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Dr Chan confirmed that the Forum was a 'groundbreaking' meeting,
and that differences of
views are welcome and expected. She finished with three key points. First, that effective
action will require "a social movement" and institutions that can use a “whole of government
and whole of society approach" to deliver transformative change. She noted the importance
of educating girls and providing women with the resources they need to keep their families
well.
Second, Dr Chan urged participants to support integrated community-based, people-
centered primary health care services for health promotion, prevention, early detection and
treatment. She emphasized the potential for addressing diabetes and access to effective
medicines as an 'early win' and referred to conversations she is having with a range of
stakeholders to take this forward.
Finally, the Director-General emphasized the importance of institutions playing their roles –
including governments, to civil society, the private sector and the media. Her final comment
was to underscore breastfeeding as a key to starting children off on the right track in life.
X. C
ONCLUSION
The WHO Global Forum assembled over 300 participants from a variety of organizations
and perspectives on NCD issues including prevention,
disease control, advocacy, as well as
those with a broader development interest.
Participants were keen to share their perspectives and to contribute to the development of
the global response to NCDs, recognizing they all have a significant role to play in future
implementation of and advocacy for NCDs. They all wish to be part of the solution.
As the first such event, the Forum successfully highlighted many areas of consensus and
joint action, as well as those where divergent views remain. There
was clear agreement that
NCDs are 'everybody's problem' and require concerted action: collaborative working
arrangements need to be identified to enable this. While there is a clear need for
multisectoral action, with whole of society and whole of government responses, this is
challenging given different and competing agendas amongst government ministries.
Communities need to be engaged, and this will require improved strategic communication,
including through the use of social media, to inform
about the burden of NCDs, position it
as a key issue, as well as to communicate to local communities what they can do.
Challenges also remain in finding ways to enable the various stakeholders to work
collaboratively on a national/regional basis in the long term and in unison with national
plans. This will require trust to be built among stakeholders and with the public, an essential
prerequisite to broader and more productive collaboration. Not surprisingly, there continue
to be differing views on how and when the private sector should be engaged, for example in
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infant and young child nutrition, as well as the appropriate balance between voluntary self-
regulation and government regulation.
Challenges of leadership were also identified and a number of questions remain that need to
be considered in the build-up to the high-level meeting:
−
How can political will be galvanized so that the different government sectors scale
up their response both individually and collectively?
−
How can NGOs rise collectively to the challenge of NCDs and generate the social
mobilization needed to support political action?
−
Will
the private sector, including industries that need to change what they current do,
act decisively?
−
Can we collectively create the environment that will support the public to 'choose'
healthier lifestyles and products?
Forum participants indentified a number of important outcomes from the September high-
level meeting that would help to move NCD prevention and control forward
−
There was broad agreement that NCD prevention and control is critical to national
development (health, social and economic) and effective development cannot occur
without addressing NCDs.
−
The ability to measure and monitor programmes and targets for NCD prevention
and control is critical, and should be a focus for discussion.
Better epidemiological
surveillance of NCDs is critical to demonstrate the extent of the problem and
empower government action based on evidence and to monitor progress.
−
Health systems strengthening, including adequate and well-trained supply of health
worker, should focus on integration across disease areas and particularly on
community-based primary health care.
−
Implementing the agreed 'best buys', e.g. raising taxes on tobacco and alcohol are
key opportunities to reduce risk factors and, potentially, generate revenue that can
be used to tackle NCDs: both are in line with FCTC and WHO recommendations.
There is very good evidence that they have an effect on reducing consumption of
tobacco and harmful consumption of alcohol.
−
Appropriate incentives are an important strategy for advancing action to prevent
and control NCDs by the public (healthy choices), health professionals, and the
private sector.
−
Country-specific implementation research is needed yield timely evidence on how to
successfully implement the known 'best buys". Ensuring rapid uptake of evidence
into policy is key to success in advancing NCDs.
Finally, specific commitments were made by many at the Forum to help scale up both
national and global action to prevent and control NCDs.
Many NGOs committed to
actively supporting NCD prevention and control interventions, as well as developing a social