First Meeting of UN Funds, Programmes and Agencies on the Implementation of the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of NCDs (New York, 8 December 2011) Concept Note Introduction: NCDs as one of the major challenges for development in the 21 st century Developing countries are committed to addressing NCDs by 2013 What gets measured, gets done: Setting targets and measuring results Shared governance for NCDs: Promoting institutionalized processes to strengthen multisectoral action for the prevention and control of NCDs Providing technical assistance and capacity-building to developing countries building on the landmark Global Strategy for the Prevention and Control of NCDs Next steps in the development process: Concerted and coordinated UN System-wide action to help developing countries build their capacity to address NCDs Scope and purpose of the First Meeting: Objectives Expected outcomes Suggested participants Logistics and registration Discussion papers NCDs as one of the major challenges for development in the 21 st century 1. More than 28 million people died from NCDs in developing countries 2008. More than 8 million of these deaths occurred before the age of 60 and could have largely been prevented. Wide disparities exist among developed and developing countries: Premature deaths from NCDs range from 58% among women in Sierra Leone to 6% in Italy, and 61% in Burkina Faso to 9% in Sweden. The social, economic, and physical environments in developing countries afford their populations much lower levels of protection from the risks and consequences of NCDs than in developed countries, where governments tends to protect their people by implementing multisectoral national policies and plans for the prevention and control of NCDs. 2. Equally important, NCDs and their risk factors also lead to increased burdens on households, including impoverishment from long-term treatment and care costs, and to a loss of productivity that threatens household income and leads to productivity loss, Page 1 of 9
making NCDs a contributing factor to poverty and hunger, which may have a direct impact on the achievement of MDGs. At the macro-economic level, it is estimated that the cumulative lost output in developing countries associated with NCDs is US$7 trillion over the period 2011-2025. 3. Acknowledging the challenge of epidemic proportions and its socio-economic impact, the General Assembly convened the High-level Meeting of the General Assembly on the Prevention and Control of NCDs from 19-20 September 2011 in New York to address the prevention and control of NCDs, with a particular focus on developmental challenges for developing countries, in accordance with resolutions A/RES/64/265 and A/RES/65/23. This was the second time in the history of the United Nations that the General Assembly met with the participation of Heads of State and Government on a health issue with a major socio-economic impact. The High-level Meeting was attended by 113 Member States, including 34 Heads of State and Government. 4. The resulting Political Declaration, which was adopted by the General Assembly on 19 September 2011 (resolution A/RES/66/2), acknowledges that NCDs constitute one of the major challenges for development in the 21 st century, highlights the rapidly growing magnitude of NCDs in developing countries, recognizes NCDs as a contributing factor to poverty and hunger in developing countries, and outlines ways to strengthen national capacities to address NCDs, as well as to respond to the challenge through international cooperation and coordination. Developing countries are committed to addressing NCDs by 2013 5. While most developing countries have a government unit, branch or department responsible for addressing NCDs, and the majority of developing countries have developed national NCD policies and plans, one-third of low-income countries reported in 2009/2010 to WHO that they had not provided financial resources or prioritized budgetary allocations to implement these plans. 6. To overcome this challenge, Heads of State and Government and representatives committed themselves in the Political Declaration to: Build national governance capacity for NCDs: Integrate NCD policies into health-planning processes and the national development agenda (paragraph 45a of the Political Declaration) Promote multisectoral action through health-in-all-policies and whole-ofgovernment approaches (33-42). Build national capacity to strengthen national NCD policies and plans to: Reduce exposure to risk factors for NCDs (42-44) by: Creating health-promoting environments (43a) and scaling up health promotion approaches (43l) Page 2 of 9
Promoting health education and health literacy (43b) Accelerating implementation of WHO Framework Convention on Tobacco Control and existing global strategies endorsed by WHO's Governing Bodies (please refer to Annex II) Implementing interventions to reduce salt, sugar and fats (43g) Encouraging policies that support the production of and access to foods that contribute to healthy diets (43h) Promoting breast feeding (43i) Promoting access to vaccinations to prevent infections associated with cancers (43j) and promote access to cancer-screening programmes (43k) Support primary health care for addressing NCDs (45) by: Strengthening health systems (45b) Improving access and affordability for NCD medicines Exploring viable health financing (45c, 45d, 45l, 49) Promoting the production, training and retention of health workers (45j) Monitoring NCDs and evaluating progress (60-63) Consider the development of national targets and indicators (63) Strengthen surveillance and monitoring systems for NCDs (60). 7. If the high mortality and heavy socio-economic burden experienced by developing countries are to be comprehensively reduced, NCDs must be integrated into the health-planning processes and the national development agenda. Planning instruments like the CCA and UNDAF provide opportunities for synergy, as do strategies for poverty reduction.. 8. At the international level, official development assistance to support developing countries in building sustainable institutional capacity to tackle NCDs remains insignificant, despite the increasing recognition of NCDs as a development priority. Discussions on the UN post-2015 development agenda must also therefore take into account prevention of NCDs. In this regard, WHO estimates that the average yearly cost for all developing countries to implement a combined set of population-based and individual-level "best buy" NCD interventions that have been identified as priority actions by WHO is U$11 billion (resulting in an overall cost of US$170 billion over the period 2011-2025). 9. At the national level, innovative approaches for long-term financing of NCD prevention and control exist in many countries. Even if only a portion of the proceeds from increased domestic taxation on alcohol and tobacco were allocated to health, resources that governments can spend on health would be greatly increased. A 50% increase in tobacco excise taxes would generate US$ 1.4 billion in additional funds in 22 low-income countries for which data are available. Page 3 of 9
What gets measured, gets done: Setting targets and measuring results 10. In order to provide guidance to Member States to consider the development of national targets and indicators based on national situations to focus on efforts to address the impacts of NCDs, the Political Declaration calls on WHO to build on the work already underway to develop a comprehensive global monitoring framework to monitor trends and to assess progress made in the implementation of national strategies and plans on NCDs (paragraph 61) and to prepare recommendations for a set of voluntary global targets (62) before the end of 2012. To meet these outcomes, WHO will work in close collaboration with United Nations funds, programmes and agencies. Shared governance for NCDs: Promoting institutionalized processes to strengthen multisectoral action for the prevention and control of NCDs 11. The Political Declaration invites the Secretary-General to submit to the United Nations General Assembly options for strengthening and facilitating multisectoral action for the prevention and control of NCDs through effective partnership (paragraph 64). These options will be developed in close collaboration with the WHO Director-General, and in consultations with UN funds, programmes and agencies,. In this regard, WHO is conducting an in-depth analysis of experience on the impact of and lessons learned from existing efforts to prevent and control NCDs through multisectoral action, including through whole-of-government approaches and whole-of society efforts. Based on the outcomes of these reviews, WHO will develop criteria and options for strengthening multisectoral action for the prevention and control of NCDs through effective partnership, in close consultations with UN funds, programmes, and specialized agencies, as well as Member States. These criteria and options will serve as input to the report of the Secretary-General to the General Assembly. Providing technical assistance and capacity-building to developing countries building on the landmark Global Strategy for the Prevention and Control of NCDs 12. Eleven years have passed since the WHO World Health Assembly endorsed the landmark Global Strategy for the Prevention and Control of NCDs to reduce the toll of premature deaths due to NCDs. Despite some impressive progress in a number of countries, much needs to be done to use that knowledge to benefit people in all developing countries. 13. The cornerstone of the global response to NCDs remains the Global Strategy on the Prevention and Control of NCDs endorsed by the WHO World Health Assembly in May 2000. In 2008, the World Health Assembly endorsed the corresponding Action Plan covering the period 2008-2013, which comprises a set of actions for Member States, international development partners, and WHO. Page 4 of 9
14. To monitor NCD-related trends and assess the progress that countries are making to address the NCD epidemic, WHO published the Global Status Report on NCDs (2010), which includes a first global baseline on deaths and premature deaths from NCDs. The Report also includes a set of "best buys "interventions for the prevention and control of NCDs that have significant public health impact, are highly cost-effective, and are inexpensive and feasible to implement. 15. In May 2011, the World Health Assembly requested WHO to develop, together with relevant UN funds, programmes and agencies, an implementation and follow-up plan for the outcomes of the High-level Meeting on NCDs, including its financial implications, for submission to the WHO Executive Board in January 2012. In this regard, WHO will develop the corresponding Action Plan covering the period 2013-2018 during the first half of 2012, in close consultation with UN funds, programmes and agencies. Next steps in the development process: Concerted and coordinated UN System-wide action to help developing countries build their capacity to address NCDs 16. Joint interagency work is essential at the national and international level. There are areas of potential collaboration among most UN funds, programmes and agencies. The Political Declaration urges the relevant UN funds, programmes and agencies to provide technical assistance and capacity-building to developing countries, especially the least developed countries, in the areas of NCD prevention and control (paragraph 62). To work together in a coordinated manner to support national efforts to establish national NCD policies and plans, the Political Declaration calls on WHO to exercise its leadership and coordination role in relation to the work of other United Nations funds, programmes and agencies, development banks, and other regional and international organizations in addressing NCDs in a coordinated manner (paragraphs 13 and 51). 17. There is a real sense of urgency to mobilize a coordinated UN System-wide response swiftly in order for the United Nations to maintain its intellectual leadership on this most important endeavour and to ensure that the implementation of the Political Declaration is (i) guided by core UN norms and standards, values and commitments; (ii) informed and shaped by the critical challenges of our time, including equity, poverty, inclusive economic growth, and gender equality; (iii) built on the momentum and lessons learned from the health-related MDGs; and (iv) built on the existing global strategies endorsed by the World Health Assembly (detailed in Annex II). Objectives of the 'First Meeting of UN Funds, Programmes and Agencies on the Implementation of the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of NCDs' 18. WHO will convene a first meeting of UN funds, programmes and agencies on the implementation of the Political Declaration of the High-level Meeting of the General Page 5 of 9
Assembly on the Prevention and Control of NCDs on Thursday, 8 December 2011, at the United Nations in New York. The objectives of the first meeting are as follows: The objectives of the meeting are as follows: To promote a common understanding among the UN System of the burden of NCDs in developing countries and its socio-economic impact To exchange information on efforts already underway and those planned across the UN System to strengthen national capacities to address NCDs To identify opportunities for UN funds, programmes and agencies to strengthen national capacities for the prevention and control of NCDs To agree on a list of recommended actions that could be included in a coordinated common UN System-wide agenda on NCDs, including actions related to: Integrating NCDs into UNDAF processes Developing joint programmes Developing a comprehensive global monitoring framework and targets for NCDs, and promoting the development of national targets and indicators Articulating policy options for strengthening multisectoral action through effective partnerships Developing an updated/follow-up global Action Plan of the Global Strategy on the Prevention and Control of NCDs (2013-2018) Including NCDs in discussions on the post-2015 UN development agenda To agree on an informal mechanism to coordinate the NCD work being carried out by UN programmes, funds and agencies, if appropriate. Expected outcomes of the First Meeting 19. The expected outcomes of the first meeting are as follows: A common understanding across the UN System of magnitude of the burden of NCDs in developing countries, its socio-economic impact, and available solutions to halt and begin to reverse the NCD burden and mitigate its impact A collective overview of ongoing and planned efforts across the UN funds, programmes and agencies to strengthen national capacities to address NCDs Opportunities identified to develop joint programmes to strengthen national capacities for the prevention and control of NCDs A unified vision and road map for the definition of a UN System-wide agenda on NCDs Terms-of reference of an ad-hoc coordination mechanism, if appropriate. Suggested participants 20. It is suggested that substantive staff from interested UN funds, programmes and agencies, the international financial institutions, development banks, and other key Page 6 of 9
international organizations consider attending the First Meeting. Logistics 21. The meeting will take place on Thursday, 8 December 2011 at a conference room (exact venue to be determined) at the United Nations in New York. More details will become available closer to the meeting. To register, please contact Dr Jacob Kumaresan, Executive Director, WHO Office at the UN in New York at email: jkumaresan@whoun.org. Discussion papers 22. The following papers will be made available to registered participants prior to the First Meeting: Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of NCDs WHO Global Status Report on NCDs WHO Country Profiles on NCDs WHO Discussion Paper on the NCD burden in developing countries and its socioeconomic impact WHO Discussion Paper on recommendations for a common UN System-wide agenda on NCDs ooo000ooo Page 7 of 9
ANNEX I Resolutions adopted by the UN General Assembly Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of NCDs (resolution A/RES/66/2): http://www.un.org/ga/search/view_doc.asp?symbol=a/66/l.1&referer=http://www.wh o.int/fctc/en/&lang=e Prevention and control of NCDs (resolution A/RES/64/265): http://esango.un.org/event/documents/ares64265.pdf Scope, modalities, format and organization of the High-level Meeting of the General Assembly on the Prevention and Control of NCDs (resolution A/RES/65/238) http://www.un.org/en/ga/president/65/issues/a-res-65-238.pdf ANNEX II Global strategies endorsed by the World Health Assembly Global Strategy for the Prevention and Control of NCDs (2000) and 2008-2013 Action Plan for the Global Strategy (2008): http://whqlibdoc.who.int/publications/2009/9789241597418_eng.pdf WHO Framework Convention on Tobacco Control (2003): http://whqlibdoc.who.int/publications/2003/9241591013.pdf WHO Global Strategy on Diet, Physical Activity and Health (2004): http://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf WHO Global Strategy to Reduce the Harmful Use of Alcohol (2010): http://www.who.int/substance_abuse/alcstratenglishfinal.pdf ANNEX II Key tools, publications and guidelines WHO Global Status Report on NCDs (2010): http://whqlibdoc.who.int/publications/2011/9789240686458_eng.pdf WHO Country Profiles on NCDs (2011): http://whqlibdoc.who.int/publications/2011/9789241502283_eng.pdf Page 8 of 9
WHO "best buys" to prevent and control NCDs (2010): http://www.who.int/nmh/publications/who_bestbuys_to_prevent_ncds.pdf Scaling up action against NCDs: How much will it cost? (2011) http://whqlibdoc.who.int/publications/2011/9789241502313_eng.pdf Resources for taking action (2011): http://www.who.int/nmh/events/un_ncd_summit2011/en/index.html High-level Meeting on NCDs: http://www.who.int/nmh/events/un_ncd_summit2011/en/index.html Page 9 of 9