Scope, Objectives and Agenda

Dr Ala AlwanAssistant Director-General

Noncommunicable Diseases and Mental HealthWorld Health Organization

Scope, Objectives and Agenda

ECOSOC/UNESCWA/WHO Western Asia Ministerial MeetingAddressing noncommunicable diseases and injuries(Doha, Qatar, 10-11 May 2009)

Noncommunicable Diseases and Injuries Magnitude

• Four major noncommunicable diseases (NCDs):– Cardiovascular diseases– Diabetes– Cancers– Chronic respiratory diseases

• Four shared modifiable risk factors:– Tobacco use– Unhealthy diet– Physical inactivity– Harmful use of alcohol

• 60% of deaths globally – 70% if injuries are included -80% in developing countries• 40-50% are premature• Magnitude has a major socio-economic impact on developing countries

NCDs and injuries are still excluded from global discussions on development


Injuries

• Cause 10% of all deaths and 16% of all disability

• Road traffic crashes alone are the leading cause of death for young people aged 10-24 years


Global Risk Assessment 2009World Economic Forum

Asset price collapseRetrenchment from globalization

Oil and gas price spike

NCDs

Flu pandemicFiscal crisis

Food crisis

Infectious disease

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Noncommunicable Diseases & InjuriesProjected global deaths (2030)

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Cancers

Stroke

Road trafficaccidents

HIV/AIDSTB

Malaria

Acute respiratoryinfections

Ischaemic heart disease

Perinatal

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2005 2006-2015 (cumulative)

Geographical regions (WHO classification)

Total deaths

(millions)

NCD deaths

(millions)

NCD deaths

(millions)

Trend: Death from infectious

disease

Trend: Death from NCD

Africa 10.8 2.5 28 +6% +27%

Americas 6.2 4.8 53 -8% +17%

Eastern Mediterranean

4.3 2.2 25 -10% +25%

Europe 9.8 8.5 88 +7% +4%

South-East Asia 14.7 8.0 89 -16% +21%

Western Pacific 12.4 9.7 105 +1 +20%

Total 58.2 35.7 388 -3% +17%

Noncommunicable DiseasesDeath trends (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 low- and middle-income countries.

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All smoking prevalence

05

1015202530354045

Low income Low er-middleincome

Upper-middle income High income

%

Q1 Q2 Q3 Q4 Q5

Source: World Health Survey 2006

Range: from Q1 = poorest quintile to Q5 = Highest income quintile

Noncommunicable DiseasesThe poorest people in developing countries are the ones who smoke the most


Noncommunicable DiseasesMacro-economic impact

Lost national income from premature deaths due to heart disease, stroke and diabetes

2005 2006-2015 (cumulative)

CountriesLost national income

(billions)Lost national income

(billions)

Brazil 3 49

China 18 558

India 9 237

Nigeria 0.4 8

Pakistan 1 31

Russian Federation 11 303

Tanzania 0.1 3

WHO: "Heart disease, stroke and diabetes alone are estimated to reduce GDP between 1 to 5% per year in developing countries experiencing rapid economic growth"

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Noncommunicable DiseasesThe vicious cycle of poverty and NCDs


NCDs are emerging as a serious threat to Arab countries

and are undermining development


Cardiovascular diseases (27%)

Infectious and parasitic diseases (17%)

Respiratory infections (10%)Perinatal conditions (10%)

Malignant neoplasms (7%)

Respiratory diseases (4%)

Unintentional injuries (7%)

Digestive diseases (4%)

Intentional injuries (4%)

Neuropsychiatric disorders (2%)

Total deaths: 4.3 million• Noncommunicable conditions: 50%• Communicable diseases*: 39%• Injuries: 11%

Total deaths: 4.3 million• Noncommunicable conditions: 50%• Communicable diseases*: 39%• Injuries: 11%

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*Including maternal and perinatal conditions and nutritional deficiencies

Diabetes (2%)

Noncommunicable DiseasesMagnitude in the Middle East


Top-10 countries in diabetes prevalence in the world(2007)

Rank and country Age- adjusted prevalence of diabetes in 20-79 yr age group (%)

1. Nauru 30.7

2. United Arab Emirates 19.5

3. Saudi Arabia 16.7

4. Bahrain 15.2

5. Kuwait 14.4

6. Oman 13.1

7. Tonga 12.9

8. Mauritius 11.1

9. Egypt 11.0

10. Mexico 10.6


NCDs and injuries are preventableWe know what works

We have cost-effective interventions:

•Tobacco control interventions

•Measures to improve healthy dietary and physical activity patterns

•Early detection and effective treatment of cancer

•Treatment of hypertension, diabetes

•Treatment of heart disease and stroke

•Intersectoral injury prevention measures


The global response to address noncommunicable diseases


1. Integrating NCD prevention into the development agenda, and into policies across all government departments

2. Establishing/strengthening national policies and programmes

3. Reducing/preventing risk factors

4. Prioritizing research on prevention and health care

5. Strengthening partnerships

6. Monitoring NCD trends and assessing progress made at country level

Under each of the 6 objectives, there are sets of actions for member states, WHO Secretariat and international partners.

2008-2013 Action Plan for the Global StrategySix Objectives of the Action Plan


Noncommunicable DiseasesThe NCD gap in the development agenda

(Health ODA* Commitments 2006 by major subsector)

$0.00

$0.10

$0.20

$0.30

$1.00

$2.00

$2.70

$0.00

$0.08

$0.10

$0.20

$0.20

$0.60

$0.70

$1.30

$1.80

$1.93

$2.10

$4.75

Water Education/ Training

Water resources protection

Waste management/ disposal

River development

Basic drinking water supply & sanitation

Water Policy/ Management

Water supply/ sanitation-large systems

Health Education

Health Training

Basic Nutrition

Family Planning

Medical Services

Medical Research

Basic Health Infrastructure

Reproductive Health Care

Basic Health Care

Health Policy/ Management

Infectious Disease Control

STD & HIV/ AIDS ControlUS$ Billions

Total = $20.9 billion

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… … MDGs … failed to identify noncommunicable conditions, in spite of the fact that these diseases account for fully 70% of the global mortality… most of the morbidity and mortality caused are preventable … a serious omission … I propose we seriously consider an MDG+, which would set goals for the

NCCs, as we have done for other … challenges .

President of the 61st World Health Assembly


Objective 1: To raise the priority accorded to noncommunicable diseases in development work at global and national level

Global NCD Action Plan 2008-2013Milestones

• Regional Ministerial Meeting on Health Literacy (Beijing, 29-30 April 2009)

• Regional Ministerial Meeting on NCDs, Poverty and Development (Qatar, 10-11 May 2009)

• ECOSOC High Level Segment on Global Health (Geneva, 6-8 July 2009)


What do we want to achieve from this meeting?

• Review the magnitude and trends of NCDs and injuries with special emphasis on socio-economic impact

• Discuss successful approaches and interventions to address NCDs and injuries and identify cost-effective measures to improve access of the poor and vulnerable populations to proper health care

• Discuss ways and means of integrating the prevention of NCDs and injuries into national, regional and global development initiatives


What do we want to achieve from this meeting?...

• Recommend key actions for countries to incorporate NCD prevention into poverty reduction strategies and relevant social and economic policies

• Recommend mechanisms to involve all government departments to ensure that NCD and injury prevention receives a cross-sectoral response

A Call for action by the international community and development agencies to respond to the needs of countries in scaling up action against NCDs and injuries

Scope, Objectives and Agenda

Documents

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