Dr Shanthi Mendis Director, Department of NCD Management a.i. World Health Organization

WHO Technical Briefing Seminar on Essential Medicines & Health Products, October 2013

Noncommunicable Diseases –Action Plan

Dr Shanthi Mendis

Director, Department of NCD Management a.i.World Health Organization

Geneva, Switzerland

NCDs - Development Challenge (2008 estimates)

0 M

5 M

10 M

15 M

20 M

25 M

30 M

35 M

Low-incomeCountries

Lower- Middle-income

Countries

Upper-Middle-income

Countries

High-incomeCountries

Communicable conditions NCDs < 60 InjuriesNCDs > 60

Premature Deaths 9 MTotal NCD deaths 36 M

2000

2003

2004

2008

Global Strategy for the Prevention and Control of Noncommunicable Diseases

Global Strategy on Diet, Physical Activity and Health

Action Plan 2008-2013 on the Global Strategy for the Prevention and Control of NCDs

2010

2009

2011

Global Strategy to Reduce the Harmful Use of Alcohol

WHO Global Status Report on NCDs

Political Declaration on NCDs

20132020

Global Mile stones : Prevention and Control of NCDs

WHO Action Plan for the Prevention and Control of NCDs for 2013-2020

WHO Global NCD Action Plan 2013-2020

Adopted by 194 Ministries of Health at the World Health Assembly 2013

The plan aims to operationalize the commitments from Heads of State and Government included in the Political Declaration of the High-level Meeting of the

United Nations General Assembly on NCDs

Objective 1:

To strengthen international cooperation and advocacy to raise the priority accorded to prevention and control of NCDs in the development agenda and in internationally-agreed development goals

Objective 2:

To strengthen national capacity, leadership, governance, multisectoral action and partnerships to accelerate country response for prevention and control of NCDs

Objective 3:

To reduce exposure to modifiable risk factors for NCDs through creation of health-promoting environments

Objective 4:

To strengthen and reorient health systems to address prevention and control of NCDs through people-centered primary health care and universal coverage

Objective 5:

To promote and support national capacity for high quality research and development for prevention and control of NCDs

Objective 6:

To monitor trends and determinants of NCDs and evaluate progress in their prevention and control

WHO Global NCD Action Plan 2013-2020 –objectives

غير األمراض مكافحة في لنتحدالسارية

Immediate actions for Member States in 2013-2014

Action AreaGovernanceRisk factors

Health systemsSurveillance

1. Set national targets for 2025 in 2013, taking into account the 9 global targets


Prevention of Heart Attacks and Strokes :

At least 50% of eligible people receive drug therapy and counseling(including glycemic control) to prevent heart attacks and strokes

Availability and affordability

An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major NCD in both public and private facilities





2. Develop national multisectoral plans in 2013 to achieve targets, taking into account the WHO Global NCD Action Plan 2013-2020

The global action plan comprises a set of

actions which, when performed collectively

by Member States, international partners and WHO, will attain the 9 global targets,

including a 25% reduction in premature

morality in NCDs by 2025





1. Implement interventions identified by WHO as "very cost effective interventions " using WHO tools:

• Tobacco use • Unhealthy diet and physical inactivity• Harmful use of alcohol

Cost effective interventions

Cancer• Prevention of liver cancer through hepatitis B immunization• Prevention of cervical cancer through screening (visual inspection with acetic acid (VIA), with timely treatment of pre-cancerous lesions





1. Implement interventions identified by WHO as "best buys" into the basic primary health care package using WHO tools:

• Integrated approach to cardiovascular diseases and diabetes:– Multidrug therapy to individuals who have

had a heart attack or stroke and to persons with a high risk of a cardiovascular event in the next 10 years

– Providing aspirin to people having an acute heart attack





2. Implement other very cost-effective and affordable interventions identified in Appendix 3 of the Global Action Plan into the basic primary health care package using WHO tools





2. Implement other very cost-effective and affordable interventions identified in Appendix 3 of the Global Action Plan using WHO tools

How much will it cost to scale-up very cost effective NCD interventions? For all LMIC, US$ 11.4 billion per year on average

• Population-based measures: close to US$ 2 billion per year

• Low- and lower-middle-income countries: < US$ 0.20 per head• Upper-middle income countries: < US$ 0.50 per head

• Individual-based measures: US$ 9.4 billion per year• Low-income countries: < US$ 1.00 per head• Lower middle-income countries: < US$ 1.50 per head• Upper-middle income countries: ~ US$ 2.50 per head





1. Strengthen NCD surveillance, covering a) monitoring of risk factors and determinants, b) outcomes (mortality and morbidity) and c) health system response and integrate into the national health information systems





2. Develop national targets and indicators, based on the WHO recommendations and WHA Resolutions

WHA682015 WHA732020 WHA782025


A global coordination mechanism on NCDs (2014)

Formal meeting of Member States to conclude the work on the terms of reference for a global coordination mechanism on the prevention and control of noncommunicable diseases (Geneva, 11–12 November 2013)

Proposed functions – A forum for Partners to: • Broker knowledge and information:• Encourage innovation:• Promote multisectoral action:• Promote accountability:• Advocate and raise awareness:

Proposed partners:• Member States• UN organizations and other intergovernmental organizations• Non-State actors

for discussion on 11-12 November 2013

Thank you

Documents

Dr Shanthi Mendis Director, Department of NCD Management a.i. World Health Organization