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PAN AMERICAN/WORLD HEALTH ORGANIZATION

PAN AMERICAN/WORLD HEALTH ORGANIZATION. Chronic Disease and Trade. Leaders in International Health Program Edmundo Granda Ugalde, October 11, 2011 C. James Hospedales PAHO/WHO. PAN AMERICAN/WORLD HEALTH ORGANIZATION: OVERVIEW.

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PAN AMERICAN/WORLD HEALTH ORGANIZATION

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  1. PAN AMERICAN/WORLD HEALTH ORGANIZATION Chronic Disease and Trade Leaders in International Health Program Edmundo Granda Ugalde, October 11, 2011 C. James Hospedales PAHO/WHO

  2. PAN AMERICAN/WORLD HEALTH ORGANIZATION: OVERVIEW • NCD like heart disease, stroke, cancer, diabetes, asthma: world’s #1 killer • Human & economic burden not sustainable; development threat • Multifactorial, multisectoral links including TRADE • Cost effective solutions; all of society solution is needed • Leadership needed at all levels UN HIGH LEVEL MEETING (SUMMIT) ON NCDs September 19-20, New York

  3. NCDs?? What does this mean? NCDs 4 by 4

  4. 145 million smokers 25% persons >15 years old obese FACING THE FACTS IN THE AMERICAS: disease burden Chronic respiratory disease Other NCDs TOTAL NCD DEATHS 2007 3,9 M Diabetes Cardiovascular diseases 36% deaths are below age 70 years Cancer Approx 250 million people living with an NCD in the Americas

  5. FRAMEWORK FOR ACTION ON NCDs Social Determinants income, education, environment, urbanization, globalization Healthy Public Policies: agriculture, trade, education, transport, finance, environment, and health sectors Health Promotion and Health Education Risk Factors Tobacco, physical inactivity, unhealthy diet, harmful use of alcohol, Healthy Environments: healthy cities, healthy schools, workplace health Non-communicable diseases Cardiovascular diseases, cancer, diabetes, chronic respiratory diseases Social Protection for Health; Health System Financing Access and quality health services, medicines and technologies NCDs lead to premature mortality

  6. PAN AMERICAN/WORLD HEALTH ORGANIZATION Regional Strategy and Plan of Action for an Integrated Approach to the Prevention and Control of Chronic Diseases, including Diet, Physical Actvity and Health September 2006

  7. PAN AMERICAN/WORLD HEALTH ORGANIZATION Policy & Advocacy Surveillance 2 Health Promotion & Prevention 3 Integrated Management of NCD 4 &

  8. FACING THE FACTS IN THE AMERICAS: Adult smoking prevalence Source: WHO Report on the Global Tobacco Epidemic, 2009: Implementing smoke-free environments

  9. FACING THE FACTS IN THE AMERICAS: Estimated Obesity (BMI >30) prevalence, 2010. Source: Ono T, Guthold R, Straong K, WHO Global Comparable Estimates, 2005

  10. Prevalence (%) of diabetes among adults in the Americas Source: Pan Am J Public Health 10(5), 2001; the CAMDI Survey; Jamaica Lifestyle Survey

  11. 80 70 60 + 20% sugar 50 Percentage BMI > 25.0 40 30 20 10 Dietary Fat (%) 20 30 25 40 35 Dietary fat and overweight : Caribbean comparisons + sugar effect  Kuwait New Caledonia Barbados  Jamaica  S. Africa  USA  Russia Trinidad & Tobago  Australia Guyana   Cuba Brazil Italy  Morocco   Kyrgyzstan Tunisia   Malaysia Philippines   China  r = 0.88 Mali   India Congo The epidemic is inevitable unless policies to substantially reduce fat and sugar intakes and increase activity are introduced now Adapted from Bray & Popkin, Am. J. Clin. Nutr., 1998; 68: 1157-73 and data from FAO 2005, CFNI and national surveys

  12. ALCOHOL IMPACT IN THE AMERICAS FACING THE FACTS: Source: Ono T, Guthold R, Straong K, WHO Global Comparable Estimates, 2005

  13. SOME OF THE OPPORTUNITIES NCDs ARE HIGHLY PREVENTABLE

  14. Many Cost Effective Interventions • Tobacco taxes and smoke free spaces (Uruguay) • Trans Fat Free Americas • Reduction of sodium in bread, Argentina; restaurants New York • Ciclovias (car free Sundays) • Mass communication and public education • Fruit and vegetable free snacks for children in school • Scale up basic health care for diabetes/hypertension (Brazil) • Reduce amputations through foot care (T&T) • School meals reformulation as part of obesity law (Colombia) • Quality of care improved using “promotoras” (Mexico) • Workplace wellness programs (World Econ Forum) • Mostly outside the health sector; need broader political commitment • TRADE policy influences many of the above; availability, price, etc

  15. The CARICOM Heads Summit on NCDs, 2007. • “We, the Heads of State of the Caribbean Community….” • 15-point “Port of Spain Declaration”; multi-sectoral • Tobacco – Ratify and implement the WHO FCTC: taxes, packaging, earmark some revenue for health promotion & disease prevention, ban smoking in public places • Alcohol- use alcohol taxes to finance NCD prevention and control • Healthy Diet - Trade policies on food imports, agriculture policies, Healthy school meals, Food labeling, reduce or eliminate trans fats • Physical activity-physical education in schools; physical activity in work places; improve public facilities for physical activity • Health services - screening and management of NCDs to achieve 80% coverage by 2012; primary and secondary prevention, comprehensive health education • Monitoring - Surveillance of risk factors; monitoring of the actions agreed upon in Declaration (CARICOM Secretariat, CAREC, UWI & PAHO/WHO) • Mobilizing Society - National Commissions on NCDs; including public, private sector and civil society, media and communications industry • Caribbean Wellness Day – Second Saturdays in September WWW.CARICOM.ORG

  16. UN High Level Meeting on NCD: an intersectoral nature >

  17. The Recent Road to the UN HLM on NCDs • CARMEN Policy Observatory meeting • Port of Spain, Nov 2010 • 2. Regional consultation on NCDs and obesity Mexico City, Feb 2011 • 3. Healthy Latin American Coalition • Buenos Aires, March 2011 • 4. Global Ministerial Meeting on NCDs • Moscow, March 2011 • 5. Pan American Conference on Obesity • Aruba, June 2011

  18. Highlights of UN High Level Meeting on NCDs

  19. SPECIFIC COMMITMENTS FROM THE UN HLM on NCDs By 2012 WHO: global monitoring framework, including indicators, and recommendations for voluntary global targets By 2013 Member States: establish/strengthen national multi-sector NCD policies and plans By 2014 UN: comprehensive review and assessment of progress

  20. NEXT STEPS for PAHO • 1. Revise Regional Strategy and Plan of Action for NCD prevention and control • include regional targets and indicators • 2. Technical cooperation with Member States to fulfill commitments of the Political Declaration • 3. Continue advocacy in global fora: Social Determinants, Rio+20, G8/G20, Summit of Americas • 4. Promote multi-sector partnerships, through the Pan American Forum for Action on NCDs • 5. Broader engagement in NCDs with other regional UN agencies

  21. “Running through the tape”… beyond the UN Summit?

  22. PAN AMERICAN FORUM FOR ACTION ON NCDs • DONORS and GOVERNMENTS • ACADEMIA AND RESEARCH INSTITUTIONS • CIVIL SOCIETY ORGANIZATIONS • PRIVATE SECTOR • MASS MEDIA • INTERNATIONAL ORGANIZATIONS • PUBLIC HEALTH TRAINING PROGRAMS Taking multi-stakeholder action to scale up what works in prevention and control

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