1. 2005 Pan American Health Organization Creating a tipping point to stop the epidemic of chronic diseases in Chile: the need for transformational partnership(s) between government, private sector, and civil society Presentation to the Cumbre de nutricion y Salud, Valparaiso, Chile, Marzo 25, 2008 C. James Hospedales Jefe, ENT, OPS/OMS Creating a tipping point to stop the epidemic of chronic diseases in Chile: the need for transformational partnership(s) between government, private sector, and civil society Presentation to the Cumbre de nutricion y Salud, Valparaiso, Chile, Marzo 25, 2008 C. James Hospedales Jefe, ENT, OPS/OMS

2. 2005 Pan American Health Organization THANK YOU! GRACIAS!

3. 2005 Pan American Health Organization

4. 2005 Pan American Health Organization Vision General Sufficiency of evidence regarding the chronic disease epidemic – perspectiva global Why we need everyone together and how do we do it Regional Strategy and Partners’ Forum on the Prevention and Control of Chronic Diseases Sufficiency of evidence regarding the chronic disease epidemic – perspectiva global Why we need everyone together and how do we do it Regional Strategy and Partners’ Forum on the Prevention and Control of Chronic Diseases

5. 2005 Pan American Health Organization Suficiencia de la evidence – perspectiva global

6. 2005 Pan American Health Organization “Planet Doctor”

7. 2005 Pan American Health Organization

8. 2005 Pan American Health Organization Planet has a fever (global warming) Population: about 7 billion humans - dangerously close to the limit of the Earth’s available resources About 1 billion are living in desperate poverty, with most in the middle, while relatively few are very rich – very unjust, unfair …Y otros problemas An amazing amount of new knowledge, technology and information systems, military powers invented

9. 2005 Pan American Health Organization How did this happen? One species that is very intelligent (at least in some ways), has become the dominant species. They emerged about 10,000 years ago, having invented agriculture, and the villages and political systems that soon followed. Up to that point, people had wiped out a few of the Earth’s largest animals, but left most of the land surface and all the oceans intact. People then used all means they could to convert the resources of the Earth and the seas into wealth, and they did so at an amazing rate, consuming the hydrocarbon fuels, land, forests, water, fish, food, destroying completely thousands of species in the process. And as a Planet doctor, realizing this made me feel very sad, because you see we are taught that the Creator God made the Earth, and when He did so, “He saw that it was good”.

10. 2005 Pan American Health Organization How did this happen? They invented ways of overcoming various epidemics and problems like small pox, plague, tuberculosis, through vaccines, water and sanitation, housing, etc. In the last 100 years or so, they became much less physically-active, with urbanization and the invention of cars and mechanized things. And even where some wanted to be more active, they could not because the environment was not safe anymore, or had become very polluted. And the continued increase in the use of fossil fuels has begun to warm the planet.

11. 2005 Pan American Health Organization Que Pasa? They invented ways of producing nitrogenous fertilizer (double the capacity of nature) to force the Earth to produce even more food, and invented pesticides, and other chemicals to control the pests. In the last 100 years, a large percentage took up smoking tobacco (and for this crazy habit, you see why I question their intelligence). Harmful use of alcohol also became more widespread and contributed to much chronic disease and injury and social harm.

12. 2005 Pan American Health Organization Que Pasa? And excessive consumption habits spread to food where high fat, high sugar, high salt foods became widespread and cheap, marketed and distributed by an efficient private sector so that even the children are now becoming often becoming fat and unhealthy. And ironically, more and more of the cheap, calorie dense, non nutritious food became consumed by the poor, worsening the gaps in the society.

13. 2005 Pan American Health Organization Muy Importante This set of circumstances (global warming, pollution, deforestation, over fishing, over- population, intensive agriculture, urbanization, despeciation) is all happening at the same time, and is all inter-connected, unlike our tendency to study or focus on one thing at a time. And the consequences of the interactions we cannot predict from our reductionist approach to science.

14. 2005 Pan American Health Organization Conclusion 1 The epidemics of obesity and cardiovascular disease, diabetes, cancer, respiratory diseases, are symptoms of our development paradigm gone astray Costs to governments, families, and business are huge and increasing, and no sostenible Symptoms of the deeper problems of a sick planet. The roots of obesity and chronic disease problem lie deep, deep in the way the species, our species, lives on this planet. The epidemics of obesity and cardiovascular disease, diabetes, cancer, respiratory diseases, are symptoms of our development paradigm gone astray Costs to governments, families, and business are huge and increasing, and no sostenible Symptoms of the deeper problems of a sick planet. The roots of obesity and chronic disease problem lie deep, deep in the way the species, our species, lives on this planet.

15. 2005 Pan American Health Organization Conclusion 2 Although our entry point in this Summit is obesity and chronic diseases, the discussions will lead to the fight against poverty, the fight to restore environmental balance, the fight to stabilize the population. It is a very complex problem. The evidence is compelling that we need to redesign our social and economic policies before we completely wreck this planet and the future of the people, and our children. And thus we must come together, politicians, business, media, academia, etc., in a new way. Although our entry point in this Summit is obesity and chronic diseases, the discussions will lead to the fight against poverty, the fight to restore environmental balance, the fight to stabilize the population. It is a very complex problem. The evidence is compelling that we need to redesign our social and economic policies before we completely wreck this planet and the future of the people, and our children. And thus we must come together, politicians, business, media, academia, etc., in a new way.

16. 2005 Pan American Health Organization Faith, Hope and Love I have Faith in the science. I have Hope at the awakening awareness, as evidenced by this Summit, and tools and partners available. What we need is Love … I have Faith in the science. I have Hope at the awakening awareness, as evidenced by this Summit, and tools and partners available. What we need is Love …

17. 2005 Pan American Health Organization Sufficiency of Evidence Preventability – 80% heart disease and diabetes preventable, 40% cancer preventable and another 30% curable – the challenge is in the application; “Discovery-delivery gap” or 20, 30, 50+ years: how to shorten? How to apply the evidence? What policies? What changes in Global and regional market forces? Preventability – 80% heart disease and diabetes preventable, 40% cancer preventable and another 30% curable – the challenge is in the application; “Discovery-delivery gap” or 20, 30, 50+ years: how to shorten? How to apply the evidence? What policies? What changes in Global and regional market forces?

18. 2005 Pan American Health Organization Sufficiency of Evidence Importance of comprehensive, integrated action combining population-based and individual measures; small changes in levels of several risk factors can have major impact. Lancet, December 2007: 32 million deaths can be avoided over the next 10 years by a combination of 15% reduction in salt consumption and comprehensive tobacco control (14 million deaths avoided) at a cost of $0.40 per person per year, and scaling-up of treatment with aspirin, and drugs to lower high blood pressure and cholesterol (18 million avoided) at a cost of $1.10 per person per year. Importance of comprehensive, integrated action combining population-based and individual measures; small changes in levels of several risk factors can have major impact. Lancet, December 2007: 32 million deaths can be avoided over the next 10 years by a combination of 15% reduction in salt consumption and comprehensive tobacco control (14 million deaths avoided) at a cost of $0.40 per person per year, and scaling-up of treatment with aspirin, and drugs to lower high blood pressure and cholesterol (18 million avoided) at a cost of $1.10 per person per year.

19. 2005 Pan American Health Organization Why we need everyone together and how do we do it

20. 2005 Pan American Health Organization Transformational Partnerships Public Sector Civil Society Private Sector Science-Based Niveles: Local National Regional Global

21. 2005 Pan American Health Organization Why do we need everyone together? Creating Tipping points From physics, popularized by Gladwell’s book; seeks to explain and describe enormous and "mysterious" sociological changes that mark everyday life Tipping Points are "the levels at which the momentum for change becomes unstoppable” A sociological term "the moment of critical mass, the threshold, the boiling point“ "Ideas and products and messages and behaviors spread like viruses do.“ Examples of such changes in his book …viruses Creating Tipping points From physics, popularized by Gladwell’s book; seeks to explain and describe enormous and "mysterious" sociological changes that mark everyday life Tipping Points are "the levels at which the momentum for change becomes unstoppable” A sociological term "the moment of critical mass, the threshold, the boiling point“ "Ideas and products and messages and behaviors spread like viruses do.“ Examples of such changes in his book …viruses

22. 2005 Pan American Health Organization Creating positive social “epidemics” "The success of any kind of social epidemic is heavily dependent on the involvement of people with a particular set of social skills." –Connectors are people who "link us up with the world... people with a gift for bringing the world together" –Mavens are "information specialists", or "people we rely upon to connect us with new information." They accumulate knowledge, especially about the marketplace, and know how to share it with others –Salesmen are "persuaders", charismatic people with powerful negotiation skills. They tend to have an trait that goes beyond what they say, that makes others want to agree with them From the book, Tipping Point, by Malcolm Gladwell "The success of any kind of social epidemic is heavily dependent on the involvement of people with a particular set of social skills." –Connectors are people who "link us up with the world... people with a gift for bringing the world together" –Mavens are "information specialists", or "people we rely upon to connect us with new information." They accumulate knowledge, especially about the marketplace, and know how to share it with others –Salesmen are "persuaders", charismatic people with powerful negotiation skills. They tend to have an trait that goes beyond what they say, that makes others want to agree with them From the book, Tipping Point, by Malcolm Gladwell

23. 2005 Pan American Health Organization Why do we need everyone together? The problem is very complex Many countries and organizations have developed many initiatives, policies, promotion and prevention programs…. But the response is fragmented Partnership/collaborations are the stage that everyone needs for action, to create needed synergy between initiatives, to create a “tipping point(s)” for the epidemic in the short to medium term The problem is very complex Many countries and organizations have developed many initiatives, policies, promotion and prevention programs…. But the response is fragmented Partnership/collaborations are the stage that everyone needs for action, to create needed synergy between initiatives, to create a “tipping point(s)” for the epidemic in the short to medium term

24. 2005 Pan American Health Organization Why do we need everyone together? Governments can make policies that help reduce risks, scale up provision for those affected and minimize final catastrophe for families and individuals, but they need the support of the private sector and an empowered civil society Regional and global market forces are major determinants of chronic diseases and health, but private sector needs government policies to level the playing field, and informed consumers to generate markets for healthier products Civil society cannot do it alone; they need an environment that makes the healthy choice the easy choice, which flows from government and private sector policies. Governments can make policies that help reduce risks, scale up provision for those affected and minimize final catastrophe for families and individuals, but they need the support of the private sector and an empowered civil society Regional and global market forces are major determinants of chronic diseases and health, but private sector needs government policies to level the playing field, and informed consumers to generate markets for healthier products Civil society cannot do it alone; they need an environment that makes the healthy choice the easy choice, which flows from government and private sector policies.

25. 2005 Pan American Health Organization No es facil! “We chose to go to the moon and do other things, not because they are easy, but because they are hard, because the goal will serve to organize and measure the best of our energies and skills, because that challenge is one we are willing to accept, on we are unwilling to postpone, and one which we intend to win, and others, too.” (John Kennedy)

26. 2005 Pan American Health Organization How do we do it? Global perspective, with local actions Inclusive Cooperative Environmentally aware Science-based Jeffrey D. Sachs: “Common Wealth; Economics for a Crowded Planet” Penguin Press, 2008 Global perspective, with local actions Inclusive Cooperative Environmentally aware Science-based Jeffrey D. Sachs: “Common Wealth; Economics for a Crowded Planet” Penguin Press, 2008

27. 2005 Pan American Health Organization How do we do it? Inclusive –Who is not here at this Summit that will feel that they should be here, and who we need to have on board for success? –What happened that the private sector is not well represented? –Which is the biggest NGO in the world; very important in Chile? Are they at the Summit? –Who feels that they should have been part of the planning of the Summit, and were not? Inclusive –Who is not here at this Summit that will feel that they should be here, and who we need to have on board for success? –What happened that the private sector is not well represented? –Which is the biggest NGO in the world; very important in Chile? Are they at the Summit? –Who feels that they should have been part of the planning of the Summit, and were not?

28. 2005 Pan American Health Organization And if you were not involved or invited? Maybe it was not intentional Forgive the organizers and join the effort! En la Biblia: "Lord, how many times shall I forgive my brother when he sins against me? Up to seven times?" Jesus answered, "I tell you, not seven times, but seventy-seven times” Matt 18: 20-21 Maybe it was not intentional Forgive the organizers and join the effort! En la Biblia: "Lord, how many times shall I forgive my brother when he sins against me? Up to seven times?" Jesus answered, "I tell you, not seven times, but seventy-seven times” Matt 18: 20-21

29. 2005 Pan American Health Organization How do we do it? Cooperative “Each of you should seek not only to your own interests, but seek also to the interests of others”. Philippians 2:4 Cooperative “Each of you should seek not only to your own interests, but seek also to the interests of others”. Philippians 2:4

30. 2005 Pan American Health Organization Some Useful Tools

31. 2005 Pan American Health Organization Some Useful Tools Interest-Based Negotiation Conflict Management Group, Cambridge, Mass, USA Mercy Corps Int’l, Seattle

32. 2005 Pan American Health Organization Some Useful Tools Communication & Relationship Keys to the “circle of power” Clarify Interests Identify Options for mutual success Criteria of Fairness Agreement & Commitment

33. 2005 Pan American Health Organization How to do it? We have to connect our interests to the interests of others Learn to speak the language of other groups sectors Connect our health metrics to social justice, to profits and productivity, to environmental concerns, to security interests, to spiritual interests, etc We have to connect our interests to the interests of others Learn to speak the language of other groups sectors Connect our health metrics to social justice, to profits and productivity, to environmental concerns, to security interests, to spiritual interests, etc

34. 2005 Pan American Health Organization How do we do it? Some useful tools THE SEVEN HABITS OF HIGHLY EFFECTIVE PEOPLE Habit 5 -- Seek First to Understand Then to be Understood Principles of Empathic Communication Stephen Covey, and the Covey Leadership Institute THE SEVEN HABITS OF HIGHLY EFFECTIVE PEOPLE Habit 5 -- Seek First to Understand Then to be Understood Principles of Empathic Communication Stephen Covey, and the Covey Leadership Institute

35. 2005 Pan American Health Organization Some Useful Tools

36. 2005 Pan American Health Organization Some Useful Tools

37. 2005 Pan American Health Organization How do we do it? “If your colleague does something to offend you, go and show him his fault, just between the two of you. If he listens to you, you have won your colleague over. If he will not listen, take one or two others along, so that the matter may be established by the testimony of two or three witnesses..” Matthew 18: 15-16 “If your colleague does something to offend you, go and show him his fault, just between the two of you. If he listens to you, you have won your colleague over. If he will not listen, take one or two others along, so that the matter may be established by the testimony of two or three witnesses..” Matthew 18: 15-16

38. 2005 Pan American Health Organization How do we do it? Persevere: the most important thing See the movie “Amazing Grace” about how the British slave trade was ended through the efforts of Member of Parliament, 1789-1906, William Pitt “After the final No, there comes a Yes, and on that Yes the future depends”, Poet, Wallace Stevens Persevere: the most important thing See the movie “Amazing Grace” about how the British slave trade was ended through the efforts of Member of Parliament, 1789-1906, William Pitt “After the final No, there comes a Yes, and on that Yes the future depends”, Poet, Wallace Stevens

39. 2005 Pan American Health Organization People will say, “No” No, we need not change; we have always done this No, we cannot change; it is too hard No, we will lose profits… or prestige No, we cannot make peace with that group… …. No, we need not change; we have always done this No, we cannot change; it is too hard No, we will lose profits… or prestige No, we cannot make peace with that group… ….

40. 2005 Pan American Health Organization Private sector interests Profits and productivity Customer satisfaction Increasing share holder value Quality and competitiveness Controlling costs (workplace wellness) New market opportunities Avoiding future litigation Image and reputation Corporate Social Responsibility Etc Profits and productivity Customer satisfaction Increasing share holder value Quality and competitiveness Controlling costs (workplace wellness) New market opportunities Avoiding future litigation Image and reputation Corporate Social Responsibility Etc

41. 2005 Pan American Health Organization Private Sector; not homogenous Food Companies Media and telecommunications Arts and entertainment Travel and tourism Finance and banking Insurance companies Auto industry Farming and agriculture Etc Food Companies Media and telecommunications Arts and entertainment Travel and tourism Finance and banking Insurance companies Auto industry Farming and agriculture Etc

42. 2005 Pan American Health Organization Private Sector: business opportunities in health Food Companies – “5-a-day” frutas y verduras Sports companies – Ciclorecreovias – bicycles, sports drinks Media, Arts and entertainment – wellness programs Telecommunications – cellphones for RF surveys? For health education with text messages? Arts and entertainment – integrate good health behavior into telenovelas? Travel and tourism – health spas, health tourism Finance and banking - healthy people earn and save Insurance companies – healthy populations can pay premiums Auto industry Farming and agriculture – fruits and veg, low fat meats Food Companies – “5-a-day” frutas y verduras Sports companies – Ciclorecreovias – bicycles, sports drinks Media, Arts and entertainment – wellness programs Telecommunications – cellphones for RF surveys? For health education with text messages? Arts and entertainment – integrate good health behavior into telenovelas? Travel and tourism – health spas, health tourism Finance and banking - healthy people earn and save Insurance companies – healthy populations can pay premiums Auto industry Farming and agriculture – fruits and veg, low fat meats

43. 2005 Pan American Health Organization Private sector and cholera In 1991, cholera threatened to spread to the Caribbean islands from Col, Ven, Guyana and governments, private sector and NGOs responded Private Sector Response against the Cholera Threat in Trinidad & Tobago. –Hospedales J, Holder Y, Deyalsingh I, et al. Bull Pan Am Health Org 1993; 27:331-6 –Private sector had spent five times more than the government in education the public about preventing cholera! In 1991, cholera threatened to spread to the Caribbean islands from Col, Ven, Guyana and governments, private sector and NGOs responded Private Sector Response against the Cholera Threat in Trinidad & Tobago. –Hospedales J, Holder Y, Deyalsingh I, et al. Bull Pan Am Health Org 1993; 27:331-6 –Private sector had spent five times more than the government in education the public about preventing cholera!

44. 2005 Pan American Health Organization Steps to establish a Tourism and Health Partnership in Caribbean 1995 “Prevention of diarrheal disease in travel industry  1996 “Prevention of foodborne disease”  1996 “Reducing cost impacts of health and disease problems”  1997 “Improving profitability through attention to health and hygiene”  !! (Inter-American Travel Congress, Costa Rica) Quality Tourism for the Caribbean (QTC): joint public- private partnership Caribbean Hotel Association-Caribbean Epidemiology Center (CAREC/PAHO), 1998 $BID $CDB 1995 “Prevention of diarrheal disease in travel industry  1996 “Prevention of foodborne disease”  1996 “Reducing cost impacts of health and disease problems”  1997 “Improving profitability through attention to health and hygiene”  !! (Inter-American Travel Congress, Costa Rica) Quality Tourism for the Caribbean (QTC): joint public- private partnership Caribbean Hotel Association-Caribbean Epidemiology Center (CAREC/PAHO), 1998 $BID $CDB

45. 2005 Pan American Health Organization A private Sector Perspective “Dr Hospedales, we have demand for healthy food products from Europe and North America, but we have no demand from South America; why should we change? We will lose money to our competitors and I don’t want to commit financial suicide’ (Vice President, XXXX Foods; en la casa de Don Franscisco, Miami, 2007) What are the interests and concerns in this statement? What options for working together? “Dr Hospedales, we have demand for healthy food products from Europe and North America, but we have no demand from South America; why should we change? We will lose money to our competitors and I don’t want to commit financial suicide’ (Vice President, XXXX Foods; en la casa de Don Franscisco, Miami, 2007) What are the interests and concerns in this statement? What options for working together?

46. 2005 Pan American Health Organization A private Sector Perspective “Dear Dr Roses, I want to congratulate you on the work of your team in diet and physical activity. It has inspired me to do a special show on obesity. You will be pleased to hear that the show broke viewership records” Don Franscisco, letter to Director, PAHO, January 2008 What can we learn here from a Univision perspective? An issue in health is good for business! “Dear Dr Roses, I want to congratulate you on the work of your team in diet and physical activity. It has inspired me to do a special show on obesity. You will be pleased to hear that the show broke viewership records” Don Franscisco, letter to Director, PAHO, January 2008 What can we learn here from a Univision perspective? An issue in health is good for business!

47. 2005 Pan American Health Organization http://www.dpaslac.org/

48. 2005 Pan American Health Organization Partnership between “Prevention and Treatment” – comprehensive approach “The value of medical care to health promotion’, Sir Douglas Black, President, UK Royal College of Physicians, 1974 Integrating prevention into medical care, preventive exams screening for smoking, BMI, cervical cancer, etc., es muy importante. Clinical and Public Health Ethical responsibility Largest decrease in Relative Risk of all cause mortality due to physical activity is in patients who have diabetes, hypertension, overweight (3-5 fold) In a diabetes quality-of-care project, advice to patients to eat healthy more likely to succeed if we to make healthy foods more accessible and affordable “The value of medical care to health promotion’, Sir Douglas Black, President, UK Royal College of Physicians, 1974 Integrating prevention into medical care, preventive exams screening for smoking, BMI, cervical cancer, etc., es muy importante. Clinical and Public Health Ethical responsibility Largest decrease in Relative Risk of all cause mortality due to physical activity is in patients who have diabetes, hypertension, overweight (3-5 fold) In a diabetes quality-of-care project, advice to patients to eat healthy more likely to succeed if we to make healthy foods more accessible and affordable

49. 2005 Pan American Health Organization Interests of the Church Spiritual health Salvation of people’s souls Spreading the kingdom of Jesus Christ Caring for the sick and disabled Fostering reconciliation between people; peace making Preventing sins of gluttony and sloth and drunkeness “Do you not know that your body is a temple of the Holy Spirit, who is in you, whom you have received from God?” -> Look after your body; take care not to pollute it with tobacco and drunkeness Spiritual health Salvation of people’s souls Spreading the kingdom of Jesus Christ Caring for the sick and disabled Fostering reconciliation between people; peace making Preventing sins of gluttony and sloth and drunkeness “Do you not know that your body is a temple of the Holy Spirit, who is in you, whom you have received from God?” -> Look after your body; take care not to pollute it with tobacco and drunkeness

50. 2005 Pan American Health Organization Partnership Government-Civil society-PAHO CARICOM Heads of State special summit on chronic diseases, September 2007; resulted in high level political commitment and healthy public policy directions Case study of Critical success factors: –Partnership PAHO-CARICOM Secretariat –Evidence of human and economic cost from Caribbean regional health institutions and Universities –Involvement of countries in planning and preparing for the Summit –Involvement of the media in raising awareness CARICOM Heads of State special summit on chronic diseases, September 2007; resulted in high level political commitment and healthy public policy directions Case study of Critical success factors: –Partnership PAHO-CARICOM Secretariat –Evidence of human and economic cost from Caribbean regional health institutions and Universities –Involvement of countries in planning and preparing for the Summit –Involvement of the media in raising awareness

51. 2005 Pan American Health Organization Opportunities for Advocacy Ibero-American Cumbre 2008, El Salvador Cumbre de las Americas 2009, Trinidad y Tobago Cumbres sub-regional: Mercosur, Communidad Andina, Sistem Integracion de Central America Ibero-American Cumbre 2008, El Salvador Cumbre de las Americas 2009, Trinidad y Tobago Cumbres sub-regional: Mercosur, Communidad Andina, Sistem Integracion de Central America

52. 2005 Pan American Health Organization Regional Strategy and Partners’ Forum on the Prevention and Control of Chronic Diseases

53. 2005 Pan American Health Organization Regional Strategy and Plan of Action for an Integrated Approach to the Prevention and Control of Chronic Diseases, including Diet, Physical Actvity and Health September 2006

54. 2005 Pan American Health Organization Policy & Advocacy Surveillance Health Promotion & Prevention Integrated Management of NCD 1 2 3 4 4 Lines of Action

55. 2005 Pan American Health Organization Regional Strategy: Key Elements Policy Monitoring, dialogues and advocacy STEPs surveillance system; InfoBase DPAS FCTC Chronic Care Model Partners’ Forum CARMEN Network Capacity building – Escuela CARMEN Disease specific plans – CVD, Diabetes, Cancer Policy Monitoring, dialogues and advocacy STEPs surveillance system; InfoBase DPAS FCTC Chronic Care Model Partners’ Forum CARMEN Network Capacity building – Escuela CARMEN Disease specific plans – CVD, Diabetes, Cancer

56. 2005 Pan American Health Organization CARMEN Network 2007 21 Members Members Argentina, Anguilla, Aruba, Bolivia, Brazil, Canada, Colombia, Costa Rica, Cuba, Curacao, Chile, El Salvador, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, Puerto Rico,Trinidad & Tobago, Uruguay Prospective Members Honduras, Suriname, Venezuela Special Projects USA-Mexico (border) CARLI (English/Dutch Caribbean) Collaborating members Collaborating members SLU,USF,NHLBI,CDC,PHAC AMNET, RAFA,ILSI,F&V,IDB

57. 2005 Pan American Health Organization Regional Partners’ Forum for Chronic Disease Prevention and Control Including public sector, private sector and civil society Platform for bringing everyone together OPS/OMS as convener and catalyst; honest broker Objectives: “10 X 2010” –Awareness and communication: Policy makers and public –Healthy diet: “Americas Pledge” on advertising to children –Physical Activity: 100 Ciclovias by 2010 –Tobacco control –Increased access health promotion and disease prevention services: Workplace wellness and PHC Including public sector, private sector and civil society Platform for bringing everyone together OPS/OMS as convener and catalyst; honest broker Objectives: “10 X 2010” –Awareness and communication: Policy makers and public –Healthy diet: “Americas Pledge” on advertising to children –Physical Activity: 100 Ciclovias by 2010 –Tobacco control –Increased access health promotion and disease prevention services: Workplace wellness and PHC

58. 2005 Pan American Health Organization Partnerships MAP CARMEN Network Countries and Institutions (PAHO Secretariat) SURVEILLANCE WHO CC on evidence-based public health CDC- BRFs and DDT WHO- STEPS and InfoBase PHAC Canada CAREC U of Nicaragua- Leon Others MANAGEMENT NCDs and RFs WHO CC on CVD NIH/NHLBI WHO CC in diabetes- CENEXA, INEN, Indiana U, IDC UWI-UDOP WHO CC at U of Newcastle WDF Novo Nordisk Gates Foundation FIP IAEA IARC CFNI Others POLICY & ADVOCACY PAHO/WHO CC on NCD, PHAC BRA, COR (Banco Mundial, Banco Interamericano) (Subregional Banks) (Universities) H PROMOTION & DISEASE PREVENTION PAHO/WHO CC on Physical Activity RAFA PANA Ciclovías – cycle ways 5- a- day – cinco al día U of South Florida- Social Marketing Univisión Fundación FES Colombia Fundación Ciudad Humana International Life Sciences Institute (Healthy Schools) (Healthy Cities) (Ovations) (Private Enterprise) (CFNI, INCAP) Others

59. 2005 Pan American Health Organization Review Sufficiency of evidence regarding the chronic disease epidemic – perspectiva global Why we need everyone together and how do we do it Regional Strategy and Partners’ Forum on the Prevention and Control of Chronic Diseases Sufficiency of evidence regarding the chronic disease epidemic – perspectiva global Why we need everyone together and how do we do it Regional Strategy and Partners’ Forum on the Prevention and Control of Chronic Diseases

60. 2005 Pan American Health Organization THANK YOU! GRACIAS!