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Page 1 Raising the priority of noncommunicable diseases in development work at global and national levels Presentation for discussion (Not an official.

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Presentation on theme: "Page 1 Raising the priority of noncommunicable diseases in development work at global and national levels Presentation for discussion (Not an official."— Presentation transcript:

1 Page 1 Raising the priority of noncommunicable diseases in development work at global and national levels Presentation for discussion (Not an official document)

2 Page 2 Causative risk factors Tobacco use Unhealthy diets Physical inactivity Harmful use of alcohol Noncommunicable diseases Heart disease and stroke Diabetes Cancer Chronic lung disease Four types of noncommunicable diseases are largely preventable by means of effective interventions that tackle shared modifiable risk factors

3 Page M Low-income countries Group III - Injuries Group II – Other deaths from noncommunicable diseases Group II – Premature deaths from noncommunicable diseases (below the age of 60), which are preventable Group I – Communicable diseases, maternal, perinatal and nutritional conditions 0 10 million 20 million 30 million 40 million 50 million 60 million 70 million Total number of deaths in the world (2004) 60% of the world's annual deaths are due to noncommunicable diseases. Approximately 25% of these deaths are premature and could be prevented 26.0 M (above the age of 60) 10% fact 9.0 M (below the age of 60) 9.0 M (below the age of 60) 18.0 M 35 million (60% of all deaths) Source: 25% of 35 million

4 Page 4 More people die from heart diseases and strokes in the poorest developing countries than in the richest industrialized countries 0 2 million 4 million 6 million 8 million 10 million Low income countries Lower middle-income countries Upper middle-income countries High income countries 5.1 m 6.1 m 8.2 m 9.0 m 2.6 m 3.8 m 7.3 m 2.6 m 3.4 m 6.5 m 2.4 m 3.0 m Estimated deaths from cardiovascular diseases (2004) fact Source:

5 Page 5 In all developing countries, premature deaths from noncommunicable diseases account for a large enough share of the disease burden to merit a serious policy response fact Low-income countriesMiddle-income countriesHigh-income countries Lower respiratory infections (11.2%) Coronary heart disease (9.4%) Diarrhoeal diseases (6.9%) HIV/AIDS (5.7%) Stroke and other cerebrovascular diseases (5.6%) Chronic obstructive pulmonary disease (3.6%) Tuberculosis (3.5%) Neonatal infections (3.4%) Malaria (3.3%) Premature and low birth weight (3.2%) Stroke and other cerebrovascular disease (14.2%) Coronary heart disease (13.9%) Chronic obstructionary pulmonary disease (7.4%) Lower respiratory infection (3.8%) Trachea, bronchus, lung cancers (2.9%) Road traffic accidents (2.8%) Hypertensive heart disease (2.5%) Stomach cancer (2.2%) Tuberculosis (2.2%) Diabetes mellitus (2.1%) Coronary heart disease (16.3%) Stroke and other cerebrovascular diseases (9.3%) Trachea, bronchus, lung cancers (5.9%) Chronic obstructive pulmonary disease (3.5%) Alzheimer and other dementias (3.4%) Colon and rectum cancers (3.3%) Diabetes mellitus (2.8%) Breast cancer (2.0%) Stomach cancer (1.8%) The top-10 leading causes of death Source:

6 Page 6 The risk of dying in developing countries from causes attributable to high-blood pressure, tobacco use, high blood glucose or physical inactivity 0 1 million 2 million 3 million 4 million 5 million 6 million 7 million Attributable deaths in developing countries by risk factor Child sexual abuse Lead exposure Global climate change Unmet contraceptive need Illicit drug use Iron deficiency Unsafe health care injections Zinc deficiency Vitamin A deficiency Occupational risks Urban outdoor air pollution Sub-optimal breastfeeding Low fruit and vegetable intake Unsafe water, sanitation, hygiene Indoor smoke from solid fuels Alcohol use Overweight and obesity High cholesterol Underweight Unsafe sex Physical inactivity High blood glucose Tobacco use High blood pressure fact

7 Page million 1.5 million 2.0 million 2.5 million Africa 0% 5% 10% 15% 20% 25% 30% AmericasEast. Med EuropeSouth- East Asia Western Pacific AfricaAmericasEast. Med EuropeSouth- East Asia Western Pacific Without action, Africa will witness the largest increase in deaths from noncommunicable diseases in 2015 (vs 2004) fact

8 Page 8 10 leading causes of deaths in females (2004) Source: WHO's report on "Women and Health: today's evidence, tomorrow's agenda" Noncommunicable diseases are among the leading causes of death among women in developing countries, as well as high-income countries fact

9 Page 9 At household level, noncommunicable diseases are affecting the poorest people in developing countries disproportionally fact 14 million people die prematurely each year in developing countries from noncommunicable diseases Loss of household income from high cost of health care Loss of household income from unhealthy behaviours Increased exposure to common modifiable risk factors: Unhealthy diets Physical inactivity Tobacco use Harmful use of alcohol Noncommunicable diseases: Cardiovascular diseases Cancers Diabetes Chronic respiratory diseases Globalization Urbanization Population ageing Limited access to effective and equitable health-care services which respond to the needs of people with noncommunicable diseases Loss of household income from poor physical status Populations in low- and middle-income countries Poverty at household level Poverty contributes to noncommunicable diseases and noncommunicable diseases contribute to poverty

10 Page 10 Noncommunicable diseases are the third largest global risk in terms of likelihood and the fourth largest global risk in terms of economic severity World Economic Forum: Global Risk 2010 Report fact Oil spikes Retrenching from globalization Asset price collapse Food price volatility Financial crisis Noncommunicable diseases Infectious diseases "A problem neither the developed world nor the developing world can afford" "Declining development assistance has already led to a significant reduction of public spending on health in many countries. When funds are limited, governments tend to focus on basic health services, in line with the MDGs, at the expense of the prevention and treatment of noncommunicable diseases." (WEF Global Risk 2010 Report) "A problem neither the developed world nor the developing world can afford" "Declining development assistance has already led to a significant reduction of public spending on health in many countries. When funds are limited, governments tend to focus on basic health services, in line with the MDGs, at the expense of the prevention and treatment of noncommunicable diseases." (WEF Global Risk 2010 Report)

11 Page 11 Not covered by the MDGs: More than 8 million premature deaths from noncommunicable diseases 10 million 20 million 30 million 40 million 50 million 60 million Total number of deaths in low- and middle-income countries (2004) Low-income countries Group III - Injuries Group II – Other deaths from noncommunicable diseases Group II – Premature deaths from noncommunicable diseases (below the age of 60), which are preventable Group I – Communicable diseases, maternal, perinatal and nutritional conditions In developing countries, more than 8 million premature deaths from noncommunicable diseases per year are omitted from the MDGs fact 14.2 M 0 million 5.3 M 20.0 M 8.1 M 17.4 M Source:

12 Page 12 $0.01 $0.06 $0.10 $0.42 $0.92 $0.93 $3.90 $0.06 $0.21 $0.22 $0.23 $0.24 $0.33 $0.45 $0.53 $0.80 $1.14 $1.16 $1.33 $1.65 $7.40 Water Education/Training Water Resources Protection River Development Waste Management/Disposal Basic Drinking Water Supply & Sanitation Water resources policy/admin. mgmt Water Supply/Sanitation - Large Systems Health Education Medical Education/Training Medical Research Basic Health Infrastructure Medical Services Basic Nutrition Tuberculosis Control Family Planning Malaria Control Basic Health Care Reproductive Health Infectious Disease Control Health Policy & Admin. Management HIV/AIDS & STDs Health ODA Commitments (2007) in US$ billions Total Health ODA: $22.1 billion Health ODA for noncommunicable diseases: 503 million (~2%) There is no OECD/DAC Creditor Reporting System code yet to track health commitments for the prevention and control of noncommunicable diseases Source: Kaiser Family Foundation (www.kff.org/globalhealth)www.kff.org/globalhealth (Based on analysis of data obtained via online query of the OECD Development Assistance Committee (DAC) Database and Creditor Reporting System (CRS) on 31 May 2009) International development agencies have been slow in responding to the call to raise the priority accorded to noncommunicable diseases in development work fact

13 Page 13

14 Page Global Strategy for the Prevention and Control of Noncommunicable Diseases In May 2008, WHO Member States started to mobilize a global response to address noncommunicable diseases, with a particular focus on developing countries WHO Framework Convention on Tobacco Control Global Strategy on Diet, Physical Activity and Health Action Plan on the Global Strategy for the Prevention and Control of Noncommunicable Diseases Global Strategy on Infant and Young Child Feeding fact

15 Page 15 Six objectives: 1. Raising the priority accorded to noncommunicable diseases in development work at global and national levels, and integrating prevention and control of non- communicable diseases into policies across all government departments 2. Establishing and strengthening national policies and programmes 3. Reducing and preventing risk factors 4. Prioritizing research on prevention and health care 5. Strengthening partnerships 6. Monitoring NCD trends and assessing progress made at country level Under each of the six objectives, there are sets of actions for Member States, the WHO Secretariat and international partners The Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases was endorsed by the World Health Assembly in May 2008 fact

16 Page 16 Regional Ministerial Meeting on Health Literacy (Beijing, April 2009) Regional Ministerial Meeting on Noncommunicable Diseases and Injuries, Poverty and Development (Qatar, May 2009) ECOSOC High-level Segment on Global Health (Geneva, 6-9 July 2009) ECOSOC Ministerial Roundtable Meeting on Non- communicable Diseases and Injuries (Geneva, 8 July 2009) ECOSOC Ministerial Declaration Continuing discussions at the UN General Assembly Many public health leaders are calling on global development initiatives to take into account the prevention and control of noncommunicable diseases Doha Declaration on Noncommunicable Diseases fact

17 Page 17 High-level forums are starting to call for the inclusion of noncommunicable diseases into discussions on development fact

18 Page 18 Mission of NCDnet: Help implement the Action Plan by catalyzing a multi-sectoral, multi-level response, with a particular focus on developing countries Goals of NCDnet: Increase focus on prevention and control of noncommunicable diseases through collective advocacy Increase resource availability (both financial and human capital) Catalyze effective multi-stakeholder action with a focus on country-level implementation At the occasion of the 2009 ECOSOC High-level Segment, WHO launched a new global network to combat noncommunicable diseases (NCDnet) on 8 July 2009 fact

19 Page 19 NCDnet is composed of the WHO Secretariat staff, an International Advisory Council, NCDnet Global and Regional Forum meetings and functional Working Groups Funding/Resourcing Mechanisms Funding/Resourcing Mechanisms International Advisory Council WHO Global/Regional Forum Meetings Advocacy and Communications Advocacy and Communications Monitoring and evaluation Innovative Resourcing Mechanisms Partnership capacity building Partnership capacity building Working groups fact


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