World Health Assembly: Drafting Group Progressing On NCDs

Members of the World Health Organization this week have made noncommunicable diseases a top priority, and work on a draft resolution and action plan is being carried out by a drafting group that will report back later in the week.

The annual World Health Assembly is taking place from 20-28 May. WHA documents are available here.

The NCD issue got its momentum from a UN political declaration of September 2011. Reflecting the importance of the issue for the WHO, the NCD working group was established immediately on the first day in Committee A, which is addressing a range of issues including NCDs. The committee is chaired by Walter Gwenigale of Liberia.

The mandate of the drafting group is to advance a draft resolution and a global action plan for the prevention and treatment of NCDs for 2013-2020. The drafting group is co-chaired by Colin McIff and Sania Mishtar, delegates from the United States and Pakistan, respectively.

The group began meeting last night and throughout the day today, making substantial progress on the draft action plan, according to a participant. An example of an area on which progress was made was in reconciling NCDs actions with social determinants of health, the official said.

The documents under discussion are: the draft resolution, WHA document A66/CONF./1 [pdf], and the global action plan for the prevention and control of NCDs, WHA document A66/9 [pdf]. In addition, a “non-paper” [pdf] with further suggestions and clarifications to the draft action plan is in consideration.

The non-paper reflects the work of a series of “informal informal” meetings held on 7, 13, and 15 May, by a group of more than 30 member states discussing the draft action plan. The informal meetings were facilitated by Colin McIff, who is the US health attaché to the UN in Geneva.

The draft resolution endorses a WHO global action plan (GAP) framework for NCDs, which includes a set of 25 indicators to monitor trends and assess progress in strategies across regional and country settings, and nine voluntary global targets.

Included in these targets is the “25 by 25” goal which is to reduce overall premature mortality (deaths between ages 30 and 70) from the four main NCDs (cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases) by 25 percent by the year 2025.

The vision of the action plan is “a world free of the avoidable burden of noncommunicable diseases.” It emphasises the cost of action versus inaction, the need to consider region- and country-specific circumstances, and calls for the establishment of a global coordination mechanism.

A global monitoring framework, Document A66/8 [pdf], will track the implementation of the action plan through monitoring and reporting on the attainment of the voluntary global targets in 2015 and 2020.

Examples of suggestions appearing in the informal group’s non-paper were the inclusion of flexibility for re-orientating parts of the action plan, as appropriate, in response to the post-2015 development agenda. Referring to the equity-based approach, the non-paper indicated that it should be recognised that the high prevalence of NCDs/unequal burden of NCDs is highly influenced by the social determinants of health, and that action on these determinants, both for vulnerable groups and the entire population, is essential to create inclusive, equitable, economically productive and healthy societies. The document also included suggestions that governments should be the key stakeholders in the development of a national policy framework for promoting health and reducing risk factors, but also recognised that the effectiveness of multisectoral action requires engaging other stakeholders.

During the meeting of committee A, most countries voiced their support for the action plan as well as the resolution, but some were concerned that the indicators and targets included in the plan were perhaps too ambitious for some lesser-developed countries. The African and Southeast Asian countries expressed concern that many countries did not have the ability/capacity to measure themselves based on these indicators. Ghana cited the paucity of data on alcohol consumption, fat and salt intake, as well as the availability of medicines as a barrier to implementing the recommended policies as stated in the draft resolution.

A delegate from Botswana, speaking on behalf of the African member states, commended the comprehensive report, but underscored the difference globally, in levels of development and NCD prevention and control. The nonpaper recommended that the WHO include region- or country-specific priorities that would consider individual national circumstances in this context.

On behalf of the Eastern Mediterranean region (EMR), Iran also stated that due to its resource-constrained environment, it might not be possible to fully implement the policies set forth in the draft resolution and action plan. The countries who expressed concern about varying levels of development and capacities to implement the recommended NCD policies urged the WHO and its member states to scale up both financial and technical support for these countries.

A representative from the United States encouraged the WHO to support member states to adapt policies to each national context, saying that flexibility and a “nimble approach to global collaboration” would be key.

William New contributed to this report.

Brittany Ngo is currently completing her Master’s in Health Policy and Global Health at the Yale School of Public Health and previously obtained a Bachelor’s of Arts in Economics from Georgetown University. Through her studies she has developed an interest in health-related intellectual property issues. She is a summer intern at Intellectual Property Watch.