Rallying United Nations organizations in the fight against noncommunicable diseases
Oleg Chestnov a, Menno Van Hilten a, Colin McIff b & Alexey Kulikov c
a. World Health Organization, Geneva, Switzerland.
b. Permanent Mission of the United States of America, Geneva, Switzerland.
c. Permanent Mission of the Russian Federation, 15 avenue de la Paix, 1211 Geneva 20, Switzerland.
Correspondence to Alexey Kulikov (e-mail: firstname.lastname@example.org).
Bulletin of the World Health Organization 2013;91:623-623A. doi: http://dx.doi.org/10.2471/BLT.13.128348
Noncommunicable diseases (NCDs), namely cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, cause 63% of the world’s total mortality.1 Of the premature deaths from NCDs that occur in people between the ages of 30 and 70 years, 86% – i.e. approximately 12 million – occur in developing countries.2 The cumulative economic losses to low- and middle-income countries from the major NCDs are expected to surpass seven trillion United States dollars (US$) over the period from 2011 to 2025 (an average of nearly US$ 500 billion per year).3
As NCDs are largely preventable, however, the number of premature deaths can be greatly reduced. This effort is supported by a vast body of evidence on effective interventions for reducing shared risk factors – tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol – and improving disease management. The Moscow Declaration on Noncommunicable Diseases,4 endorsed by ministers of health in May 2011, and the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases,5 endorsed by heads of state and government in September 2011, have been decisive in raising the priority given to the prevention and control of NCDs on the agendas of meetings of national and international leaders. Because national policies in sectors other than health have a major bearing on the risk factors for NCDs, health gains can be achieved much more readily by influencing public policies in sectors outside health than by making changes in health policy alone. Many governments in low- and middle-income countries have realized the quick gains to be made against the NCD epidemic by investing modestly in interventions for enabling health systems to respond and reducing exposure to shared risk factors, but many are struggling to move from commitment to action.
The demand for “how to” policy advice to support national efforts is very high. According to an analysis of 144 World Health Organization (WHO) country cooperation strategies that national authorities agreed to jointly, 136 strategies included requests for technical support for the prevention and control of NCDs.6 Nonetheless, current plans for meeting individual country needs in this area are inadequate and will need to be replaced by a more holistic approach to meet the rapidly growing demand from low- and middle-income countries.
The 2013 Substantive Session of the Economic and Social Council (ECOSOC) marked a turning point in addressing this deficit. On 22 July 2013, ECOSOC adopted a resolution requesting the Secretary-General of the United Nations (UN) to establish a United Nations Interagency Task Force on the Prevention and Control of Noncommunicable Diseases.7 The resolution, proposed on behalf of 109 co-sponsoring Member States of the UN, was developed under the leadership of the Russian Federation.
The Task Force, created by expanding the mandate of the existing United Nations Ad Hoc Interagency Task Force on Tobacco Control, will coordinate the activities of relevant UN organizations and other intergovernmental organizations as they support countries in their efforts to implement the WHO Global NCD Action Plan 2013–2020. The Plan, which was endorsed by the World Health Assembly in May 2013, provides Member States, WHO and other UN organizations, intergovernmental organizations, nongovernmental organizations and the private sector with a road map and menu of policy options to realize the commitments made by heads of state and governments in the UN Political Declaration on NCDs. When implemented collectively between 2013 and 2020, these will contribute to progress on nine voluntary global targets, including a 25% relative reduction in premature mortality from NCDs by 2025.
WHO will convene and lead the Task Force. As a first step, and in full consultation with WHO’s Member States, draft terms of reference, including a division of tasks and responsibilities, will be developed for consideration by Member States at a formal meeting convened by WHO in Geneva on 13 November 2013. This will be followed by the development of programmes to operationalize these tasks and responsibilities and transfer knowledge and technical expertise on NCDs to low- and middle-income countries.
By providing a platform for joint action that reflects how some of the most pressing development challenges are addressed by those who face them daily, the Task Force can play an important role in helping countries to improve their health systems and shape public policies outside the health sector for years to come. It can support governments in their efforts to reduce people’s exposure to the risk factors for NCDs; enable health systems to respond to enormous challenges; set national targets and measure results; advance multisectoral action; strengthen national capacities; and promote international cooperation.
UN organizations are preparing to raise the priority accorded to NCDs on the health and development agendas. This is therefore a critical time to make the world more aware of the fact that NCDs constitute one of the major challenges for development in the 21st century5 and of the new opportunities that lie ahead for making global progress against these diseases.
- Resolution WHA66.10. Follow-up to the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. In: Sixty-sixth World Health Assembly documentation [Internet]. Geneva: World Health Assembly; 2013. Available from: http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_R10-en.pdf [accessed 5 August 2013].
- World Health Organization [Internet]. Mobilizing the UN System to realize the commitments included in the Political Declaration on NCDs [discussion paper from Third Meeting of UN Agencies on NCDs, Geneva, 12 October 2012]. Geneva: WHO; 2013. Available from: http://www.who.int/nmh/events/2012/discussion_paper_oct2012.pdf [accessed 19 August 2013].
- From burden to “best buys”: reducing the economic impact of NCDs in low- and middle-income countries. Geneva: World Health Organization & World Economic Forum; 2011. Available from: http://www.who.int/nmh/publications/best_buys_summary/en/index.html [accessed 5 August 2013].
- First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control: Moscow, 28–29 April 2011. Geneva: World Health Organization; 2011. Available from: http://www.who.int/nmh/events/moscow_ncds_2011/conference_documents/en/ [accessed 5 August 2013].
- 2011 High Level Meeting on Prevention and Control of Non-communicable Diseases [Internet]. Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. New York: United Nations General Assembly; 2011 (Document A/66/L.1). Available from: http://www.un.org/en/ga/ncdmeeting2011 [accessed 5 August 2013].
- WHO reform: programmes and priority setting. Analysis of WHO country cooperation strategies. Geneva: World Health Organization; 2012. Available from: http://www.who.int/dg/reform/consultation/WHO_Reform_3_en.pdf [accessed 5 August 2013].
- World Health Organization [Internet]. United Nations to establish WHO-led Interagency Task Force on the Prevention and Control of Noncommunicable Diseases. Geneva: WHO; 2013. Available from: http://www.who.int/mediacentre/news/notes/2013/ncds_ecosoc_20130722/en/index.html [accessed 5 August 2013].