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WHO Says Progress On Noncommunicable Diseases Is “Insufficient And Uneven” In 194 Countries Committed To Reduce Premature Mortality By 25% By 2025

Every year 38 million die from noncommunicable diseases, nearly 16 million of them prematurely before they reach the age of 70. Meeting for the second time since 2011 in New York this month, UN Member States learned from the World Health Organization that progress in tackling major chronic diseases such as heart disease, cancer, diabetes, and chronic lung disease has been “insufficient and uneven” since 2011 when a UN political declaration was issued. The declaration was considered a watershed event at that time because 194 UN Member States pledged to combat avoidable noncommunicable diseases and preventable deaths.

At the high level meeting this month, countries renewed their commitment to take bold measures called for by the Secretary General of the UN  Ban Ki-moon. He told the delegates that “success will depend on finding new ways to strengthen the ability of countries to adopt bolder measures.”

Straight Talk From WHO Director

Just how bold and challenging the needed measures will be was made clear in some of the remarks made by WHO Director Margaret Chan in her opening address. In a candid and straightforward address, she made several sobering statements and painted several tough challenges ahead for the participating countries. Below are some of the key excerpts from her address.

I see no lack of commitment. I see a lack of capacity to act, especially in the developing world. Our latest data show that 85% of premature deaths from NCDs occur in developing countries.

Fundamental Change Needed

 

The challenges presented by these diseases are enormous. They demand some fundamental changes in the way social progress is measured, the way governments work, the way responsibilities are assigned, and the way the boundaries of different government sectors are defined.

 

The fact that NCDs have overtaken infectious diseases as the world’s leading cause of morbidity and mortality has profound consequences. This is a seismic shift that calls for sweeping changes in the very mindset of public health…

Public health must shift its focus from cure to prevention, from short-term to long-term management, from delivering babies, vaccines, and antibiotics to changing human behaviours, from acting alone to acting in concert with multiple sectors and partners.

Progress As Cause of Illness

 

… Socioeconomic progress is actually creating the conditions that favour the rise of NCDs. Economic growth, modernization, and urbanization have opened wide the entry point for the globalization of unhealthy lifestyles. Risk factors for NCDs are becoming part of the very fabric of modern society.

Health Sector Can’t Do It Alone

 

The health sector bears the brunt of these diseases but has very little control over their causes. The health and medical professions can plead for stronger tobacco and alcohol legislation, more exercise, and healthier diets. We can treat the diseases, but we cannot re-engineer social environments to promote healthy lifestyles.

 

This is another shift that needs to take place. Governments cannot assume that NCDs are a health problem and that the health sector can manage on its own. We cannot.

 

For prevention, the cornerstone of our response, governments need to take on a primary role and responsibility. Social environments need to change, population-wide, nation-wide. This will not happen without political commitment at the highest level of government.

 

Only high-level political commitment can orchestrate the kind of broad-based collaboration needed to make substantial progress, especially on prevention. Heads of state and government are best placed to introduce coherent public policies, coordinate actions, and push for legislative support.  Unprecedented challenges need unprecedented commitments.

WHO Update

 According to WHO, more than 190 of the participating governments have agreed to a global action plan to reduce premature deaths from chronic diseases by 25% by 2025. The action plan includes a menu of options for countries and partners to implement. (see next article in this issue.)

Encouraging Sign

An encouraging sign of the commitment to tackle chronic diseases is the accountability mechanism for all countries described in the Lancet’s July 7 issue. Called NCD Countdown 2025, the mechanism is modeled on a process used successfully to monitor and improve actions related to achieving the maternal, newborn, and child survival goals for 2015.  ■

 


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