Beat NCDs With Healthier Behaviours, Environments & Education, Says WHO High-Level Commission

Make the ¨healthiest choices the easiest choices¨ to prevent many non-communicable diseases. This was a key message from an Independent High-Level Commission report on Non-communicable diseases (NCDs), released Tuesday at a WHO Global Meeting to Accelerate Progress NCDs and Mental Health in Muscat, Oman.

WHO

The report, ¨It´s Time to Walk the Talk¨, released on the second day of a four-day meeting (9-12 December) is the final report in a series produced by the High-Level Commission, which was convened by WHO Director General Dr Tedros Adhanom Ghebreyesus in 2017.

It calls for WHO to lead the way in advocating for national government policies that create healthier environments and encourage healthier behaviours, which can prevent many chronic diseases – through measures such as stronger government taxes and regulatory measures. Promoting greater ¨health literacy¨about healthy choices individuals can make as well as incorportating NCD prevention and treatment fully into health systems are other cornerstone recommendations of the new report.

The Commission, co-chaired by Finland, Sri Lanka and the Russian Federation, was created by the WHO Director General shortly after he took office; it was charged with identifying innovative ways to curb NCDs that are responsible for seven out of ten deaths worldwide, including from cardiovascular disease, cancers, diabetes, respiratory diseases and mental health conditions.

The first Commission´s first report, focusing on actions countries can take to beat NCDs, was released in June 2018. This second report, focuses on the role that WHO can play, WHO said in a press release.

Sir George Alleyne, Speaking in Muscat, Oman.

However, WHO should play a strong leadership role in recomending effective policies to UN member states, said Commission member Sir George Alleyne who led Tuesday´s presentation on the report´s recommendations.

“The first recommendation [of the report] is how to encourage heads of state and governments to fulfill their commitments, emphasizing the role of WHO to provide strategic leadership,¨ said Alleyne, director emeritus of the Pan American Health Organization and former UN special envoy on HIV/AIDS in the Caribbean. He spoke in Muscaat before the conference attended by some 600 representatives of countries, UN agencies, academic, philanthropy and civil society.

“Key measures recommended in the report involve involve promoting health literacy and accelerating multisectoral collaboration,¨ he added, saying that while “WHO should use its technical cooperation to motivate ….governments to fulfill their obligations. The heads of state and government have an inescapable responsibility to ensure that there is a redution in the burden of NCDs throughout the world, to empower individuals to make healthier choices, and to make the healthiest choice the easiest choice.”

He said that strategies thus need to take a ¨twin approach” targeting, ¨responsibility at the level of individual  behaviour and at the level of the contextual environment.

“WHO should work at both levels, at the level of the individual and the level of the environment. While providing information to the individual, it should not forget the fundamental responsibility of the government, which is the responsibility of regulation, legislation and taxation, the various regulatory measures that should be applied.”

NCD prevention, diagnosis and treatment should also be embedded into Universal Health Coverage, Alleyne emphasised. ¨There should be no debate about the essentiality of NCDs in that package of health service that should be offered.”

Huge Gap Between SDG Ambition & NCD Trends

WHO´s Menno van Hilten told the meeting that the High Level Commission was part of an initiative by WHO to step up its actions with bold recommendations on how to close the gap between the Sustainable Development Goal target (SDG3.4) that aims to slashing premature NCD deaths by one-third by 2030, and the reality of rising NCD deaths and disability in many countries today.

“The problem of NCDs fits onto one slide,¨ he said. ¨The world is off track to meet SDG 3.4 on NCDs, the red line is the current trend, the green line is the path that we shoudl have been on.  There is a huge gap between the red and the green line . This gap is a major problem because the UN General Assembly has said that NCDs constitute one of the major challenges for development in the 21st century,” declared VanHilten.

Norwegian State Secretary Aksel Jakobsen told conference participants that Norway´s new NCD strategy for its international development assistance – launched last month – will support low-income countries in combatting deaths from air pollution, tobacco, unhealthy diets and physical inactivity through strengthened health systems, healthy behaviours and cleaner environments.

For countries that request assistance, the strategy will help governments build stronger systems of taxes and regulations to reduce air pollution and discourage consumption of health-harmful tobacco, sugary foods and drinks  all of which are key NCD risk factors. “Norway will work to support global commitments and effective measures to prevent harmful air quality. We will, for instance, support work on taxation and regulations,” Jakobsen said. 

In terms of how the private sector can contribute to fighting NCDs, including better access to NCD treatments, Thomas Cueni, head of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), told the Oman conference that the Private Sector Constituency Statement on Universal Health Coverage, released by the civil society stakeholder movement UHC 2030 on the sidelines of September’s UN High Level Meeting on Universal Health Coverage, is an important starting point.

“Critical enablers which are all equally applicable to NCDs are: processes that allow for structured and meaningful engagement of all partners; national health strategies and plans; a robust regulatory and legal system; more and better investment in health; and the appropriate capacity to work with non-state actors,” Cueni said.

He cited as an example, one IFPMA-member supported project City Cancer Challenge, an initiative launched by the Union for International Cancer Control (UICC) that is supporting nine major cities and nearly 200 health care institutions in low and middle income countries with a combined population of over 45 million people develop more sustainable financial models for cancer treatment and control.

“This is ambitious, joined-up thinking that is trying to move beyond the piecemeal nature of individual programs into something more coordinated and hence, potentially more impactful,” Cueni said.

Altogether, the new report lays out 8 sets of recommendations for WHO including:

  • Encourage Heads of State and Government to fulfil their commitment to provide strategic leadership by involving all relevant government departments, businesses, civil society groups as well as health professionals and people at risk from or suffering from NCDs and mental health conditions;
  • Support countries in efforts to empower individuals to make healthy choices, and “make the healthiest choice the easiest choice, including through the creation of enabling environments”, health literacy, and policy, legislative, and regulatory measures that reduce exposure to risk factors for NCDs and mental health conditions;
  • Encourage countries to invest in the prevention and control of NCDs and mental health conditions as a key opportunity to enhance human capital and accelerate economic growth;
  • Advise countries to include services to prevent and treat NCDs and mental health as essential components of Universal Health Coverage;
  • Ensure that no one falls into poverty because they have to pay for health care out of their own pockets through the provision of adequate social protection for everyone;
  • Increase engagement with businesses and provide technical support to Member States so they can mount effective national responses to NCDs and mental health conditions;
  • Encourage governments to promote meaningful engagement with civil society;
  • Advocate for the establishment of a multi-donor trust fund to support countries in activities to reduce NCDs and promote mental health.

WHO estimates that every year, some 41 million people die from NCDs, 15 million of them between the ages of 30 and 69. Although only about 35% of total deaths in low-income regions such as Sub-Saharan Africa are due to NCDs today, NCD deaths are projected to increase to more than 50% of the toll by 2030. And already, people stricken with NCDs in low- and middle-income countries tend to die at a younger age because they cannot access prevention and treatment as easily.

See the livestream from the conference here:

Image Credits: WHO.