World Health Assembly: Members Adopt Resolution On Preventing And Controlling NCDs

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The first global target on noncommunicable diseases has been gavelled through a World Health Assembly meeting. Member states have decided on a voluntary global target in reducing overall mortality from cardiovascular disease, cancer, diabetes or chronic respiratory disease.

In a committee meeting on the prevention and control of noncommunicable diseases (NCDs) on 24 May during the World Health Assembly (WHA), member states adopted, without any further discussion, a resolution put forth by the delegations of Australia, Barbados, Brazil, Canada, Norway, Russia, Switzerland, Thailand and the United States, and supported by over 50 countries, including the European Union.

Speaking on behalf of the group, the chief medical officer of Barbados said that there was “sufficient agreement and support” to recommend the adoption of a mortality target to send a message of the importance accorded to NCDs by the WHO. By adopting the proposal, member states have agreed to “adopt a global target of a 25% reduction in premature mortality from NCDs by 2025.”

The resolution on NCDs will be submitted to the plenary for approval on the last day of the 65th WHA on 26 May. A copy of the draft resolution is available here (IPW, WHO, 24 May 2012).

Gaining Momentum for Debate to Come

There was broad consensus amongst member stations on this global target. In fact, a similar commitment was made by the 60th WHA with the target of “reducing death rates from NCDs by 2 percent annually during the period of 2006-2015,” which calculates to an 18 per cent reduction over 9 years. The resolution recognises that this global target builds on that commitment.

But even if achieving consensus on the mortality rate was, according to some delegates, an “easy win,” member states stressed that this agreement marks an important step in the NCD global policymaking process. A delegate from Denmark told Intellectual Property Watch that it was important to “gain momentum” with the global overarching target as “it will be more difficult to achievement agreement on the other targets.”

In a WHO press conference on the resolution, Timothy Armstrong, coordinator of Surveillance and Population-based Prevention in the Department of Chronic Diseases and Health Promotion at the WHO, said, “This is a landmark decision on the prevention and control of NCDs.”

“For the first time, we are moving away from aspirational goals to an action-based approach that will be anchored in quantifiable targets,” Armstrong said.

This is the first step of a much larger NCD policymaking package. The Political Declaration established by the High-Level of the General Assembly on the Prevention and Control of NCDs, held last September in New York, called on the WHO to prepare recommendations for a set of voluntary targets and commitments for the prevention and control of NCDs and their underlying risk factors by the end of 2012.

Ongoing Conversation on Targets

[Update:] The global target is widely seen by non-governmental organisations as an important step in developing a global strategy for addressing NCDs. In response to the decision, Joanna Ralston, CEO of the World Heart Federation and steering group member of the NCD Alliance, told Intellectual Property Watch, “We are delighted at the leadership supporting the global target as it’s the most important one. It gives us something to rally around.”

“But the global target in isolation is not enough to tackle one of the most complex health challenges facing the world today. The other targets are needed to achieve this goal. And we are urging leaders to agree on those targets promptly,” Ralston said. [end]

Deciding on which targets to include in the global set has proved to be a contentious endeavour. This resolution “expressed strong support” to reach consensus on four targets relating to risk factors including tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity.

Additionally, it “decided to note” wide support around targets relating to raised blood pressure and salt/sodium. And it “further noted” that there is also support for the development of targets relating to obesity, fat intake, alcohol cholesterol, and healthy system responses such as availability of essential medicines for NCDs.

Inclusion of the noted targets was important for many member states concerned by the limited number of targets going into the Assembly. Recommendations presented to delegates in a second revised WHO discussion paper on the topic were limited to five. They included mortality rate, reduced prevalence of hypertension/raised blood pressure, tobacco smoking, physical inactivity and dietary salt intake.

India was amongst countries in support of including targets related to medicine for the treatment of NCDs. A delegate from India told Intellectual Property Watch that “while the resolution may not be the best, at least it is still possible.”

“Yesterday’s resolution made it clear that this is still an open conversation. Much more work is left to be done,” the delegate said, underlining the importance of universal access to medicines in India. “The availability of drugs is an important aspect for us. It’s an important means to reaching our overarching global target of reducing the mortality rate.”

Non-governmental organisations continue to raise concern that accessibility to treatments for NCDs is not being adequately addressed (IPW, Public Health, 16 September 2011). In an interview at the WHA, a spokesperson for the Universities Allied for Essential Medicines expressed “concern” that language in the resolution on medicines “does not go far enough.”

“By specifying essential medicines, important medicines for treating NCDs, especially cancer, are excluded,” she said. “If you want to talk about treatment, you have to address access, availability and affordability.”

NCD 2012 Calendar

Committed to adhering to the timeline set out by the High-Level Meeting on NCDs Political Declaration, the resolution calls for a formal member state meeting to be held before the end of October 2012. There member states should “conclude the work on the comprehensive global monitoring framework, including indicators and a set of global voluntary targets for the prevention and control of NCDs.”

In the meantime, regional consultations are ongoing. The October 2012 outcome will be submitted to the 132nd Executive Board in January and 66th WHA next year.

Separately, the High-Level Meeting on NCDs also requested a report on options for strengthening and facilitating multisector action for the prevention and control of NCDs through effective partnership for member state consideration by the end of the year. The United Nations Secretary General has requested the submission of the WHO’s input to the report by 27 August.

Related articles here and here.

Rachel Marusak Hermann may be reached at info@ip-watch.org.

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