(personal) reflections on the NCD Summit

Nicola Watt, LSHTM

Why am I here?

Non government Non-NGO Not-really-an-academic Think of me as a fly on the wall reflecting on

some of the things she’s seen….

Multilateral negotiations – a parallel universe What can any one

country achieve? What can the

negotiation as a whole achieve?

Pictures thanks to UN

How does anyone work out what’s really going on?

The main achievement – a startling consensus on pathways

Even Moscow to New York a decisive “jump”

declaration more comprehensive and enlightened (in terms of determinants) than most of us imagined

NCDs really arrived on collective conscience

Beaglehole et al Lancet April 2011

the “numbers game”

4 x 4 diseases and risk factors 5 priority actions 4 questions

is there really a global crisis of NCDs; how is NCD a development issue; are affordable and cost-effective interventions available; and do we really need high-level leadership and

accountability? 2 urgent follow up actions

Dissemination of the declaration Short term milestones for agreement of targets

1 2 3

4 5

3 Conundrums

1. The Christmas tree accusation – horizontal

vs vertical, shopping list vs broad and

vague….

2. The causes of the causes of the causes of

the causes of the….

3. The vexing vested interest

Conundrum 1 – the Christmas tree of NCDs Mental health

“excluded”? Manageability and ease

of communication? Or flexibility to country context?

Inevitably leads to the horizontal vs vertical debate

Conundrum 2 - Are the best buys the best bet?

For: Focus on the risk factors gave

the debate momentum If governments do nothing else,

they’d still save lives

Against/on the fence is focus on the low-

hanging fruit right in the long term? - even ignoring immediate hurdles to implementation

Focusing on social determinants gives maximum common ground with rest of the development agenda….

Conundrum 3 – the importance of ego “conflict of interest” arguments rein Different levels –

1. importance to both developed and developing countries - unites and divides

2. economic interests make it incredibly difficult for governments to see their way through the political and economic arguments

MEMEME

The opportunity and the challenge

What kind of society do we

want?

NCDs threat “commensurate” with global financial imbalances (WEF Global Risks 2011)

sustainable development agenda (Rio +20 round the corner)

MDG deadline looming; little appetite for bottomless GH funding

global community newly sensitised to NCDs….

an opportunity to think big?

Who said this?

“We need to act with boldness and determination” 

Today’s challenges might be tomorrow’s big idea.

Thank you