1. Dr Timothy Armstrong
Coordinator
Surveillance and Population-based Prevention
Department of Chronic Diseases and Health Promotion
World Health Organization

2. Why is surveillance important?

3. Political Declaration on NCDs
61. Call upon WHO, with the full participation of Member States, informed by their national situations, through its existing structures, and in collaboration with United Nations agencies, funds and programmes, and other relevant regional and international organizations, as appropriate, building on continuing efforts to develop before the end of 2012, a comprehensive global monitoring framework, including a set of indicators, capable of application across regional and country settings, including through multisectoral approaches, to monitor trends and to assess progress made in the implementation of national strategies and plans on NCDs.
Let's have a look at the text included in the Political Declaration on NCDs that relates to the topic we are discussing today.
Paragraph 61 of the Political Declaration calls upon WHO, with the full participation of Member States, informed by their national situations, through its existing structures, and in collaboration with United Nations agencies, funds and programmes, and other relevant regional and international organizations, as appropriate, building on continuing efforts to develop before the end of 2012, a comprehensive global monitoring framework, including a set of indicators, capable of application across regional and country settings, including through multisectoral approaches, to monitor trends and to assess progress made in the implementation of national strategies and plans on NCDs.

4. Political Declaration on NCDs
62. Call upon WHO, in collaboration with Member States through the governing bodies of WHO, and in collaboration with United Nations agencies, and other relevant regional and international organizations, as appropriate, building on the work already under way, to prepare recommendations for a set of voluntary global targets for the prevention and control of NCDs, before the end of 2012.
Paragraph 62 calls upon WHO, in collaboration with Member States through the governing bodies of WHO, and in collaboration with United Nations agencies, and other relevant regional and international organizations, as appropriate, building on the work already under way, to prepare recommendations for a set of voluntary global targets for the prevention and control of NCDs, before the end of 2012

5. Political Declaration on NCDs
63. Consider the development of national targets and indicators based on national situations, building on guidance provided by WHO, to focus on efforts to address the impacts of non-communicable diseases and their risk factors and determinants.
Paragraph 63 commits Member States to consider the development of national targets and indicators based on national situations, building on guidance provided by WHO.

6. Framework for national NCD surveillance
Outcomes
Mortality: NCD specific mortality
Morbidity: cancer incidence and type
Exposures
Behavioural risk factors: tobacco use, physical inactivity, harmful use of alcohol and unhealthy diet
Metabolic risk factors: raised blood pressure, overweight/obesity, raised blood glucose, and raised cholesterol.
Social determinants: education, material well being, access to health care
Health System Response
Interventions and health system capacity: infrastructure, policies and plans, access to key health care interventions and treatments, partnerships.

7. Monitoring framework and indicators for NCDs
Outcomes
Cancer incidence by type
Mortality between ages 30 – 70 due to CVD, cancer, diabetes, or CRD
Exposures
Adult alcohol per capita consumption
Heavy drinking occasions
Insufficient physical activity
Low fruit and vegetable consumption
Overweight/obesity
Raised blood glucose/diabetes
Raised blood pressure
Raised total cholesterol
Salt/sodium intake
Tobacco smoking
Health systems response
Access to palliative care
Availability of basic diagnostics and medicines
Cervical cancer screening
Multidrug therapy for CVD risk reduction
Policies to eliminate trans fats
Policies to reduce marketing of unhealthy foods to children
Vaccination for Hepatitis B
Vaccination for HPV

8. Criteria recommended for selection of indicators and targets
High epidemiological and public health relevance
Coherence with major strategies and priorities
Evidence driven targets and indicators
Availability of evidence-based effective and
feasible public health interventions
Evidence of achievability at the country level
Existence of unambiguous data collection instruments and
potential to set a baseline and monitor changes over time.

9. Relationship between global and national targets
National targets should be consistent with the global target.
Targets may be adapted nationally, based on the country's situation.
Adaptations would reflect what might be achievable in a specific country based on their performance, current exposure and what actions can be achieved.
National adapted targets may be more or less ambitious than the global target.

10. "What gets measured, gets done!"
Core indicators
Few "tracer" targets
Focuses national attention
Major contribution to achievements in NCD prevention and control

11. NCD Country Profiles