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The Director's Corner

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This time, the United Nations High-Level Meeting on non-communicable diseases must deliver

A message from José Luis Castro, Executive Director, The Union

Non-communicable diseases (NCDs) are the world’s greatest threat to health today. They include all cancers, diabetes and other non-infectious conditions and are the leading cause of death and disability worldwide – responsible for 40 million deaths every year, 15 million of them premature. Without the impetus from countries and their leadership to commit to action, the trajectory of death and disability from NCDs can only go in one direction.

The United Nations Sustainable Development Goals have a target to reduce premature mortality from NCDs by one third by 2030. But if this is to happen, the public health response must revise its approach toward NCDs as separate entities, neatly boxed off from infectious diseases such as tuberculosis (TB). If the goal of universal health coverage is to be achieved, then an integrated response to all disease prevention, care and treatment, is not optional – it is the only possible approach.

The need for an integrative response is backed by the evidence. Diabetes Mellitus (DM) and TB are a deadly combination, with DM almost tripling the risk of developing TB, according to World Health Organization estimates.

Looking ahead to September 2018, we have an incredible opportunity to flag this approach, given the back-to-back scheduling of two United Nations High-Level Meetings (UN HLMs) on TB and NCDs, on the 26 and 27 September respectively. This is the third HLM for NCDs and the first ever convened for TB. How do we make them count?

The Union is activating for action on several levels. The previous two HLMs on NCDs did not go far enough in obtaining concrete action or sustainable financial plans. Nor was due time given to highlighting the deadly co-epidemic of DM-TB, or that tobacco use is a significant driver for both these and other chronic conditions. The Union is committed to ensuring that, third time around, these co-morbidities are prioritised on the agenda.

As well as campaigning for recognition of these dual epidemics, the public health community must emphasise the positive advantages of having these two critical HLMs on consecutive days. TB and NCDs should be treated in the round, not in silos, and investment is not an ‘either or’ – both conditions require a serious step-change in resourcing. For that reason, we want the same outcomes from both HLMs: committed leadership at the highest level; strong public health systems that are fit for purpose and accessible to the people they should be serving; sustained investment and resourcing; and better data and monitoring. And for every resulting political declaration, there should be a strong focus on accountability, backed by mechanisms that ensure solid implementation of any declarations made. 

It is crucial that the HLMs reinforce each other, with the needs of patients, their families and their communities, prioritised over any single issue.

Read more about the first UN HLM on TB here and the third UN HLM on NCDs here

Find our toolkit advocating for action on the UN HLM on TB here