Showing posts with label NCD. Show all posts
Showing posts with label NCD. Show all posts

Wednesday, September 21, 2011

WHO: NCDs damage health, including economic health

Margaret Chan
http://www.who.int/dg/speeches/2011/un_ncds_09_19/en/index.html

Noncommunicable diseases damage health, including economic health 

Dr Margaret Chan
Director-General of the World Health Organization

Address at the High-level meeting on noncommunicable diseases, United Nations General Assembly
New York, United States of America

19 September 2011
Excellencies, Heads of State, Heads of Government, Ministers, Mr President of the UN General Assembly, Mr Secretary-General, Your Royal Highness Princess Dina Mired, distinguished delegates, ladies and gentlemen,
First, let me commend your leadership and courage in addressing and tackling noncommunicable diseases. I am honoured to address this session, and I am strong in my conviction that this meeting must serve as a wake-up call.
But not for the medical and public health professions. We are already wide awake, and with deep concerns. We know the statistics and the ominous trends that now encircle the globe. We know what lies ahead.
Right now, medical and health professionals see the patients, dispense chronic care, manage the complications and disabilities, write the medical bills, and agonize over the huge costs to families and societies. We plead for lifestyle changes and strict tobacco regulation.
But health ministries, acting alone, cannot re-engineer societies in ways that protect entire populations from the well-known and easily modified risks that lead to these diseases. And this is what needs to happen. This meeting must be a wake-up call for governments at their highest level.
This must be a watershed event, with a clear before and after. With ignorance, complacency, and inertia replaced by awareness, shock, and the right actions, right away.
Why must this responsibility fall on heads of state? Because the problem is too big and too broadly based to be addressed by any single government ministry.
Because the rise of these diseases is being driven by powerful, universal forces, like rapid urbanization and the globalization of unhealthy lifestyles. Because the response to these trends must come with equal power, with top-level power that can command the right protective policies across all sectors of government.
Ladies and gentlemen,
The worldwide increase of noncommunicable diseases is a slow-motion disaster, as most of these diseases develop over time. But unhealthy lifestyles that fuel these diseases are spreading with a stunning speed and sweep.
I can understand why some developing countries are being taken by surprise by the onslaught of these diseases. Their initial burden was greatest in affluent societies with strong R&D capacities to develop ever-better treatments.
When drugs are available to reduce blood pressure, lower cholesterol, and improve glucose metabolism, the situation looks somehow under control. This appearance is misleading and blunts the urgent call for policy change.
The root causes of these diseases are not being addressed, and widespread obesity is the tell-tale signal. Worldwide, obesity rates have almost doubled since 1980.
This is a world in which more than 40 million pre-school children are obese or overweight. This is a world where more than 50% of the adult population in some countries is obese or overweight.
Obesity is the signal that something is terribly wrong in the policy environment. Widespread obesity in a population is not a marker of failure of individual willpower, but of failure in policies at the highest level.
Processed foods, very high in salt, trans fats, and sugar, have become the new staple food in nearly every corner of the world. They are readily available and heavily marketed. For a growing number of people, they are the cheapest way to fill a hungry stomach.
The world certainly needs to feed its population of nearly 7 billion people. But it does not need to feed them junk food.
Just as you cannot hide obesity, you cannot hide the huge costs of these diseases to economies and societies.
These are the diseases that break the bank. Left unchecked, these diseases have the capacity to devour the benefits of economic gain. In some countries, for example, care for diabetes alone consumes as much as 15% of the national health care budget.
A recent World Economic Forum and Harvard University study estimates that, over the next 20 years, noncommunicable diseases will cost the global economy more than US$ 30 trillion, representing 48 percent of global GDP in 2010.
In large parts of the developing world, these chronic conditions are detected late, when patients need extensive and expensive hospital care for severe complications or acute events. Most care for these diseases is covered through out-of-pocket payments, leading to catastrophic medical expenditures.
For all these reasons, noncommunicable diseases deliver a two-punch blow to development. They cause billions of dollars in losses of national income, and they push millions of people below the poverty line, each and every year.
Ladies and gentlemen,
These diseases break the bank, but they are largely preventable through cost-effective measures. Some have an especially big pay-back.
For example, full implementation of the WHO Framework Convention on Tobacco Control would bring the single biggest blow to heart disease, cancer, diabetes, and respiratory disease.
I call on heads of state and heads of government to stand rock-hard against the despicable efforts of the tobacco industry to subvert this treaty. We must stand firm against their open and extremely aggressive tactics.
In terms of demand reduction, increases in tobacco taxes and prices are the most effective measure. They not only protect health. They bring in considerable revenue. The same is true for taxes on alcohol.
Salt in processed foods is a major reason why daily salt intake in most countries exceeds the WHO-recommended level. Salt reduction is one of the most cost-effective, feasible, and affordable public health interventions.
At the individual level, people at high risk of cardiovascular disease can be protected with a very low-cost regimen of generic medicines.
Ladies and gentlemen,
As I said, this high-level meeting on noncommunicable diseases must be a watershed event.
In the absence of urgent action, the rising financial and economic costs of these diseases will reach levels that are beyond the coping capacity of even the wealthiest countries in the world.
Excellencies, you have the power to stop and reverse the noncommunicable disease disaster. You have the power to protect your people and keep your development efforts on track.
Thank you.
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What is non-communicable disease (NCD)?

"Noncommunicable diseases are one of the leading threats to global economic growth and development. Over the next 15 years, noncommunicable diseases will cost low- and middle-income countries more than US$ 7 trillion," says Jean Pierre Rosso, Chairman, World Economic Forum (WEF), quoting the results of a WEF and Harvard School of Public Health study released on 18 Sept 2011. "When so many of the workforce is sick and dies in their productive years, national economies lose billions of dollars in output. And millions of families are pushed into poverty."


Over the past 2 and a half years, there has been a strong push from civil society for governments of the world to address the growing epidemic of non-communicable diseases (NCDs).  These past two days (19-20 September 2011) those efforts have come to fruition. The UN General Assembly held a High-Level Meeting for the Prevention and Control of NCDs and adopted a Political Declaration for action on NCDs.


But first: what are non-communicable diseases or NCDs? Simply put, these are non-infectious or non-transmissible diseases. For seemingly practical purposes, an arbitrary delineation was drawn between communicable and non-communicable diseases. The main NCDs are heart/cardiovascular disease, chronic lung disease, cancer, and diabetes. These four main NCDs kill three in five people worldwide, and cause great socioeconomic harm within all countries, particularly developing nations. The main NCD risk factors are tobacco use, alcohol abuse, obesity, and lack of exercise.


In 2000, the United Nations member states agreed to eight Millennium Development Goals (MDGs), Goal #6 of which brought focus to the growing burden of infectious or communicable diseases such as TB, malaria, and HIV/AIDS.  This was followed in 2001 by a Special Session of the UN General Assembly on HIV/AIDS. Thus over the past decade, the world has seen tremendous political, social, and economic resources poured into reducing prevalence of TB, malaria, and HIV/AIDS worldwide.


Unfortunately, the NCDs did not receive the same level of attention or commitment, such that while we have seen the prevalence of TB, malaria, and HIV/AIDS continuing to decline over time, the prevalence of NCDs has been steadily growing to epidemic proportions.  36 million people die every year from NCDs, accounting for more than 60% of global deaths.  Majority of these deaths occur in low and middle income countries, and 6 million of these are caused by tobacco use.


Many people used to think that NCDs were a problem only of rich countries; however that is certainly not the case, and many low and middle income countries now face a double burden of both communicable/infectious disease and NCDs.


It is therefore timely (better late than never) that the UN General Assembly is holding a historic High-Level Meeting on NCDs. This is only the second UN GA Meeting on health; the first was the Special Session on HIV/AIDS in 2001.  Hopefully, this meeting will jumpstart a race to drastically reduce NCDs across the globe. 


UN Member States have now adopted a Political Declaration that commits governments to accelerate implementation of the WHO Framework Convention on Tobacco Control (FCTC) and encourages countries, which have not yet done so, to consider acceding to the FCTC. The Declaration also recognizes that reducing tobacco consumption is an important contribution to reduce NCDs and that price and tax measures are an effective and important means of reducing tobacco consumption.


Dr. Margaret Chan, WHO Director-General, highlighted this in her address to the UN General Assembly, “Full implementation of the WHO Framework Convention on Tobacco Control would bring the single biggest blow to heart disease, cancer, diabetes, and respiratory disease. In terms of demand reduction, increases in tobacco taxes and prices are the most effective measure. They not only protect health. They bring in considerable revenue.” 

Speech of Dr. Margaret Chan, WHO Director-General: here

More info re NCDs and the UN High-level Meeting:
http://www.who.int/nmh/events/un_ncd_summit2011/en/index.html

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