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Prevention and Control of Non-Communicable Diseases: Advocacy and Partnerships

This session explores the role of the National Programme Manager in advocating for and forming partnerships to prevent and control non-communicable diseases. Speakers from the World Health Organization will share strategies and tools to effectively communicate the importance of addressing NCDs to decision-makers. The session will also include interactive exercises and discussions.

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Prevention and Control of Non-Communicable Diseases: Advocacy and Partnerships

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  1. Профилактика неинфекционных заболеваний и борьба с ними 预防和控制非传染病 Prevención y control de las enfermedades no transmisibles الوقاية من الأمراض غير المعدية ومكافحتها Prévention et maîtrise des maladies non transmissibles Prevention and control of non-communicable diseases 11:15-12:00 – Friday 11 March 2011 The role of the National Programme Manager in advocacy and partnerships

  2. Профилактика неинфекционных заболеваний и борьба с ними 预防和控制非传染病 Prevención y control de las enfermedades no transmisibles الوقاية من الأمراض غير المعدية ومكافحتها Prévention et maîtrise des maladies non transmissibles Prevention and control of non-communicable diseases Dr Ashley Bloomfield, Partnership Adviser, NCDnet Mr Paul Garwood, Communications Officer Mr Menno van Hilten, External Relations Officer World Health Organization

  3. People remember... • 20% of what they hear • 40% of what they hear and see • 80% of what they discover for themselves

  4. Rules of engagement • Format: • 5 exercises • A bit of theory in between • Interactive • Informal • Interruptions encouraged  • Time management: • 11:15 – 12:00

  5. Setting expectations • After this session, you'll have the basic tools (and skills) to convince decision-makers that: • NCDs merit increased investment • NCD action carries substantial benefits

  6. Exercise 1 If you had a chance to speak to US President Obama (*) for 2 minutes, what would you tell him about NCDs? * Or any other President or Prime-Minister from a G-20 country

  7. Challenge 1 What is the point? We are not always clear WHY we speak, write or make a presentation

  8. Challenge 2 We are trained to be logical, complete, accurate, evidence-based and fear being misunderstood.

  9. Challenge 3 We tend to concentrate on what we know and don't always think of why our message is important to listeners, viewers or the audience …now

  10. Scientists, experts and programme managers speak like this Challenge 4 Ministers and decision-makers speak like this "I need 30 minutes of your time to share 40 years of my accumulated technical expertise" "We must make the prevention and control NCDs and the improvement of maternal health top priorities on the development agenda" "Yesterday's article in the Lancet discusses the prevention of pre-eclampsia in diabetic women."

  11. "Dear President Obama" • In all developing countries, and by any metric, NCDs now account for a large enough share of premature deaths and poverty to merit a concerted and coordinated public policy response. • A global vision and affordable solutions exist to prevent 8 million premature deaths from NCDs in developing countries each year. • At WHO, we witness how programme managers in developing countries are increasingly challenged to formulate effective strategies to address NCDs. Donors, like USAID, should start considering their requests for technical assistance, even if these problems are not included (yet) in the MDGs. • You and the other leaders of the G-20 have a unique opportunity to include NCDs in global development initiatives and related investment decisions at the upcoming High-level Meeting of the United Nations General Assembly in New York in September 2011, which will be attended by Heads of State and Government.

  12. "Communications 101" Elements of communication: • Sender • Message • Target Audience • Proof points • Channel • Time

  13. "Communications 101" Message: the four O's Ongoing situation Opportunities One recommendation Operationalization

  14. G-20 media donors UN World Bank InternationalDevelopment Agencies Minister of Foreign Affairsand Planning UN Agencies Target Audiences Ministers of Health NCD focal points in MoH NCD counterparts in other Ministries(agriculture, finance, trade, transport, urban planning, education and sport) National NGO leaders Civil Society/Population/People with NCDs

  15. G-20 media donors UN World Bank InternationalDevelopment Agencies Minister of Foreign Affairsand Planning UN Agencies Target Audiences Ministers of Health NCD focal points in MoH NCD counterparts in other Ministries(agriculture, finance, trade, transport, urban planning, education and sport) National NGO leaders Civil Society/Population/People with NCDs

  16. "Dear President Obama"(Key message on NCDs to international leaders) • In all developing countries, and by any metric, NCDs now account for a large enough share of premature deaths and poverty to merit a concerted and coordinated public policy response. • A global vision and affordable solutions exist to prevent 8 million premature deaths from NCDs in developing countries each year. • At WHO, we witness how programme managers in developing countries are increasingly challenged to formulate effective strategies to address NCDs. Donors, like USAID, should start considering their requests for technical assistance, even if these problems are not included (yet) in the MDGs. • You and the other leaders of the G-20 have a unique opportunity to include NCDs in global development initiatives and related investment decisions at the upcoming High-level Meeting of the United Nations General Assembly in New York in September 2011, which will be attended by Heads of State and Government. Ongoing situation Opportunities One recommendation Operationalization

  17. Translating key messages into a presentation  In all developing countries, and by any metric, NCDs now account for a large enough share of premature deaths and poverty to merit a concerted and coordinated public policy response.

  18. Group III - Injuries Low-income countries Group II – Other deaths from NCDs Group II – Premature deaths from NCDs (below 60 years), which are preventable Group I – Communicable diseases, maternal, perinatal and nutritional conditions NCDs are the single biggest cause of death 10% 60 million 5.1 M 50 million 26.9 M(above the age of 60) 40 million 30 million Source: WHO global estimates 2008 9.1 M (below the age of 60) 20 million 15.7 M 10 million 0 Total deaths in the world (2008)

  19. Group III - Injuries Low-income countries Group II – Other deaths from NCDs Group II – Premature deaths from NCDs (below 60 years), which are preventable Group I – Communicable diseases, maternal, perinatal and nutritional conditions 90% of global premature deaths from NCDs occur in low- and middle-income countries 2.9M 13.6M 25 million 20 million Total deaths (2008) 15 million Source: WHO global estimates 2008 5.3M 10 million 1M 2.3 M 8.3M 0.5M 0.8M 6.6M 1.4M 4.4M 5.6M 1.4M 1M 1.2M 0.6M High-income countries Upper middle-income Lower middle-income Low-income countries

  20. Other NCDs Diabetes Respiratory diseases Cancers Cardiovascular diseases Four types of NCDs account for most deaths in all regions 100% 80% 60% 40% 20% 0% WHO Region for Africa WHO Region for the Eastern Mediterranean WHO Region for the Americas WHO Region for Europe WHO Region for South-East Asia WHO Region for the Western Pacific

  21.  New perspectives Poverty at household level Populations in low- and middle-income countries Increased exposure to common modifiable risk factors Noncommunicable diseases Loss of household income Limited access to effective and equitable health-care services More than 8 million people die before the age of 60 in developing countries from noncommunicable diseases NCDs are linked to poverty and cause poverty

  22. NCDs are closely related to poverty and contribute to poverty Smoking prevalence (2004) 45 Lowest household income quintiles 40 35 30 Highest household income quintiles 25 (percentage) 20 15 10 5 0 Upper-middle-income High-income Low-income countries Lower-middle Income

  23. Translating key messages into a presentation  A sound global vision and concrete road map exist to prevent 8 million premature deaths from NCDs in developing countries each year.

  24. World Health Assembly in 2000: There is a clear vision on how to address NCDs *Surveillance* Mapping the epidemic of NCDs *Prevention* Reducing the level of exposure to risk factors *Management* Strengthen health care for people with NCDs

  25. World Health Assembly in 2008: There is a clear roadmap for all countries and partners Six objectives: 1. Raising the priority accorded to NCDs in development work at global and national levels, and integrating prevention and control of NCDs into policies across all government departments 2. Establishing and strengthening national policies and programmes 3. Reducing and preventing risk factors 4. Prioritizing research on prevention and health care 5. Strengthening partnerships 6. Monitoring NCD trends and assessing progress made at country level

  26. In May 2000, WHO Member States began mobilizing a global response to address NCDs, with a particular focus on developing countries 2000 Global Strategy for the Prevention and Control of Noncommunicable Diseases Global Strategy on Infant and Young Child Feeding 2002 WHO Framework Convention on Tobacco Control Global Strategy on Diet, Physical Activity and Health 2003 WHA resolution on cancer prevention and control 2004 Action Plan on the Global Strategy for the Prevention and Control of NCDs 2005 Set of recommendations on the marketing of foods and non-alcoholic beverages to children 2008 2010 Global Strategy to Reduce the Harmful Use of Alcohol 2011 High-level Meeting on NCDs (New York, 19-20 September 2011)

  27. Translating key messages into a presentation  At WHO, we witness how programme managers in developing countries are increasingly challenged to formulate effective strategies to address NCDs. Donors, like USAID, should start considering their requests for technical assistance, even if these problems are not included yet in the MDGs

  28. Millennium Development Goals (MDGs) The eight MDGs break down into 21 quantifiable targets that are measured by 60 indicators. www.undp.org/mdg

  29. Official Development Assistance (2007) 18% • US$ 120 Billion per year • Including US$22 Billion for health • Provided by 26 governments to 141 developing countries • Objective: poverty alleviation (= MDGs) Health

  30. HIV/AIDS US$7.4 B Health Policy 1.65 Infectious Disease Control 1.33 Reproductive Health Care 1.16 Basic Health Care 1.14 Malaria Control 0.8 Family Planning 0.53 TB Control 0.45 Basic Nutrition 0.33 Medical Services 0.24 Basic Health Infrastructure 0.23 Medical Research 0.22 Medical Education 0.21 Health Education 0.06 Water Supply/Sanitation 3.9 Water Resources Policy 0.93 Basic Drinking Water Supply 0.92 Waste Management 0.42 River Development 0.1 Water Resources Protection 0.06 Water Education 0.01 0 1 2 3 4 5 6 US$7 Billion 8 Global commitments to public health (2007) (measured in Official Development Assistance) • Total Health ODA in 2007: $22.1 billion • Health ODA for NCDs: ? (Source: Kaiser Family Foundation, 23 July 2009, based on OECD/DAC)

  31. HIV/AIDS 42.9% Health Policy 5.5% Infectious Disease Control 5.7% Reproductive Health Care 6.4% Basic Health Care 4.2% Malaria Control 5.4% Family Planning 0.3% TB Control 3.0% Basic Nutrition 1.7% Medical Services 0.3% Basic Health Infrastructure 0.7% Medical Research 1.3% Medical Education 0.6% Health Education 0.2% Water Supply/Sanitation 14.6% Water Resources Policy 4.0% Basic Drinking Water Supply 2.5% Waste Management 1.2% River Development 0.5% Water Resources Protection -0.8% Water Education 0% 0 5 10 15 20 25 30 35 40 45% 50 Growth in global commitments (2001-2007) (measured in growth of Official Development Assistance) • Total ODA growth 2001-2007: $14.9 billion • Health ODA growth for NCDs: ? (Source: Kaiser Family Foundation, 23 July 2009, based on OECD/DAC)

  32. The Paris Declaration invites donors to base their support on demand from developing countries Pending

  33. Translating key messages into a presentation  You and the other leaders of the G-20 have a unique opportunity to include NCDs in global development initiatives and related investment decisions at the upcoming High-level Meeting of the United Nations General Assembly in New York (19-20 September 2011)

  34. Raising the priority of NCDs in development work United Nations General Assembly resolution A/RES/64/265 13 May 2010 Cameroon on behalf of Member States who are members of the Group of African States Member States which sponsored the draft resolution

  35. 2009 ECOSOC High-level Segment: Russian Federation announced the First Global Ministerial Conference on NCDs

  36. ECOSOC 2009 Ministerial Declaration:NCDs are a leading threat to development • 18. We also recognize that the emergence of non-communicable diseases is imposing a heavy burden on society, one with serious social and economic consequences, and that there is a need to respond to cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, which represent a leading threat to human health and development. • In this regard, we: • Call for urgent action to implement the World Health Organization Global Strategy for the Prevention and Control of Non-Communicable Diseases and its related Action Plan; • Recognize that diabetes is a chronic, debilitating and costly disease associated with severe complications; • Stress the need to scale up care for mental health conditions, including prevention, treatment and rehabilitation; • Reaffirm the importance of the Framework Convention on Tobacco Control within the sphere of global public health and call upon States parties to the Convention to fully implement it.

  37. United Nations General AssemblyResolution 64/265 adopted on 13 May 2010

  38. United Nations General Assembly in September 2010:Address the developmental challenges posed by NCDs We, Heads of State and Government, commit ourselves to ... 63.k.      Strengthening the effectiveness of health systems and proven interventions to address ... the increased incidence of non-communicable diseases ... 76.i Undertaking concerted action and a coordinated response at the national, regional and global levels in order to adequately address the developmental and other challenges posed by non-communicable diseases, namely cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, and working towards a successful high-level meeting of the General Assembly in 2011.

  39. United Nations General AssemblyResolution 65/238 adopted on 13 December 2010

  40. WHO's role in the preparatory process leading towards theUN High-level Meeting on NCDs (New York, 19-20 September 2011)

  41. Mandate from the United Nations General Assembly Resolutions A/RES/64/265 and A/RES/65/238

  42. Who is in charge? Mr Joseph Deiss President of the UN General Assembly Co-Facilitators Ambassador Raymond Wolfe Permanent Representative of Jamaica (New York) Ambassador Sylvie Lucas Permanent Representative of Luxembourg (New York) Member States

  43.  WHO's role in the preparatory process leading towards theUN High-level Meeting on NCDs (New York, 19-20 September 2011)

  44.  Regional Consultations for Member States Dates

  45. Regional Consultation for Member States Eastern Mediterranean Region (Tehran, 25-26 October 2010) • Include the prevention and control of NCDs among the top priorities in national health strategies and plans, and in global development initiatives and in related investment decisions. • Focus on galvanizing action to accelerate the implementation of the Action Plan of the Global Strategy for the Prevention and Control of NCDs. • Global goal, targets and indicators should be established and monitored. • Heads of State and Government should establish mechanisms to ensure the effective involvement of (public and private) sectors outside health, and uphold their accountability in relation to the impact of their policies on health. • Countries should develop standards, rules and regulations, for marketing and advertising of tobacco, food and non-alcoholic beverages, and other unhealthy goods, according to their needs and local contexts.

  46. Regional Consultation for Member States European Region (Oslo, 25-26 November 2010) • Generate global commitment and momentum to implement the Global Strategy for the Prevention and Control of NCDs and its Action Plan • Scale up technical support for low- and middle-income countries (including as part of priorities for Official Development Assistance) • Establish global targets and indicators in order to halt and begin to reverse premature deaths from NCDs • Acknowledge that NCDs are a threat to socio-economic development that the developed world nor the developing world can afford. • Also acknowledge that NCDs are a development issue and intimately linked to poverty and the MDGs. • Promote approaches that involve all government departments • Measures must also address the social determinants

  47. Subregional Consultation for Pacific Island Member States (Nadi, Fiji, 3-5 February 2011) • Demonstrate political leadership at the highest level to take responsibility for and address the NCD crisis at national and regional levels • Ensure the right multi-sectoral policy environment to mainstream the response • Support priority cost-effective interventions, monitor their implementation and expand the evidence base through research and surveillance • Resource and sustain the response adequately • Ensure full accountability of all sectors for their respective contributions • Significantly strengthen advocacy and community engagement to maintain a focus on the NCD crisis • Strengthen health systems to effectively respond to the crisis.

  48. Ministerial Declaration adopted at theRegional Consultation for the Americas(Mexico, 24-25 February 2011) The Ministers of Health and their representatives: • Promote recognition of the rising prevalence of NCDs on the national, as well as the international development agenda • Reaffirm their commitment to strengthen policies and programmes for the prevention and control of NCDs • Call on WHO to propose to Member States targets for the Action Plan for the Global Strategy for the Prevention and Control of NCDs against which countries' progress will be measured, with a view to future inclusion in the MDGs • Promote access to comprehensive and cost-effective prevention, treatment and care for integrated management of NCDs • Provide leadership in promoting active participation of all sector of government and civil soetiy in implementing measures to prevent and control NCDs • Promote collaborative efforts and partnerships among key multisectoral stakeholders in public and private sector

  49. Ministerial Meeting on Health and Developmental Challenges of NCDs(Jakarta, 1-4 March 2011) We call upon global leaders, donor partners and UN Agencies to: • Include NCD prevention and control in internationally agreed developmental goals, including the MDGs. • Assist countries in integrating NCD control in their primary health-care based health systems strengthening initiatives in a harmonized manner. • In accordance with national priorities enhance capacity building, technical and financial support to Member States to supplement national efforts for sustainable NCD prevention and control programmes. • Support countries for research for control and prevention of NCDs.

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