The meeting today, April 27, of the Global Forum on "Addressing the Challenge of Non Communicable Diseases," organized by the World Health Organization (WHO), provided an opportunity for more than 250 representatives present to comment upon the epidemic and what should be done about it.
Attendees representing NGOs, academia, the corporate sector and governments heard from WHO Director General Margaret Chan concerning WHO's new report on the subject, but the majority of the day was given over to attendees for adding their thoughts to the international dialogue on NCDs.
Following a brief opening session, representatives broke into six concurrent sessions, each with its own discussant panel and reporter. At the conclusion of the day, the reporters gave brief summaries of the discussions to a plenary session, and Sir Michael Hirst, president-elect of the International Diabetes Federation, and Dr. Chan made summing up comments. The notes from today's meeting are being collected and will be presented to the Ministerial meeting that will begin here in Moscow on April 28.
Below are a selection of notes from the concurrent sessions:
Private Sector Session
- Nature of products that private sector makes that relate to the NCD issue needs clarification
- The private sector has not made its case for positive action on NCDs well, and some private sector entities are guilty of sending "mixed messages"
- Participants encouraged the private sector to consolidate its contributions, and better articulate potential public/private architecture and incentives on NCDs
- The Private sector should clarify what is meant by the need for universal access to essential medicines.
- Governments should fix distribution/regulation challenges related to medications.
- Corporations can help the public see the private sector as key partners in the NCD fight.
- Private sector contributions on NCDs should be emphasized at the highest levels in government, and especially beyond the health sector (economics/labor)
- Research in the private sector on NCDs requires incentives
- Corporations can better explain how the private sector is playing a full part in civil society's response to NCDs.
- Corporations can emphasize workplace wellness programs, since many affected by NCDs are employees
- Companies can focus research and development in pharmaceutical, devices, ICT, sport sectors.
Food and Beverage Industries Session
- Many companies are already working on product composition (by reduing salt, fat and sugars), while others are providing enhanced information, and cutting down marketing of unhealthy products to kids.
- Among ongoing initiatives include the Pan American Health Organization's Partners Forum, and the World Economic Forum's workplace wellness campaign.
- Many food and beverage manufacturers and retailers are also engaged in food security efforts.
- More small companies should be recruited
- There is an existing partnership in Russia for the food and beverage industry to help increase physical activity in the workplace
- There is a tension between approachess: the International Food and Beverage Association encourages the adoption of voluntary commitments , while others favor taxation and regulation of the food and beverage industries.
- There is a question about the definition of “responsible marketing” of food and beverage products
- There is some consensus that continuing dialogue is good, measurement is important, and that conducive environments and “all of society” solutions are vital
Health Professionals Section
- There is a relatively poor distribution of health workers, competencies and training levels
- There is a need to encourage health care workers to shift to primary prevention and care
- Education, and training opportunities should increase
- In most countries, we need to find new ways of working in the health care sector on NCDs
- Approaches should include nurses, community health workers, non formal health sector workers
- Hospitals, organizations, Ministries and others should mainstream NCDs in healthforce work
- Not all healthcare is simple; we should encourage cross sectional and multisectoral initiatives
- There should be a priority on country-led NCD programs.
- The emphasis should be on primary and community prevention and care for NCDs
- Health care workers should make available and use existing platforms, including professional societies.
Research and Development Section
- We already know a great deal about how consumption of food and beverages, as well as activity levels, influence health.
- Greater specificity is needed; therefore nations should invest in NCD surveillance activities with geographic specificity
- Governments should better integrate science within the health policy agenda
- Health systems "own" the non communincable diseases, but not their causes
- Nations should prioritize international collaboration for science funding around NCDs
- We should integrate existing health systems with new broader policy work on NCDs
- Nations should develop curricula on the science of NCDs
- National level NCD programs should include fnance ministries and World Bank representatives
- Countries should conduct implementation science and implementation research related to NCDs
Cross Government Response Section
- Governments should raise the profile of health education at national, regional and local levels
- We should encourage multisector communication
- Enforcement mechanisms regarding NCD programs should be prioritized
- Government officials should be convinced through evidence that some NCD gains through prevention and treatment can be short-term, while most are long-term.
- We should take into account the needs of migrants and other vulnerable populations
- Governments should prioritize making improvements in health surveillance for NCDs systems
- We should encourage innovative approaches that engage other government sectors beyond the health sector
- National commitments should include: better presenting the scientific evidence on NCDs, bringing religious organizations into the fight against NCDs, creating line items for NCDs in national budgets, raising alcohol and tobacco taxes, community-based initiatives, strengthening human resources for health, creating workplace-based programs on NCDs, considering extending protections like those in the Framework Convention on Tobacco Control to other risk factors, strengthening health systems, and providing resources on NCD planning, prevention and treatment to cities and towns.
- All UN development programs (including UNDP and UNICEF), as well as national development programs, should be engaged in work on NCDs, similar to how development agencies have seized upon the HIV/AIDS issue.
Civil Society Section
- Specialists are already aware of the disease burden from NCDs, but many civil society organizations and the general public still have a lack of attention to the issue.
- We need a unified civil society response to NCDs; the NCD "crowd" needs to become a "community."
- The role of civil society in confronting the epidemic needs to be clear.
- Existing challenges include: technical/normative (is mental health included?), branding (is "non communicable diseases" the best label?), building government buy-in with specific funding allocations, creating robust health systems and financial services related to NCDs, interfacing with commercial and private sector interests.
- Participants suggested the following outcomes of civil society work on NCDs: funding (development allocations for NCDs) including taxes and innovative streams; structural changes in NCD leadership, partnership, patient group engagement, and the harnessing of social media; time-bound outcome targets and clear follow-up mechanisms; clarity on the meaning of "health systems strengthening"; and attitudinal changes such as reducing resistance to incorporating private sector approaches.
- Even though NCDs are normally considered the responsibility of governments, a number of civil society organizations present pledged to make their own commitments to work on NCDs at various levels. These included international consortia working on Alzheimer's disease, mental health organizations, religious organizations (including 7th Day Adventists, World Council of Churches, and World Vision) and international development nonprofits.
Also today discussions continued on the proposed "Moscow Declaration on NCDs" that will be considered by government delegations beginning tomorrow. A new version of the document appeared with some changes from the "zero draft." Government delegations noted that not all nations' input had been considered.
Also, the World Health Organization announced that it had convened the first meeting of the civil society steering group on NCDs that will address civil society participation in the High Level Session on NCDs in September. The identities of the seven members of the group were not disclosed.