Urgent action is needed to reduce the estimated annual 41 million deaths from noncommunicable diseases (NCDs) across the globe.
The response to date for NCDs, which includes heart disease, stroke, diabetes, cancer and lung diseases, and accounts for more than 70 percent of all deaths, has been largely inadequate. To achieve success, a comprehensive approach should be adopted that considers the social, economic, environmental and commercial factors in which the diseases are rooted and involves actors from across sectors, said experts at a global public health conference last week in Bangkok.
Over 1,000 public health experts from 77 countries gathered from 29 January to 3 February 2019 for the Prince Mahidol Award Conference, an annual global public health policy conference co-hosted by the Prince Mahidol Award Foundation, the Thai Ministry of Public Health, Mahidol University, the World Health Organization, United Nations Development Programme (UNDP) and other global partners.
The theme of this year’s conference was “The Political Economy of NCDs: A Whole of Society Approach”, and focused on identifying major bottlenecks, root causes and solutions to accelerate implementation of NCD prevention and control at national and global levels.
Low- and middle-income countries have been especially heavily impacted. More than three-quarters of NCD deaths are occurring in these countries.
“NCDs are not just a health problem. If we are going to get NCDs under control, we first need to have a full understanding of the root causes, of the roles played and relative power of the different actors – manifest through legislation, production, representation, oversight and recourse,” said Douglas Webb, Team Leader on Health and Innovative Financing with the HIV, Health and Development Group of UNDP.
“It’s going to require partnerships across all sectors – both inside and outside government – and strong leadership, governance, planning and support through global financing mechanisms.”
During the week-long conference, UNDP participated in and organized sessions including a parallel session titled “What's Law Got to Do with It?” The session examined the progress to date, best practices and challenges with regards to using the law to prevent, control and treat NCDs. For example, legislation can help to reduce the use of harmful tobacco or alcohol products and promote healthy diets and activities. Speakers also discussed the need to sensitize and support parliamentarians to accelerate progress towards implementation of the 2030 Agenda for Sustainable Development.
“Despite the availability of scientific evidence and cost-effective interventions, implementation remains a challenge in many countries. The law, therefore, can be a vitally important catalyst for effective NCD responses – for instance, to reduce NCD risk factors or establish public health-driven normative legal frameworks that can shape politics, economics and good governance,” said Tenu Avafia, Team Leader on Human Rights, Key Populations and Treatment Access with the HIV, Health and Development Group of UNDP.
Key challenges that were highlighted during the conference included, at the global level, a lack of internationally legally binding instruments to regulate NCD risk factors such as alcohol and processed foods, with the exception of the WHO Framework Convention on Tobacco Control.
Attention was drawn as well to the significant funding gaps that exist, particularly in low- and middle-income countries, that require innovative solutions such as new financing sources and models.
At the national level, participants reported an absence of political will and leadership, a lack of policy coherence between public health goals and economic growth, and weak mechanisms, infrastructure and resources for policy adoption and implementation.
Participants called for stronger and coordinated efforts to raise awareness among the public about the burden that NCDs cause for public health and the relationships between NCDs, poverty and social and economic development.
On the final day of the conference, a Synthesis document was released that consolidated the challenges, gaps and recommended priority actions for different actors to take, and a Statement calling for a collaborative effort to advance the whole of society approach to NCDs.