Dr Shanthi Mendis Director, Department of NCD Management a.i. World Health Organization

1. WHO Technical Briefing Seminar on Essential Medicines & Health Products, October 2013Noncommunicable Diseases –Action Plan Dr Shanthi Mendis Director, Department of NCD Management a.i. World Health Organization Geneva, Switzerland

2. NCDs - Development Challenge (2008 estimates) 35 M Premature Deaths 9 M Total NCD deaths 36 M 30 M 25 M 20 M 15 M 10 M 5 M 0 M Low-income Countries Lower- Middle-income Countries Upper-Middle-income Countries High-income Countries Communicable conditions NCDs < 60 NCDs > 60 Injuries

3. Global Mile stones : Prevention and Control of NCDs 2000 Global Strategy for the Prevention and Control of Noncommunicable Diseases 2003 Global Strategy on Diet, Physical Activity and Health 2004 Action Plan 2008-2013 on the Global Strategy for the Prevention and Control of NCDs 2008 Global Strategy to Reduce the Harmful Use of Alcohol 2009 WHO Global Status Report on NCDs 2010 2011 Political Declaration on NCDs 2013 2020 WHO Action Plan for the Prevention and Control of NCDs for 2013-2020

4. WHO Global NCD Action Plan 2013-2020 Adopted by 194 Ministries of Health at the World Health Assembly 2013 The plan aims to operationalize the commitments from Heads of State and Government included in the Political Declaration of the High-level Meeting of the United Nations General Assembly on NCDs

5. WHO Global NCD Action Plan 2013-2020 –objectives

6. Immediate actions for Member States in 2013-2014 Set national targets for 2025 in 2013, taking into account the 9 global targets

7. Prevention of Heart Attacks and Strokes : At least 50% of eligible people receive drug therapy and counseling (including glycemic control) to prevent heart attacks and strokes Availability and affordability An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major NCD in both public and private facilities

8. Immediate actions for Member States in 2013-2014 Develop national multisectoral plans in 2013 to achieve targets, taking into account the WHO Global NCD Action Plan 2013-2020 The global action plan comprises a set of actions which, when performed collectively by Member States, international partners and WHO, will attain the 9 global targets, including a 25% reduction in premature morality in NCDs by 2025

9. Immediate actions for Member States in 2013-2014 • Implement interventions identified by WHO as "very cost effective interventions " using WHO tools: • Tobacco use • Unhealthy diet and physical inactivity • Harmful use of alcohol

10. Cost effective interventions • Cancer • Prevention of liver cancer through hepatitis B immunization • Prevention of cervical cancer through screening (visual inspection with acetic acid (VIA), with timely • treatment of pre-cancerous lesions

11. Immediate actions for Member States in 2013-2014 • Implement interventions identified by WHO as "best buys" into the basic primary health care package using WHO tools: • Integrated approach to cardiovascular diseases and diabetes: • Multidrug therapy to individuals who have had a heart attack or stroke and to persons with a high risk of a cardiovascular event in the next 10 years • Providing aspirin to people having an acute heart attack

12. Immediate actions for Member States in 2013-2014 Implement other very cost-effective and affordable interventions identified in Appendix 3 of the Global Action Plan into the basic primary health care package using WHO tools

13. Immediate actions for Member States in 2013-2014 Implement other very cost-effective and affordable interventions identified in Appendix 3 of the Global Action Plan using WHO tools

14. How much will it cost to scale-up very cost effective NCD interventions? For all LMIC, US$ 11.4 billion per year on average • Population-based measures: close to US$ 2 billion per year • Low- and lower-middle-income countries: < US$ 0.20 per head • Upper-middle income countries: < US$ 0.50 per head • Individual-based measures: US$ 9.4 billion per year • Low-income countries: < US$ 1.00 per head • Lower middle-income countries: < US$ 1.50 per head • Upper-middle income countries: ~ US$ 2.50 per head

15. Immediate actions for Member States in 2013-2014 Strengthen NCD surveillance, covering a) monitoring of risk factors and determinants, b) outcomes (mortality and morbidity) and c) health system response and integrate into the national health information systems

16. Immediate actions for Member States in 2013-2014 Develop national targets and indicators, based on the WHO recommendations and WHA Resolutions

17. A global coordination mechanism on NCDs (2014) • Formal meeting of Member States to conclude the work on the terms of reference for a global coordination mechanism on the prevention and control of noncommunicable diseases (Geneva, 11–12 November 2013) • Proposed functions – A forum for Partners to: • Broker knowledge and information: • Encourage innovation: • Promote multisectoral action: • Promote accountability: • Advocate and raise awareness: • Proposed partners: • Member States • UN organizations and other intergovernmental organizations • Non-State actors for discussion on 11-12 November 2013

18. Thank you