwide.

 

The failure on the front of retaining alcohol targets in WHO's second discussion paper  clearly indicates this as the result of lobbying, as the adoption of targets would affect profits. One piece of good news in the second discussion paper was a new target to reduce levels of physical inactivity by 10% by 2025. Only 25 countries commented on this new, smaller set of targets, although 59 attended a Member State consultation on 26-27 April.

“If countries are serious about tackling the NCD crisis afflicting them all, they must be bold and commit to 10 targets*, not 5 or fewer. We need to recapture the passion demonstrated at th UN Summit and commit to realising in full the ambitions articulated in the Political Declaration,” says Keeling.

Keeling points out that the UN recently adopted 10 new targets for 2015 on HIV/AIDSi when this is just one condition. Surprisingly the international community appears to be resisting the same number of targets for NCDs, though it is a group of diseases  including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, that have at least four common risk factors (tobacco use, harmful alcohol use, unhealthy diets and physical inactivity).

As the WHO Director General, Dr Margaret Chan says, measurable targets are essential, ‘What gets measured, gets done.’ The NCD Alliance believes that, at the very least, UN  Member States should commit to the overarching target on mortality at the 65th World Health Assembly, in order to unequivocally demonstrate their commitment to the process agreed at the UN High-level Meeting.

 

The NCD Alliance is also calling for an emphasis on treatment as well as prevention in whatever targets are adopted.  “Prevention efforts are absolutely essential to reducing future cases of NCDs. And in addition there is an urgent need to provide care for people living with NCDs today to prevent premature death and crippling complications,” says Keeling.

The NCD Alliance has emphatically called for retention of 10 targets be kept, with one dedicated to “Equitable and increased availability of affordable, quality essential medicines and technologies for communicable and non-communicable diseases in all healthcare sectors”. The NCD Alliance  unites a network of over 2,000 civil society organisations in more than 170 countries.

The four founding members of NCD Alliance are the most professional  organisations in  their respective fields, the International Diabetes Federation, the Union for International Cancer Control, the World Heart Federation, and the International Union Against Tuberculosis and Lung Disease. This is what makes it important that the Alliance's  ten targets must be adopted in  full to tackle the NCDs seriously, which it deserves.