presentation for discussion (not an official document)

Raising the priority of noncommunicable diseases in development work at global and national levels

Presentation for discussion(Not an official document)

Causative risk factors

Tobacco use

Unhealthy diets

Physical inactivity

Harmful use of alcohol

No

nco

mm

un

icable

diseases

Heart disease and stroke Diabetes Cancer Chronic lung disease

Four types of noncommunicable diseases are largely preventable by means of effective interventions that tackle shared modifiable risk factors

5.8 M5.8 M

Low-income countriesGroup III - InjuriesGroup II – Other deaths from noncommunicable diseasesGroup II – Premature deaths from noncommunicable diseases (below the age of 60), which are preventableGroup I – Communicable diseases, maternal, perinatal and nutritional conditions

0

10 million

20 million

30 million

40 million

50 million

60 million

70 million

Total number of deaths in the world (2004)

60% of the world's annual deaths are due to noncommunicable diseases.Approximately 25% of these deaths are premature and could be prevented

26.0 M(above the age of 60)

26.0 M(above the age of 60)

10%

fact

9.0 M(below the age of 60)

9.0 M(below the age of 60)

18.0 M18.0 M

35 million(60% of all deaths)

So

urce

:

25% of 35 million

More people die from heart diseases and strokes in the poorest developing countries than in the richest industrialized countries

0 2 million 4 million 6 million 8 million 10 million

2004

2015

2030

Low income countries

Lower middle-income countries

Upper middle-income countries

High income countries

5.1 m

6.1 m

8.2 m

9.0 m

2.6 m

3.8 m

7.3 m

2.6 m

3.4 m

6.5 m

2.4 m

3.0 m

Estimated deaths from cardiovascular diseases (2004)

factS

ou

rce:

In all developing countries, premature deaths from noncommunicable diseases account for a large enough share of the disease burden to merit a serious policy response

fact

Low-income countries Middle-income countries High-income countries

• Lower respiratory infections (11.2%)• Coronary heart disease (9.4%)• Diarrhoeal diseases (6.9%)• HIV/AIDS (5.7%)• Stroke and other cerebrovascular diseases

(5.6%)• Chronic obstructive pulmonary disease

(3.6%)• Tuberculosis (3.5%)• Neonatal infections (3.4%)• Malaria (3.3%)• Premature and low birth weight (3.2%)

• Stroke and other cerebrovascular disease (14.2%)

• Coronary heart disease (13.9%)• Chronic obstructionary pulmonary disease

(7.4%)• Lower respiratory infection (3.8%)• Trachea, bronchus, lung cancers (2.9%)• Road traffic accidents (2.8%)• Hypertensive heart disease (2.5%)• Stomach cancer (2.2%)• Tuberculosis (2.2%)• Diabetes mellitus (2.1%)

• Coronary heart disease (16.3%)• Stroke and other cerebrovascular diseases

(9.3%)• Trachea, bronchus, lung cancers (5.9%)• Chronic obstructive pulmonary disease

(3.5%)• Alzheimer and other dementias (3.4%)• Colon and rectum cancers (3.3%)• Diabetes mellitus (2.8%)• Breast cancer (2.0%)• Stomach cancer (1.8%)

The top-10 leading causes of death

So

urce

:

The risk of dying in developing countries from causes attributable to high-blood pressure, tobacco use, high blood glucose or physical inactivity

0

1 million

2 million

3 million

4 million

5 million

6 million

7 million

Attributable deaths in developing countries by risk factor C

hild

sex

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Lea

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Glo

bal c

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ange

Unm

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acep

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Ill

icit

drug

use

Ir

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efic

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y

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alth

car

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Zin

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ir po

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int

ake

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, san

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ne

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om s

olid

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use

O

verw

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t and

obe

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H

igh

chol

este

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U

nder

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nsaf

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P

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nact

ivity

Hig

h bl

ood

gluc

ose

Tob

acco

use

Hig

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ood

pres

sure

fact

0

1.0 million

1.5 million

2.0 million

2.5 million

Africa

0%

5%

10%

15%

20%

25%

30%

Americas East.Med

Europe South-EastAsia

WesternPacific

Africa Americas East.Med

Europe South-EastAsia

WesternPacific

Without action, Africa will witness the largest increase in deaths from noncommunicable diseases in 2015 (vs 2004)

fact

10 leading causes of deaths in females (2004)

Sou

rce:

W

HO

's r

epor

t on

"W

omen

and

Hea

lth:

toda

y's

evid

ence

, to

mor

row

's

agen

da"

Noncommunicable diseases are among the leading causes of death among women in developing countries, as well as high-income countries

fact

At household level, noncommunicable diseases are affecting the poorest people in developing countries disproportionally

fact

14 million people die prematurely each yearin developing countries from noncommunicable diseases

Loss of household incomefrom high cost of health care

Loss of household incomefrom unhealthy behaviours

Increased exposure to common modifiable risk factors:Unhealthy diets

Physical inactivityTobacco use

Harmful use of alcohol

Noncommunicable diseases:Cardiovascular diseases

CancersDiabetes

Chronic respiratory diseases

GlobalizationUrbanization

Population ageing

Limited access to effective and equitable health-care services which respond to the needs of people with noncommunicable diseases

Loss of household incomefrom poor physical status

Populations in low- and middle-income countriesPoverty at household level

Poverty contributes to noncommunicable diseases and noncommunicable diseases contribute to poverty

Noncommunicable diseases are the third largest global risk in terms of likelihood and the fourth largest global risk in terms of economic severity

World Economic Forum: Global Risk 2010 Report

fact

Oil spikes

Retrenching from globalization

Asset price collapse

Food price volatility

Financial crisis

Noncommunicable diseases

Infectious diseases"A problem neither the developed world nor the developing world can afford""Declining development assistance has already led to a significant reduction of public spending on health in many countries. When funds are limited, governments tend to focus on basic health services, in line with the MDGs, at the expense of the prevention and treatment of noncommunicable diseases." (WEF Global Risk 2010 Report)

"A problem neither the developed world nor the developing world can afford""Declining development assistance has already led to a significant reduction of public spending on health in many countries. When funds are limited, governments tend to focus on basic health services, in line with the MDGs, at the expense of the prevention and treatment of noncommunicable diseases." (WEF Global Risk 2010 Report)

Not covered by the MDGs:

More than 8 million premature deaths from noncommunicable diseases

10 million

20 million

30 million

40 million

50 million

60 million

Total number of deaths in low- and middle-income countries (2004)

Low-income countriesGroup III - InjuriesGroup II – Other deaths from noncommunicable diseasesGroup II – Premature deaths from noncommunicable diseases (below the age of 60), which are preventableGroup I – Communicable diseases, maternal, perinatal and nutritional conditions

In developing countries, more than 8 million premature deaths from noncommunicable diseases per year are omitted from the MDGs

fact

14.2 M

0 million

5.3 M5.3 M

20.0 M20.0 M

8.1 M8.1 M

17.4 M17.4 M

So

urce

:

$0.01$0.06$0.10

$0.42$0.92$0.93

$3.90$0.06$0.21$0.22$0.23$0.24$0.33$0.45$0.53

$0.80$1.14$1.16$1.33

$1.65$7.40

Water Education/TrainingWater Resources Protection

River DevelopmentWaste Management/Disposal

Basic Drinking Water Supply & SanitationWater resources policy/admin. mgmt

Water Supply/Sanitation - Large SystemsHealth Education

Medical Education/TrainingMedical Research

Basic Health InfrastructureMedical Services

Basic NutritionTuberculosis Control

Family PlanningMalaria Control

Basic Health CareReproductive Health

Infectious Disease Control

Health Policy & Admin. ManagementHIV/AIDS & STDs

Health ODA Commitments (2007) in US$ billions

• Total Health ODA: $22.1 billion

• Health ODA for noncommunicable diseases: 503 million (~2%)

There is no OECD/DAC Creditor Reporting System code yet to track health commitments for the prevention and control of noncommunicable diseases

Source: Kaiser Family Foundation (www.kff.org/globalhealth)

(Based on analysis of data obtained via online query of the OECD Development Assistance Committee (DAC) Database and Creditor Reporting System (CRS) on 31 May 2009)

International development agencies have been slow in responding to the call to raise the priority accorded to noncommunicable diseases in development work

fact

2000

2002

2003

2004

2008

Global Strategy for the Prevention and Control of Noncommunicable

Diseases

In May 2008, WHO Member States started to mobilize a global response to address noncommunicable diseases, with a particular focus on developing countries

WHO Framework Convention on Tobacco Control

Global Strategy on Diet, Physical Activity and Health

Action Plan on the Global Strategy for the Prevention and Control of Noncommunicable Diseases

Global Strategy on Infant and Young Child Feeding

fact

Six objectives:

1. Raising the priority accorded to noncommunicable diseases in development work at global and national levels, and integrating prevention and control of non-communicable diseases into policies across all government departments

2. Establishing and strengthening national policies and programmes

3. Reducing and preventing risk factors

4. Prioritizing research on prevention and health care

5. Strengthening partnerships

6. Monitoring NCD trends and assessing progress made at country level

Under each of the six objectives, there are sets of actions for Member States, the WHO Secretariat and international partners

The 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases was endorsed by the World Health Assembly in May 2008

fact

• Regional Ministerial Meeting on Health Literacy (Beijing, 29-30 April 2009)

• Regional Ministerial Meeting on Noncommunicable Diseases and Injuries, Poverty and Development (Qatar, 10-11 May 2009)

• ECOSOC High-level Segment on Global Health (Geneva, 6-9 July 2009)

• ECOSOC Ministerial Roundtable Meeting on Non-communicable Diseases and Injuries (Geneva, 8 July 2009)

ECOSOC Ministerial Declaration

Continuing discussions at the UN General Assembly

Many public health leaders are calling on global development initiatives to take into account the prevention and control of noncommunicable diseases

Doha Declaration on Noncommunicable

Diseases

fact

High-level forums are starting to call for the inclusion of noncommunicable diseases into discussions on development

fact

Mission of NCDnet:

Help implement the Action Plan by catalyzing a multi-sectoral, multi-level response, with a particular focus on developing countries

Goals of NCDnet:

● Increase focus on prevention and control of noncommunicable diseases through collective advocacy

● Increase resource availability (both financial and human capital)● Catalyze effective multi-stakeholder action with a focus on country-

level implementation

At the occasion of the 2009 ECOSOC High-level Segment, WHO launched a new global network to combat noncommunicable diseases (NCDnet) on 8 July 2009

fact

NCDnet is composed of the WHO Secretariat staff, an International Advisory Council, NCDnet Global and Regional Forum meetings and functional Working Groups

Funding/Resourcing Mechanisms

Funding/Resourcing Mechanisms

International Advisory CouncilInternational Advisory Council

WHO

Global/Regional Forum MeetingsGlobal/Regional Forum Meetings

Advocacy and

Communications

Advocacy and

CommunicationsMonitoring and

evaluation

Monitoring and evaluation

Innovative Resourcing Mechanisms

Innovative Resourcing Mechanisms

Partnership capacitybuilding

Partnership capacitybuilding

Working groups

fact

presentation for discussion (not an official document)

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