1. Global Strategy and Global Action Plan
for the prevention and control of NCDs
Dr Shanthi Mendis
MBBS MD FRCP FACC
Director a.i.
Department for the Management of NCDs 1

2. Global Mile stones : Prevention and Control of NCDs
2000
Global Strategy for the Prevention and Control of Noncommunicable Diseases
2003
Global Strategy on Diet,
Physical Activity and Health
2004
Action Plan on the Global Strategy for the Prevention and Control of NCDs
2008
Global Strategy to Reduce the Harmful Use of Alcohol
2009
WHO Global Status Report on NCDs
2010
2011
Political Declaration on NCDs
2013
2020
WHO Action Plan for the Prevention and Control of NCDs for

3. UN High-level Meeting on NCDs
NCDs as priority within the development agenda
Leading role of WHO as the Global Public Health Agency
Specific assignments that WHO has to deliver by 2014

4. WHO Executive Board resolution EB130.R7
2. REQUESTS the Director-General:
to develop, in a consultative manner, a WHO action plan for the prevention and control of NCDs for 2013–2020, building on lessons learnt from the 2008–2013 action plan and taking into account the outcomes of the High-level Meeting of the United Nations General Assembly on the Prevention and Control of NCDs, the Moscow Declaration on Healthy Lifestyles and NCD Control, the Rio Declaration on Social Determinants of Health, building on and being consistent with existing WHO strategies and tools on tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity;
to submit to the Sixty-sixth World Health Assembly, through the Executive Board, a WHO action plan for the prevention and control of NCDs for 2013–2020 for consideration and possible adoption.

5. Process
2012
April – October 2012: Regional consultations (WHO Regional Discussion Papers)
26 July 2012 – 7 September 2012: Web-based consultation (WHO Discussion Paper)
16-17 August 2012: First informal consultation with Member States and UN
10 October 2012: Web-based consultation ('Zero Draft' Action Plan)
1 November 2012: Second informal consultation with Member States and UN
2013
January 2013: Executive Board (Draft Action Plan)
8 February – 10 March 2013 : Web-based consultation (Revised Draft Action Plan)
6-7 March 2013: Informal dialogues with NGOs and Private Sector entities
11-13 March 2013: Third informal consultation with Member States and UN
May 2013: World Health Assembly (Final Draft Action Plan)

6. WHO Global NCD Action Plan 2013-2020 –objectives
To strengthen international cooperation and advocacy to raise the priority accorded to prevention and control of NCDs in the development agenda and in internationally-agreed development goals
Objective 2:
To strengthen national capacity, leadership, governance, multisectoral action and partnerships to accelerate country response for prevention and control of NCDs
Objective 3:
To reduce exposure to modifiable risk factors for NCDs through creation of health-promoting environments
Objective 4:
To strengthen and reorient health systems to address prevention and control of NCDs through people-centred primary health care and universal coverage
Objective 5:
To promote and support national capacity for high quality research and development for prevention and control of NCDs
Objective 6:
To monitor trends and determinants of NCDs and evaluate progress in their prevention and control
The Action Plan comprises a set of actions which, when performed collectively by Member States, UN agencies, international partners and WHO, will reduce the burden of preventable morbidity and disability and avoidable mortality due to NCDs.

7. Global NCD Action Plan 2013-2020
Vision
A world free of the avoidable burden of noncommunicable diseases.
Goal
To reduce the preventable and avoidable burden of morbidity, mortality and disability due to noncommunicable diseases by means of multisectoral collaboration and cooperation at national, regional and global levels, so that populations reach the highest attainable standards of health, quality of life, and productivity at every age and those diseases are no longer a barrier to well-being or socioeconomic development.

8. Global NCD Action Plan 2013-2020 Overarching principles and approaches
Human rights
Equity based approach
Universal health coverage
Life-course approach
Evidence-based strategies
Multisectoral action
National action and international cooperation and solidarity
Empowerment of people and communities
Management of conflict of interest

10. Voluntary global targets
Appendix 3
Obj.
Set of actions
Voluntary global targets
WHO tools 1
Raise public and political awareness and understanding about NCDs social marketing, mass-media and responsible media reporting
Strengthen international collaboration for training the health workforce
Integrate NCDs into the development agenda and poverty alleviation strategies
Contributes indirectly to achieve a 25% relative reduction in premature by2025
WHO Global status report on NCDs 2010
WHO Fact Sheets
Global Atlas on Cardiovascular disease 2011
IARC GLOBOCAN 2008
Existing regional/national tools

11. Voluntary global targets
Appendix 3
Obj.
Set of actions
Voluntary global targets
WHO tools 2
Increase and prioritize budgetary allocations for NCDs
Assess national capacity for prevention and control of NCDs
Develop and implement a national multisectoral policy and plan
Develop and implement a national multisectoral strategy to engage relevant sectors outside health
Contributes indirectly to achieve a 25% relative reduction in premature mortality by 2025
UN Secretary-General’s report A/67/373
NCD country capacity survey tool
NCCP Core Capacity Assessment tool
Existing regional/national tools

12. Voluntary global targets
Appendix 3
Obj.
Set of actions
Voluntary global targets 3
Tobacco use (these interventions reduce>50% of tobacco burden, 25-30m DALYs averted)
Reduce affordability of tobacco products by increasing tobacco excise taxes
Create by law completely smoke-free environments in all indoor workplaces, public places and public transport
Warn people of the dangers of tobacco and tobacco smoke through effective health warnings and mass media campaigns
Ban all forms of tobacco advertising, promotion and sponsorship
Harmful alcohol use (these interventions reduce 10-20% alcohol burden, 5-10m DALYs averted)
Excise tax increases on alcoholic beverages
Comprehensive restrictions and bans on alcohol advertising and promotion
Restrictions on the availability of retailed alcohol
 Unhealthy diet and physical inactivity (intervention to reduce salt averts 5 m DALYs)
Salt reduction through mass media campaigns/reduced salt content in processed foods
Replacement of trans-fats with polyunsaturated fats
Public awareness programme about diet and physical activity
 A 30% relative reduction in prevalence of current tobacco use in persons aged 15+ years
    
At least a 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context.   
A 10% relative reduction in prevalence of insufficient physical activity
A 30% relative reduction in mean population intake of salt/sodium intake
A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure according to national circumstances
Halt the rise in diabetes and obesity

13. Voluntary global targets
Appendix 3
Obj.
Set of actions
Voluntary global targets 4
Integrate highly cost effective noncommunicable disease interventions into the basic primary health care package to advance the universal health coverage agenda
Explore viable health financing mechanisms and innovative financing approaches, like tobacco and alcohol taxation, to generate resources to expand health coverage
Improve availability of affordable basic technologies and essential medicines, including generics, required to treat major noncommunicable diseases in both public and private facilities
Scale-up coverage starting with very cost effective high impact interventions listed below   
Cardiovascular disease and diabetes (these interventions reduce 37% of CVD burden, 64m DALYs averted)
Multi-drug therapy (including glycaemic control for diabetes mellitus) to individuals who have had a heart attack or stroke, and to persons with high risk (≥ 30%) of a fatal and nonfatal cardiovascular event in the next 10 years
Acetylsalicylic acid for acute myocardial infarction
Cancer (the intervention to address cervical cancer reduces 6% of the cancer burden, 5m DALYs averted)
Prevention of liver cancer through hepatitis B immunization
Prevention of cervical cancer through screening (visual inspection with acetic acid [VIA]) and treatment of pre-cancerous lesions
An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major noncommunicable diseases in both public and private facilities.
At least 50% of eligible people receive drug therapy and counseling (including glycaemic control) to prevent heart attacks and strokes
A 25% relative reduction in overall mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases

14. Voluntary global targets
Appendix 3
Obj.
Set of actions
Voluntary global targets 5
Develop and implement a prioritized national research agenda for NCDs
Strengthen research capacity through cooperation with research institutes
Contributes indirectly to achieve a 25% relative reduction in premature mortality by 2025 6
Develop national targets and indicators based on global monitoring framework
Establish/strengthen a comprehensive NCD surveillance system, including reliable registration of deaths by cause, cancer registration, periodic data collection on risk factors, and monitoring national response,
Integrate NCD surveillance/monitoring into national health information systems

15. World Health Organization
19 May 2018
UN Task Force on NCDs

16. Cross-sectoral government engagement to reduce risk factors and potential health effects of multisectoral action
Sector
Tobacco
Physical inactivity
Harmful use of alcohol
Unhealthy diet
Agriculture 
Communication
Education
Energy
Environment
Finance
Food
Health
Housing
Industry
Justice/Security
Legislature
Transport
Social/Welfare
Sports
Trade
Urban planning

17. UN Secretary-General's report: Five functional gaps in the global response to NCDs5
Advocacy and awareness raising
Financing and resource mobilization
Capacity building
Product access
Product development and innovation

18. Thank you 18