Adopt Non-Communicable Diseases targets at World Health Assembly, civil society demands

By Ochieng’ Ogodo

Journalist-Kenya

[Nairobi] Ahead of next weeks’ 65^th World Health Assembly in Geneva, civil society members are expressing fear that Non-Communicable Diseases may not be tackled adequately in the meeting.

This, they say, may result in a setback on progresses on global target to tackle NCDs and cripple the momentum that has been built, following last September’s historic UN Summit on NCDs in New York in which UN member states committed to a range of actions to tackle the NCD epidemic.

NCDs are responsible for 60 percent of all global deaths and are the leading cause of death in most high-income countries (80%-90%), and also in most low-income and middle-income countries. The burden of these conditions is growing.  In all settings

 The Chair of the NCD Alliance and CEO of the International Diabetes Federation Ann Keeling said in a press release May 17, “In the run-up to the UN Summit on NCDs, we urged Member States to include meaningful targets to prevent and control NCDs.  We particularly called for the adoption of an overarching goal to reduce preventable deaths from NCDs by 25% by 2025. Member States deferred decisions about targets to 2012.  Eight months on from the UN Summit, there can be no excuse for the world’s Health Ministers not to adopt at least this global goal, and supporting targets.”

 In accordance with the Political Declaration agreed at the UN Summit, the World Health Organization (WHO) released a discussion paper in December 2011, in which 10 targets were presented. As well as an overarching target of reducing preventable NCD deaths by 25% by 2025, there were nine other targets covering tobacco, salt, alcohol, and a range of other contributors to the NCD epidemic.

But following input from just 21 Member States (when the UN has 194), the second discussion paper, released in March, had reduced the proposed targets to just five.

Rheumatoid arthritis: A person's joints swell                 Photo: Quizlet

Mortality and blood pressure targets remained – both 25 percent relative reductions by 2025. The tobacco and salt targets had been watered down.  The civil society now says other targets had been dropped, including the target on alcohol (a relative reduction of 10 percent adult per capita consumption—after intense lobbying from the alcohol industry, which objected strongly to any attempt to reduce overall consumption worldwide, since this clearly directly affects profits. 

But in the second discussion paper was a new target to reduce levels of physical inactivity by 10 percent by 2025. Only 25 countries commented on this new, smaller set of targets, although 59 attended a Member State consultation on 26-27 April.

Keeling said, “If countries are serious about tackling the NCD crisis afflicting them all, they must be bold and commit to 10 targets, not 5 or fewer. We need to recapture the passion demonstrated at the UN Summit and commit to realising in full the ambitions articulated in the Political Declaration.”

She pointed out that the UN recently adopted 10 new targets for 2015 on HIV/AIDS when this is one condition. Yet the international community appears to be resisting the same number of targets for NCDs, including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, that have at least four common risk factors (tobacco use, harmful alcohol use, unhealthy diets and physical inactivity).

Measurable targets are essential since, as WHO Director General Dr Margaret Chan says, ‘What gets measured, gets done.’ The NCD Alliance believes that, at the very least, UN Member States should commit to the overarching target on mortality at next week's World Health Assembly, in order to unequivocally demonstrate their commitment to the process agreed at the UN High-Level Meeting.

The Alliance is also calling for an emphasis on treatment as well as prevention in whatever targets are adopted.

“Prevention efforts are absolutely essential to reducing future cases of NCDs. And in addition there is an urgent need to provide care for people living with NCDs today to prevent premature death and crippling complications,” said Keeling. 

The NCD Alliance wants the 10 targets to be kept, with one dedicated to “Equitable and increased availability of affordable, quality essential medicines and technologies for communicable and non-communicable diseases in all healthcare sectors”.