Chronic respiratory diseases Alliance against Chronic Respiratory Diseases Chronic respiratory...

Global Alliance against Chronic Respiratory Diseases

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Chronic respiratory diseases:One of the priorities of a global strategy for

prevention and control of noncommunicable

diseases

Dr Ala Alwan, Assistant Director-General

World Health OrganizationGARD General Meeting, 30-31 May 2008, Istanbul


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• Noncommunicable diseases including CRDs

• The action plan for the global strategy on

noncommunicable diseases 2008-2013

• What does the plan mean to CRD prevention and GARD

members?

Overview


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Assistant

Director-General

Chronic Diseases

and Health

Promotion

Mental Health and

Substance Abuse

Nutrition for

Health and

Development

Tobacco Free

Initiative

Violence and

Injury Prevention

and Disability

Standing

Committee on

Nutrition

WHO Centre for

Health

Development

WHO's cluster for Noncommunicable Diseases and Mental Health (NMH)

D


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+17%-3%38835.758.2Total

+20%+11059.712.4Western Pacific

+21%-16%898.014.7South-East Asia

+4%+7%888.59.8Europe

+25%-10%252.24.3Eastern Mediterranean

+17%-8%534.86.2Americas

+27%+6%282.510.8Africa

Trend: Death from

NCD

Trend: Death from

infectious disease

NCD

deaths

(millions)

NCD deaths

(millions)

Total

deaths

(millions)

Geographical regions

(WHO classification)

2006-2015 (cumulative)2005

Noncommunicable diseases (2005-2015)

WHO projects that over the next 10 years, the largest increase in deaths from cardiovascular disease, cancer, respiratory disease and diabetes will occur in Africa, the Middle East and Asia

(WHO Preventing Chronic Diseases: A vital investment, 2005)


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Currently hundreds of millions of people have chronic respiratory diseases

� including 300 million people with asthma (increasing)

� 210 million people with COPD (increasing)

� and millions of others with other chronic respiratory diseases, such as sleep apnoea, pulmonary hypertension, occupational

disorders and allergic rhinitis, which are often underdiagnosed

Over 4 million people died of chronic respiratory diseases in 2005

(WHO Preventing Chronic Diseases: A vital investment 2005)

Chronic Respiratory Diseases


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Deaths by cause in the world (2004-2030)

(WHO World Health Statistics, 2008)


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Tobacco

Tobacco use is a risk factor for six of the eight leading causes of death in the world

(WHO World Health Statistics, 2008)


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Why action is needed to address NCDs

• Why action is needed now to address noncommunicable diseases:

– 60% of global deaths are due to noncommunicable diseases (and still increasing)

– 40% of cancer is preventable

– 80% of cardiovascular disease, stroke and diabetes is preventable

– A large part of chronic respiratory diseases is preventable

– Cost-effective secondary prevention interventions exist and have worked in many countries

• Major noncommunicable diseases:

– Cardiovascular disease

– Cancer

– Chronic Respiratory disease

– Diabetes

• Shared preventable risk factors:

– Tobacco use

– Unhealthy diet

– Physical inactivity

– Harmful use of alcohol

Chronic

Respiratory

DiseasesCardiovascular

Disease

DiabetesCancer

Physical

inactivity

Obesity

Unhealthy

diets

SmokingHarmful use of

alcohol

Malnutrition

Other NCDs


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Primary preventionpopulation-wide

Secondaryprevention

Primary prevention atindividuallevel

Very cost

effective

Cost effective

Cost effective if

targeted at high

risk people

Cost-effective strategies exist


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Increased health support by donors is mostly directed towards HIV/AIDS,

not noncommunicable diseases

US$2.9 billion ±0.1%

Official Development Aid (ODA) to the health sector in 2002

Allocated to noncommunicable diseases and mental health

International donors


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The global response to address NCDs

Global strategy on diet,

physical activity and

health

Global strategy on

noncommunicable diseases

Action Plan for the Global strategy

on noncommunicable diseases

A six-year Global Action Plan to address cardiovascular disease, cancer, respiratory disease and diabetes was endorsed by the WHO World Health Assembly on 24 May 2008.

Implementation of the

global strategy on NCDs

2008 2000 2003 2004 2007 2013 implementation in

countries

WHO Framework

Convention on Tobacco

Control

Global strategy on

harmful use of alcohol


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Process:

• January 2008 – Discussions at WHO's Executive

Board

• February 2008 – Informal consultations with Member States, International Partners and the

business community

• April 2008 – Final draft Action Plan was published on the internet (www.who.int/gb)

• 24 May 2008 – Six-year Action Plan endorsed by

the 61st World Health Assembly

Action Plan for the Global strategy

on noncommunicable diseases

Global NCD Action Plan


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"... any discussion of health development must

include the chronic noncommunicable

diseases. Heart disease and cancer now rank

as leading killers in all parts of the world,

regardless of a country’s income status.

Diabetes and asthma are on the rise

everywhere. "

Chronic Respiratory Diseases

Dr Margaret Chan, Director General, World Health Organization

Opening address to the 61st World Health Assembly (19-24 May 2008)


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NCD Action Plan Objectives 2008-2013

1. Raise the priority accorded to noncommunicable disease in development work at global and national levels, and to integrate prevention of such diseases into policies across all government departments

2. Establish and strengthen national policies and plans for the prevention and control of noncommunicable diseases

3. Promote interventions to reduce the main shared modifiable risk factors for noncommunicable diseases: tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol

4. Promote research for the prevention and control of noncommunicable diseases

5. Promote partnerships for the prevention and control of noncommunicable diseases

6. Monitor noncommunicable diseases and their determinants and evaluate progressat the national, regional and global levels


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Global Strategy for the Prevention and Control of NCDsImplementation Plan: Objectives 2008-2013

Objective 1: To raise the priority accorded to NCDs in development work at global and national levels, and to integrate prevention of such diseases into

policies across all government departments:

Key messages:

• NCDs including CRDs are closely linked to socio-economic development

• Public policies in sectors other than health have a major bearing on NCD-

CRD risk factors: All Government Approach to Prevention

• Inequities to exposure of risks and to access to care result in major

inequalities in occurrence and outcomes of CRDs: Addressing the social

determinants of health


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Objective 1: To raise the priority accorded to NCDs in development work at global and national levels, and to integrate prevention of such diseases into policies across all government departments:

Key Actions:

• Raise priority given to CRDs on the agendas of relevant high level forums and meetings of policy makers

• Build and disseminate evidence-base and surveillance data to inform policy makers and to assess the burden imposed by CRDs with emphasis on poor populations

• Develop tools to assess impact of public policies on determinants and risk factors and provide models for evidence-based policies

• Incorporate NCD-CRD prevention and control into poverty reduction plans


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Objective 2: To establish/strengthen national policies and plans for NCD prevention

Key Areas of Actions:

• Strengthen national multisectoral framework for the integrated prevention of

NCDs: Policy, plan, multisectoral work, legislation to reduce risk factors

• Integrate the prevention of NCDs into national health development:

surveillance, prevention and health care

• Reorient and strengthen health systems to respond more effectively to health

care needs of chronic diseases; integrate CRD control into primary health care


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Global Strategy for the Prevention and Control of NCDsWhat do we need to do?

Objective 3: To promote interventions to reduce the main modifiable risk factors e.g

tobacco use

Key Areas of Actions for Tobacco Use (FCTC – MPOWER)

• Monitor tobacco use tobacco prevention policies

• Protect people from tobacco smoke in public places and workplaces

• Offer help to people who want to stop

• Warn people about dangers of tobacco

• Enforce bans on advertising, promotion, and sponsorship

• Raise tobacco taxes and prices


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Objective 4: To promote research for the prevention and control of NCDs-CRDs


• Develop a prioritized research agenda, with special focus on gaps in prevention

and control in low and middle income countries (assessing burden, monitorinf

impact of social determinants and disparities, assessing national capacity,

evaluate cost-effectiveness and impact of interventions including early

detection, evaluate health care models, study approaches to improving access

to essential medicines and technologies..etc..

• Strengthen national capacity in research and encourage establishment of

national centres and networks

• Strengthen joint work, coordination and the role of WHO Collaborating Centres


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Objective 5: To promote partnerships for the prevention and control of NCD/CRDs


• Encourage the involvement of international and regional initiatives/institutions in

implementing the Global Strategy plan

• Strengthen role of WHO collaborating centres by linking their plans to the GS

plan

• Facilitate global and regional networking

• Invite all stakeholders to strengthen joint work and coordination


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Objective 6: To monitor NCDs/CRDs and evaluate progress at national and global

levels


• Develop an information system to collect, analyze and disseminate data on

trends in respect of mortality, disease burden, risk factors, policies, and actions

taken by countries

• Set realistic and evidence-based targets and indicators to track global and

national progress

• Strengthen technical support to countries in improving their collection of data

and statistics, on risk factors, determinants and mortality


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Making a difference

in combating CRDs:

A challenge to

all GARD Members

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