NCDs are responsible for 60% of all global deaths. They are the leading cause of death in most high-income countries (80%-90%), and also in most low-income and middle-income countries. In all settings, the burden of these conditions is growing.
Ann Keeling, Chair of the NCD Alliance and CEO of the International Diabetes Federation, comments, “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. Mortality and blood pressure targets remained – both 25% relative reductions by 2025. The tobacco and salt targets had been watered down. The other targets had been dropped, including the target on alcohol (a relative reduction of 10% 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. One piece of good news in the second discussion paper was a new target to reduce levels of physical inactivity by 10% by 2025. Only 25 countries commented on this new, smaller set of targets, although 59 attended a Member State consultation on 26-27 April.
“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,” says Keeling. She points 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 NCD 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,” says Keeling. The Alliance proposes 10 targets 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”.
To interview Ann Keeling, chair of the NCD Alliance and CEO of the International Diabetes Federation, please contact Isabella Platon, Head of Communications, International Diabetes Federation. T) +32 25431625 / mobile +32 471 611 373 E) Isabella.Platon@idf.org
Or Tony Kirby at Tony Kirby PR Ltd T) +44 (0) 7834 385827 E) tony@tonykirby.com
Notes to editors: The NCD Alliance unites a network of over 2,000 civil society organisations in more than 170 countries. The four founding members are the International Diabetes Federation, the Union for International Cancer Control, the World Heart Federation, and the International Union Against Tuberculosis and Lung Disease.
The five proposed targets in the second WHO paper referred to above are:
1. Mortality from NCDs: 25% relative reduction in overall mortality from cardiovascular disease, cancer, diabetes, or chronic respiratory disease in people aged 30-70 years.
2. Blood pressure/hypertension: 25% relative reduction in prevalence of raised blood pressure among persons aged 18+years (defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥90 mmHg).
3. Tobacco smoking: 30% relative reduction in prevalence of current tobacco smoking among persons aged 15+ years.
4. Dietary salt intake: 30% relative reduction in mean adult (aged 18+) population intake of salt, with aim of achieving recommended level of less than 5 grams per day.
5. Physical inactivity: 10% relative reduction in prevalence of insufficient physical activity in adults aged 18+ years. In addition to these, the NCD Alliance is advocating for another five targets as below:
6. Equitable and increased availability of affordable, quality assured essential medicines and technologies for communicable and non-communicable diseases in all healthcare sectors.
7. Prevention of heart attack and stroke: 80% coverage of multidrug therapy (including glycaemic control) for people aged 30+ years with a 10 year risk of heart attack, stroke or diabetes ≥ 30%, or existing cardiovascular disease.
8. Alcohol: 10% relative reduction in persons aged 15+, alcohol per capita consumption (APC).
9. Trans-fats: removal of industrially produced trans-fats from the food supply.
10. Obesity: No increase in obesity prevalence. Childhood obesity: Sustained downward trend in prevalence of obesity in below-5s and school-aged children to < 5% of the population by 2025.
The first WHO discussion paper, 21 December 2011, can be found here:
http://www.who.int/nmh/events/2011/consultation_dec_2011/WHO_Discussion_Paper_FINAL.pdf
The second WHO discussion paper, 22 March 2012, can be found here: http://www.who.int/nmh/events/2012/discussion_paper2_20120322.pdf
A document summarising the NCD Alliance position on targets, see here: http://ncdalliance.org/sites/default/files/rfiles/NCD%20Alliance%20submission%20to%20WHO%2019%20April%202012_0.pdf
And here:
http://ncdalliance.org/sites/default/files/rfiles/NCDA%20Position%20on%20Targets%2029%20March.pdf
For details on the 10 targets recently agreed on HIV referred to above, see here: http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/JC2262_UNAIDS-ten-targets_en.pdf
There will be a side-event on NCDs during the World Health Assembly in Geneva at 17:30H Geneva local time, Monday 21 May 2012, featuring:
Ann Keeling: Chair, NCD Alliance and CEO, International Diabetes Federation
Stephen Prudhomme: VP, Global Strategies, American Heart Association representing the Preventive Health Partnership
Paula Johns, Executive Director, Aliança de Controle do Tabagismo, Brazil and Chair, Framework Convention Alliance, representing the American Cancer Society Meet the Targets Grant Program
Jacob Gayle, VP, Medtronic Foundation and Community Affairs
Agnes Binagwaho, Minister of Health, Rwanda
Salomon Chertorivski, Secretary of Health, Mexico.
The session will last one hour and will be moderated by Dr Richard Horton, Editor-in-Chief of The Lancet Medical Journal.
The event will take place in Ballroom B, Intercontinental Hotel 7–9 Chemin Du Petit Saconnex, Geneva. Journalists interested in attending should contact tony@tonykirby.com
Ann Keeling, Chair of the NCD Alliance and CEO of the International Diabetes Federation, comments, “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. Mortality and blood pressure targets remained – both 25% relative reductions by 2025. The tobacco and salt targets had been watered down. The other targets had been dropped, including the target on alcohol (a relative reduction of 10% 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. One piece of good news in the second discussion paper was a new target to reduce levels of physical inactivity by 10% by 2025. Only 25 countries commented on this new, smaller set of targets, although 59 attended a Member State consultation on 26-27 April.
“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,” says Keeling. She points 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 NCD 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,” says Keeling. The Alliance proposes 10 targets 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”.
To interview Ann Keeling, chair of the NCD Alliance and CEO of the International Diabetes Federation, please contact Isabella Platon, Head of Communications, International Diabetes Federation. T) +32 25431625 / mobile +32 471 611 373 E) Isabella.Platon@idf.org
Or Tony Kirby at Tony Kirby PR Ltd T) +44 (0) 7834 385827 E) tony@tonykirby.com
Notes to editors: The NCD Alliance unites a network of over 2,000 civil society organisations in more than 170 countries. The four founding members are the International Diabetes Federation, the Union for International Cancer Control, the World Heart Federation, and the International Union Against Tuberculosis and Lung Disease.
The five proposed targets in the second WHO paper referred to above are:
1. Mortality from NCDs: 25% relative reduction in overall mortality from cardiovascular disease, cancer, diabetes, or chronic respiratory disease in people aged 30-70 years.
2. Blood pressure/hypertension: 25% relative reduction in prevalence of raised blood pressure among persons aged 18+years (defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥90 mmHg).
3. Tobacco smoking: 30% relative reduction in prevalence of current tobacco smoking among persons aged 15+ years.
4. Dietary salt intake: 30% relative reduction in mean adult (aged 18+) population intake of salt, with aim of achieving recommended level of less than 5 grams per day.
5. Physical inactivity: 10% relative reduction in prevalence of insufficient physical activity in adults aged 18+ years. In addition to these, the NCD Alliance is advocating for another five targets as below:
6. Equitable and increased availability of affordable, quality assured essential medicines and technologies for communicable and non-communicable diseases in all healthcare sectors.
7. Prevention of heart attack and stroke: 80% coverage of multidrug therapy (including glycaemic control) for people aged 30+ years with a 10 year risk of heart attack, stroke or diabetes ≥ 30%, or existing cardiovascular disease.
8. Alcohol: 10% relative reduction in persons aged 15+, alcohol per capita consumption (APC).
9. Trans-fats: removal of industrially produced trans-fats from the food supply.
10. Obesity: No increase in obesity prevalence. Childhood obesity: Sustained downward trend in prevalence of obesity in below-5s and school-aged children to < 5% of the population by 2025.
The first WHO discussion paper, 21 December 2011, can be found here:
http://www.who.int/nmh/events/2011/consultation_dec_2011/WHO_Discussion_Paper_FINAL.pdf
The second WHO discussion paper, 22 March 2012, can be found here: http://www.who.int/nmh/events/2012/discussion_paper2_20120322.pdf
A document summarising the NCD Alliance position on targets, see here: http://ncdalliance.org/sites/default/files/rfiles/NCD%20Alliance%20submission%20to%20WHO%2019%20April%202012_0.pdf
And here:
http://ncdalliance.org/sites/default/files/rfiles/NCDA%20Position%20on%20Targets%2029%20March.pdf
For details on the 10 targets recently agreed on HIV referred to above, see here: http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/JC2262_UNAIDS-ten-targets_en.pdf
There will be a side-event on NCDs during the World Health Assembly in Geneva at 17:30H Geneva local time, Monday 21 May 2012, featuring:
Ann Keeling: Chair, NCD Alliance and CEO, International Diabetes Federation
Stephen Prudhomme: VP, Global Strategies, American Heart Association representing the Preventive Health Partnership
Paula Johns, Executive Director, Aliança de Controle do Tabagismo, Brazil and Chair, Framework Convention Alliance, representing the American Cancer Society Meet the Targets Grant Program
Jacob Gayle, VP, Medtronic Foundation and Community Affairs
Agnes Binagwaho, Minister of Health, Rwanda
Salomon Chertorivski, Secretary of Health, Mexico.
The session will last one hour and will be moderated by Dr Richard Horton, Editor-in-Chief of The Lancet Medical Journal.
The event will take place in Ballroom B, Intercontinental Hotel 7–9 Chemin Du Petit Saconnex, Geneva. Journalists interested in attending should contact tony@tonykirby.com