WHO strategies on Noncommunicable diseases and Chronic care

1. WHO strategies on Noncommunicable diseases and Chronic care Jill Farrington Coordinator, Noncommunicable Diseases Division of Technical Support WHO Regional Office for Europe

2. Overview • Themes • Relevant WHO strategies /initiatives • European NCD strategy

3. Chronic disease (lung) Healthy lifestyles (tobacco, physical activity) Empowerment of patient (self-management) Settings for care (home, community, hospital) Themes • Evidence-based interventions (Guidance) • Cost-effectiveness • Outcomes (quality of life) • Integrated care • Use of technology • Determinants of health (poverty)

4. Innovative Care for Chronic Conditions

5. Innovative Care for Chronic Conditions Eight essential elements for taking action • Support a paradigm shift • Manage the political environment • Build integrated health care • Align sectoral policies for health • Use health care personnel more effectively • Centre care on the patient and family • Support patients in their communities • Emphasise prevention

6. Preparing the 21st century global healthcare workforce Five basic competencies • Patient centred care • Partnering • Quality improvement • Information and communication technology • Public health perspective

7. Building blocks

8. Seven leading conditions in Europe = 4.7 million deaths and 50.8 million DALYs • Ischaemic heart disease • Unipolar depressive disorders • Cerebrovascular disease • Alcohol use disorders • Chronic pulmonary disease • Road traffic injury • Lung cancer

9. Noncommunicable Diseases • THE public health challenge in Europe: 77% diseases burden; 86% mortality in 2002 • Widening gaps within and between Member States • Worrying trends in risk factors • Increasing burden on health systems, economy and society • Significant potential for health gain

10. CVD mortality (up to 65 years) in the WHO European Region <= 300 <= 240 <= 180 <= 120 Last available data 0 - 60 EUROPE 126.93 No data SDR per 100000 Cardiovascular diseases cause more than half of all deaths in Europe

11. Seven leading risk factors account for most of the burden of disease in Europe

12. Contribution of main risk factors to main chronic diseases Source: forthcoming European Health Report 2005, adapted from Ezzati et al.

13. Objectives To map emerging epidemics NCD To reduce exposure to common risk factors for NCD (tobacco, unhealthy diet, physical inactivity) To strengthen health care for people with NCD (CVD, cancer, diabetes, chronic respiratory disease) Global strategy for the prevention and control of noncommunicable diseases 2000 Key components • Surveillance • Promotion of health and prevention of disease burden • Health care interventions to manage disease

14. Diet, Physical Activity, Tobacco European Food and Nutrition Action Plan 2000-2005 • Growing, buying and eating the right kinds of foods can reduce the risk of disease and simultaneously promote a sustainable environment • Food safety • Nutrition • Food security Global Strategy on Diet, Physical Activity & Health 2004 • Reducing risk factors • Raising awareness and understanding of positive impact • Developing policy • Monitoring, research, support

15. Diet, Physical Activity, Tobacco Framework Convention on Tobacco Control • Entered into force on 27 February 2005 • Legally binding treaty setting international standards on tobacco price and tax increases, tobacco advertising, sponsorship and labelling, illicit trade etc • 17 of the 65 states ratifying the FCTC so far are European European Strategy on Tobacco Control 2002 • Strategic framework • Measures to reduce demand for tobacco products • Measures to reduce the supply of tobacco products

16. Why a European NCD strategy? • Regional response to global strategies • Europe has diversity and specificity • Opportunity to reset the focus • Both horizontal and vertical approaches needed • Moving towards a common goal: reducing the burden from NCD • Greater support to countries facing particular challenges • Facilitating mobilisation of resources beyond health sector

17. Political commitment Integrated approach Active role for health system Patient centred care Citizen involvement Mobilisation of relevant sectors Reduction of health inequalities Attention to the most vulnerable Life course approach NCD policy as part of the broader public health effort 10 Principles for action

18. RC54 Resolution • Comprehensive action-oriented • Strong focus on implementation • An integral part of the updated HEALTH21 policy framework • Take account of pre-existing commitments of Member States & relevant strategies • In collaboration with Member States, intergovernmental agencies, NGOs and other relevant partners, including industry

19. Timeline • 1st meeting NCD national counterparts April 05 • Drafting group June 2005 • Drafting group October 2005 • 2nd meeting NCD national counterparts November 2005 • Country consultation March 2006 • Strategy finalised June 2006

20. WHO strategies on Noncommunicable diseases and Chronic carewww.who.intwww.euro.who.int Jill Farrington Coordinator, Noncommunicable Diseases Division of Technical Support WHO Regional Office for Europe jfa@euro.who.int