Microsoft Word Report on who global Forum on ncds final 19 August 2011. doc

 

 

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There was quite a discussion on the issue of mental health and some support for including it 

in the current priorities that will be considered at the high-level meeting.  This was a theme 

at some of the regional consultations.  The strong links between mental health disorders, 

including substance use disorders, and other NCDs was emphasized.   

 

It was noted that some governments also want to include mental health as part of the 

current work.  Another participant noted that all chronic diseases will benefit both 

immediately and in the future if we capitalize on the political opportunity afforded by the 

high-level meeting.  Dr Ala Alwan from WHO briefly outlined the key reasons why mental 

health is not included in the current focus: 

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The Global Strategy on NCDs, which dates from 2000, is focused on the four main 

diseases – cardiovascular disease, diabetes, cancers and chronic respiratory diseases – 

and these are also the focus of resolutions agreed by Member States related to the 

UN high-level meeting 

−

 

Together these four diseases account for around 80% of NCD-related deaths 

globally. 

−

 

These four diseases share the same main risk factors so prevention approaches are 

similar, while prevention approaches for mental health disorders 

 

Dr Alwan noted that improvements to health care will benefit both mental health disorders 

and the priority NCDs: health workforce training, access to essential drugs, health 

information systems and health financing.   

 

The question was raised as to how the global response to NCD prevention and control will 

be funded – the figure of USD9 billion per annum has been proposed by some 

commentators.  On a related note, access to affordable medicines in low-income countries 

was identified as a key challenge by several participants.  This will require solutions involving 

both the research-based and generic pharmaceutical industries, but ultimately depends on the 

prudent policies on the part of governments. 

 

Panellists commented that funding will require political leadership that goes beyond 

ministers of health, and clearly innovative financing mechanism will be needed.  

Governments will need to identify funding sources, and need to receive a clear message that 

this would be a very good investment given the potential health care costs averted.  It was 

noted that the private sector is also a significant potential source of funds through 

appropriate partnerships. 

 

There was a call for extending education about NCD prevention to lay people, who are able 

to undertake quite a lot of the preventive activities, which don't require trained health 

professionals: public health is everybody's concern.  The value of extending education to 

children was also emphasized.   

 

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Several specific points were made to which the panellists then responded.  First, the 

significance of the relationship between NCDs and ageing was highlighted as a potential way 

to engage finance and other government sectors.  Second, the question was specifically asked 

about whether NCDs should be included in the Millennium Development Goals (MDGs).  

Finally, the point was made that, for youth, NCDs are the social justice challenge of their 

generation much as HIV/AIDS was for the previous one.  They have an important and 

unique contribution to make, not least the use of social media to build momentum. 

 

There were different views on whether NCDs should be included in the MDGs.  It was 

pointed out that in the last MDG review in 2010, NCDs were not added to the current 

MDG indicators. However, there was agreement that an accountability framework with 

NCD-related goals and targets, and monitoring of progress in achieving them, are essential. 

 

There was a call for meaningful patient engagement in decisions about both policy and 

practice.  Patients are well connected to their communities and have an important role to 

play in raising awareness and improving health literacy. 

 

The analogy of the health care process – taking a history, doing the relevant diagnostic tests, 

making a diagnosis and then treating appropriately – was used to frame the need to clearly 

convince governments of the need to invest in NCD prevention.  The point was made that 

while the health care system 'owns' diseases, nobody owns primary prevention.  This 

underscores the need to intervene in non-health care settings, in particular in educational 

institutions. 

 

To close, the moderator asked each of the panellists to comment on the lessons from 

addressing the HIV/AIDs challenge for the current NCD one, and to identify their single 

top priority for the high-level meeting in September.  Mr Wooldrigde noted that at the 

World Economic Forum in January 2011, the UN Secretary-General Ban Ki-Moon had 

emphasized the importance of political action and commitment in moving the NCD agenda 

forward and that this was critical in making progress on HIV/AIDS. 

 

Regarding the lessons learnt, it was noted that NCDs are a much bigger problem that 

HIV/AIDS could ever be so the challenge is even greater.  Thinking about NCDs as an 

epidemic, as happened with HIV/AIDS, is important as it emphasizes the reversibility of the 

problem.  Mobilizing a wide base of support through broad-based partnerships was critical 

to the success of the response to HIV/AIDS.  Public-private partnerships can work, but 

require a 'grown-up discussion' that we still need to have in the NCD arena.  Time-bound 

and specific commitments were essential for making progress, as was regular monitoring and 

reporting of progress towards their achievement.  It is important not to set different 

conditions in competition, and a holistic approach is needed that caters to the needs of 

people who often have both communicable and noncommunicable diseases simultaneously.  

Finally, innovative resourcing and procurement systems have been developed that provide a 

template for the NCD response. 

 

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