Health and Global Policy InstituteyBreakfast Briefing

b29 November 2011

Judith WattSt t i C lt t t NCD AlliStrategic Consultant to NCD Alliance

www.ncdalliance.org

Good morning   I will address three pointsGood morning ... I will address three points

• Why tackling non‐communicable diseases (NCDs) is a priority for health, for development, and for all of us

• What the NCD Alliance is, what we have done and what we plan for the future 

• How Japan can become a global champion for preventing and controlling NCDsand controlling NCDs

What is an NCD?What is an NCD?

• I don’t need to tell you … because all of us have personal experience of NCDs

• All of us know someone who is battling cancer, or who is living with diabetes, or who is disabled because of a stroke or emphysema, or who died of a heart attack

• But we do need to explain why are we now grouping• But we do need to explain why are we now grouping these diseases together and calling for urgent action to prevent and control themp

• It is because they are an enormous threat to the world

Global Risks Landscape 2010World Economic ForumWorld Economic Forum

droughts

terrorism

And it is going to get a lot worse ...30

Intentional injuries

And it is going to get a lot worse ...

25

ns)

Other NCDs

Road traffic accidentsOther unintentionalIntentional injuries

15

20

s (m

illio

n

Cancers

Other NCDs

10Dea

th

CVD

5

HIV TB malaria

Other infectious

Mat//peri/nutritional

02004 2015 2030 2004 2015 2030 2004 2015 2030

High income Middle income Low income

HIV, TB, malaria

Projected NCD deaths in 2015 and 2030

Total deathsaround the world:58 million58 million

Total deathsaround the world:58 million58 million

Deaths from NCDs around the world:36 million

Total deathsaround the world:58 million58 million

Deaths from NCDs around the world:36 million

Deaths from NCDs in developing countries:developing countries:28 million

Total deathsaround the world:58 million58 million

Deaths from NCDs around the world:36 million

Deaths from NCDs in developing countries:developing countries:28 million

Deaths from NCDs in developing countries h b dthat can be prevented:14 million

4x4:  4 major diseases4x4:  4 major diseases

4x4:  4 major diseases x 4 major risk factors4x4:  4 major diseases x 4 major risk factors

Tobacco use will cause 6.4m deaths a year by 2015– 10% of all deaths10% of all deaths

Respiratory di

Cardiovascular di diseases

29%diseases29%

Tuberculosis1%

Cancers33%

Other

Diabetes2%

Other6%

Mathers CD, Loncar D (2006) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3(11): e442. doi:10. 1371/journal.pmed.0030442

Cancers Respiratory Cardiovascular Other diseases

Lung Chronic Coronary heart Gastric ulcerLung

Oral cavity

Pharynx

Chronic obstructive pulmonary disease (COPD)

Coronary heart disease (CHD)

Cerebrovasculardisease (Stroke)

Gastric ulcer

Cataract

Periodontitis

Larynx

OesophagusPancreas

Acute respiratory illnesses

Pneumonia

( )

Aortic aneurysm

Peripheral arterial disease

Duodenal ulcer

Crohn’s diseasePancreas

Urinary bladder

Renal pelvis

Poor asthma control

In adolescents:

disease Macular degeneration

Tobacco bl i

Kidney

Stomach

U i i

In adolescents:

Impaired lung growth

A th l t d

amblyopia

Osteoporosis

DiabetesUterine cervix

Myeloid leukaemia

Asthma-related symptoms (wheezing)

Respiratory

Tuberculosis

Reproductive problems:

Nasal cavities

Nasal sinuses

Liver

Respiratory effects in uterowith maternal smoking

problems:

Reduced fertility

Low birthweightLiver

Sudden Infant Death Syndrome

Speaking about NCDs at Speaking about NCDs at Davos in January 2011, Director­General of WHO,Director General of WHO,Dr Margaret Chan

"Let me propose aLet me propose a critical priority:tobacco tobaccotobacco, tobacco, tobacco  we must fight it ”... we must fight it.

Speaking in 2009 about NCDs and development,UN Secretary­General,Ban Ki­Moon

“Cancer, diabetes, and heartCancer, diabetes, and heart diseases are no longer the diseases of the wealthy.diseases of the wealthy.

Today, they hamper the people d th i f thand the economies of the 

poorest populations even more th i f ti dithan infectious diseases.

This represents a public health emergency in slow motion.” 

Enter the NCD Alliance

NCD Alliance NetworkNCD Alliance Network

• A network of more than 2000 NGOs in more than 170 countries

• Over 350 Common Interest Group Members• 20+ National NCD Alliances• Collaborations with top NCD academics, including:

• The Lancet NCD Action Group• Harvard University• London School of Hygiene and Tropical Medicine

• Regular liaison with WHO in Geneva and regions• New relationships with UNDP, DESA and other UN agencies

Targets widely consulted onTargets widely consulted on

NCD Alliance and Lancet NCD Action Group:Five priority actions for the NCD crisis

1 • Political leadership

p and 

ance2 • Prevention

D Action Group

the NCD

 Alli

3 • Treatment

he Lancet N

CD

4 • International co‐operation

Th

5 • Monitoring, reporting and accountability

L d hiP tiTreatment

Leadership• Establish a high‐level Partnership for NCD Prevention and Control

Prevention• Accelerate FCTC implementation 

• Strengthen health‐care systems

• Integrate NCDs into successor goals to MDGs

• Commit to whole‐of‐government action –

• Reduce salt intake

• Reduce saturated and trans‐fat

• Increase access to quality, low‐cost medicines Commit to whole of government action 

with civil society and appropriate private sector involvement

and trans fat intake

• Reduce sugar intake

and technologies:

o Combination drugs for CVDintake

• Reduce harmful use of alcohol

International cooperation• Promote synergies between programmes for NCDs and other global health priorities

o Insulin for diabetes

o Asthma • Increase  opportunities for physical activity

for NCDs and other global health priorities

Invest in these low­cost strategies 

inhalerso Anti‐cancer vaccines

Monitoring, reporting and accountability• Identify ambitious targets and a transparent reporting system 

o Pain relief for end‐of‐life care

Convening Experts & Influencing Policy g p g y

Milestones

UN Resolution toCivil Society Hearing at UN (June 2011)

UN High‐Level Meeting 

(September 2011)

Modalities Resolution  

(December 2010)

UN Resolution to hold High‐Level Meeting on NCDs 

(May 2010)

Launch of NCD Alliance 

(May 2009)

Campaign for specific language and outcomesCampaign for High‐Level Meeting

NCDs – only the second health issue to come before the United Nations after AIDS in 2001before the United Nations, after AIDS in 2001

Immediate priorities for NCD AllianceImmediate priorities for NCD Alliance• Complete Strategic Review and new Strategic Plan• Refine position on targets and indicators, and monitoring framework

• Develop campaign plan for integration of NCD targets into post‐2015 development goalsD l i l f i i t di i• Develop campaign plan for improving access to medicines and technologies

• Develop options for global partnerships• Develop options for global partnerships• Progress tobacco control priorities, especially taxation campaigncampaign

• Identify NCD champion countries and Heads of State –could Japan be one?could Japan be one?

Japan: a global champion for NCDs?

• Prioritize NCD prevention and control in JapanA l i FCTC• Accelerate action on FCTC

• Create a national NCD Allianceld l d h l f• Build on current leadership in international assistance for 

NCDs (recognized by Sri Lanka and El Salvador at HLM)J ’ t i ti l f i l i f NCD i t• Japan’s support is essential for inclusion of NCDs into post‐2015 successors to MDGs 

• Leadership in process leading up to 2014 High Level• Leadership in process leading up to 2014 High‐Level Review