TWN Info Service on Health Issues (May11/06)
WHO: Spotlight on non-communicable diseases
prevention and control
This took place at the 64th World Health Assembly
(WHA) meeting in
The Secretariat's report (document A64/21) deals with WHO's role in the preparation, implementation and follow-up to the high-level meeting of the United Nations General Assembly on the prevention and control of NCDs to be held in September 2011.
The topic of NCDs has special prominence at this year's WHA because of the high-level meeting (HLM) where Heads of State and Government are expected to participate.
This flows from the UN General Assembly Resolution 64/265 adopted in May 2010 which in its preamble reaffirms "the need for international cooperation in the area of public health through the exchange of best practices aimed at building capacity at the public health system, providing financial assistance, the production of and increased access to affordable, safe, effective and high quality medicines, the training, recruitment and retention of pubic health personnel, the development of infrastructure and the transfer of technology".
Many Member States, in their interventions during the 21 May WHA discussion, underscored the strong link between NCDs and development, and stressed the need to address the social determinants of health (SDH) as well as to take measures to improve access to affordable medicines, to effectively combat NCDs. Interventions also called for more funding and political commitment, better private sector regulation and policy-making free of conflict of interests. Several Member States also supported the inclusion of mental health in the context of NCDs.
A resolution was finally adopted by the WHA focusing on the role of WHO in the preparation of the September HLM. This was agreed to by an informal working group that met on the margins of the WHA to reshape the content of the draft resolution submitted by some countries in January to the WHO Executive Board.
The resolution endorses the Moscow Declaration (outcome of the First Global Ministerial Conference on Healthy Lifestyles and Non-communicable Disease Control held in Moscow on 28-29 April 2011), which is annexed to the resolution, as a key input for the preparations leading to the HLM. It urges Member States to continue to support the preparations at national, regional and international levels for the HLM, including situation analyses of NCDs and their risk factors as well as an assessment of national capacity and health systems' response to address NCDs.
It also urges Member States to be represented at the level of Heads of State and Government at the HLM and reiterates the UN General Assembly (UNGA) call for action through an action-oriented outcome document. It also urges Member States to consider as appropriate and relevant to include representatives of civil society, non-governmental organisations, academia and networks working on the control and prevention of NCDs.
The resolution requests the WHO Director-General (DG, Dr Margaret Chan) to continue her existing lead role to coordinate UN specialised agencies, funds and programmes, other relevant intergovernmental agencies to support Member States. This would include undertaking concerted action and coordinating responses in order to promptly and appropriately address the challenges posed by NCDs, including further building up of situation analyses on NCDs and risk factors as well as highlighting the social and economic impact of NCDs, including financial challenges, in particular in developing countries.
It also requests the DG to prepare a report on
the outcome of the
The resolution also requests the UN Secretary-General to submit a global status report on NCDs with a particular focus on the developmental challenges faced by developing countries, to the GA at its 65th session in collaboration with Member States, WHO and other relevant funds, programmes and specialised agencies of the UN system.
Further to the May 2010 Resolution, the GA passed another resolution (65/238) inviting the WHO to hold regional multi-sectoral consultations in cooperation with regional commissions and other relevant agencies to provide input to the preparatory process for the HLM.
Pursuant to this key role, WHO has organized regional
consultations as well as the
The Moscow Declaration states that, in order to
secure an ambitious and sustainable outcome, "we commit to actively
engage with all relevant sectors of Government, on the basis of this
Moscow Declaration, in the preparation of and the follow-up to the United
Nations General Assembly High-level Meeting on the Prevention and Control
of NCDs in September 2011 in
Consumers International said that it is essential that while action is stepped up to address NCDs, care is taken to increase consumer protection and avoid giving the for-profit sector unprecedented opportunities to influence policies. The effect of insufficient vigilance will be felt most keenly in food-related NCDs - where Member States urgently need encouragement to take effective legislative action to control harmful food marketing. It also strongly urged that the critically important role of marketing controls and the protection of breastfeeding and optimal complementary feeding is recognized as an integral component of WHO's NCD strategy.
Medicus Mundi International said that "it is disappointing that there is no reference to the work of the Commission on Social Determinants of Health (CSDH) in the Secretariat report. Unhealthy behaviors do play an important role in determining NCDs, however there are structural determinants like education, income, gender and ethnicity which are underlying causes of NCDs and behavioral risk factors. It stressed the importance of equity dimensions of NCDs as emphasized by CSDH and that these are closely linked to the social and environmental factors; not just individual behaviors. Therefore, if the UNGA is to provide an action-oriented outcome document preventive measures for social and environmental factors must be included.
It also urged Member States to address the access
to affordable treatment for NCDs by clearly spelling out the response
Corporate Accountability International asked Member States to apply the safeguards in Article 5.3 of the Framework Convention on Tobacco Control creating clear and enforceable standards in relation to water, public health and nutrition. These measures must go beyond individual conflicts of interest, and address institutional conflicts of interest.
The Secretariat, in reply to the discussion, stated that mental health is a major issue and lacks appropriate intervention in many countries. It stressed the need to address the five building blocks of health systems and hoped that such an approach would in turn also help to address mental health. It also recalled that mental health is highlighted in the global status report on NCDs.
Regarding conflict of interest, the Secretariat stated that the WHO Guideline on working with the private sector would guide its work. Further, the DG called upon Member States to take a stand against the pressurising tactics of tobacco companies against the implementation of the framework convention.
(* K. M. Gopakumar is a senior researcher with Third World Network and Dr. Chiara Bodini is a public health expert from the Centre for International Health, University of Bologna.) +