The global agenda for NCD prevention and control & focus of the Seminar

1. The global agenda for NCD prevention and control& focus of the Seminar Nick Banatvala & Pascal Bovet 9th WHO-IUMSP International Seminar on the Public Health Aspects of Noncommunicable Diseases Lausanne, 4-8 May 2015

2. Key messages to date • NCDs are already leading health problems in almost all countries and their magnitude is still increasing • Shared risk factors • Premature deaths • The poor are disproportionately affected • Negative impact on socioeconomic development • As countries continue to develop, market forces will further promote unhealthy patterns. • Action is urgently needed

3. Focus on 4 NCDs and 4 common risk factors for NCDs

4. Global Burden of Diseases: global mortality, 2004-2030 30 Intentional injuries Other unintentional 25 Road traffic accidents Other NCD 20 Cancers Deaths (millions) 15 CVD 10 Mat//peri/nutritional 5 Other infectious HIV, TB, malaria 0 2004 2015 2030 2004 2015 2030 2004 2015 2030 High-income countries Middle-income countries Low-income countries

5. World Health Assembly in 2000: 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

7. WHO Global NCD Action Plan 2013-2020including a set of very-effective and affordable interventions ("best buys")

8. WHO Global Monitoring Framework on NCDs:9 global NCD targets to be attained by 2025 A 25% relative reduction in risk of premature mortality from cardiovascular disease, cancer, diabetes or chronic respiratory diseases At least a10% relative reduction in the harmful use of alcohol A10% relative reduction in prevalence of insufficient physical activity A 25% relative reduction in prevalence of raised blood pressure or contain the prevalence of raised blood pressure A30% relative reduction in prevalence of current tobacco use A30% relative reduction in mean population intake of salt/sodium At least50% of eligible people receive drug therapy and counselling to prevent heart attacks and strokes An80% availability of the affordable basic technologies and essential medicines, incl. generics, required to treat NCDs Halt the rise in diabetes and obesity

9. WHO Global Monitoring Framework on NCDs:25 outcome indicators Mortality and Morbidity Risk factors National Systems Response • Cervical cancer screening • Drug therapy and counselling • Essential NCD medicines and technologies • Hepatitis B vaccine • Human Papilloma Virus vaccine • Marketing to children • Access to palliative care • Policies to limit saturated fats and virtually eliminate trans fats • Unconditional probability of dying between the ages of 30 and 70 years from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases • Cancer incidence by type of cancer • Harmful use of alcohol (3) • Low fruit and vegetable intake • Physical inactivity (2) • Salt intake • Saturated fat intake • Tobacco use (2) • Raised blood glucose/diabetes • Raised blood pressure • Overweight and obesity (2) • Raised total cholesterol Total number of related indicators in brackets

10. United Nations General Assembly 2011 UN Political Declaration on NCDs 2014 UN Outcome Document on NCDs Reiterated the same roadmap of 19 national commitments, including four time-bound commitments: By 2015, consider setting national targets By 2015, consider developing national multisectoral policies and plans By 2016, implement "best buys" to (i) reduce risk factors for NCDs and (ii) enable health systems to respond International commitments: By 2017, WHO to submit a progress report to the UN General Assembly By 2018, UN General Assembly to convene a third High-level Meeting on NCD Roadmap of 19 concrete national commitments, including one time-bound commitment: • By 2013, consider developing national multisectoral policies and plans International commitments (completed): • By 2012, WHO to develop a global monitoring framework for NCDs, including global targets • By 2013, WHO to submit a progress report to the UN General Assembly • By 2014, UN General Assembly to convene a second High-level Meeting on NCDs

11. Examples of regional framework & process indicators

12. The way forward Vision: Global Strategy & UN Political DeclarationRoadmap: Updated framework & process indicators WHO Tools: Covering all areas Governance National targets and indicatorsOperational multisectoral action plans Prevention Implement “best buys” Health care Implement “best buys”; strengthen PHC Surveillance Implement framework on surveillance

13. Topics addressed during Seminar • Global situation of NCD • Major strategies to prevent and control NCDs & risk factors • Priority interventions (best buys) • Surveillance, global and national targets • Selected processes underlying implementation (governance, multisectoral action, leadership, etc) • Review of a number of tools and resources available to implement 2013-2020 WHO Plan of Action • Build knowledge and skills to implement strategy and plan of action for NCD prevention and control at national level