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  Noncommunicable Diseases in the 2011 Global Public Health Agenda
  01 Ҿѹ 2554

Date: 1 Feb 2011

Noncommunicable diseases (NCDs) enjoy a place of prominence on the global public health agenda in 2011. At the 128th WHO EB, the assembly was abuzz with news of a joint Russian and WHO initiative, the "First global ministerial conference on healthy lifestyles and noncommunicable disease control [1]" to be held in Moscow on 28-29  April 2011 and the UN High-level Meeting of the General Assembly on Non-Communicable Diseases [2] in September 2011.

This invitation only ministerial conference is expected to attract 300 participants. The conference website lays out the following aim and goals:

The aim of the conference is to "support Member States develop and strengthen policies and programmes on healthy lifestyles and NCD prevention. These efforts are based on the Global strategy for the prevention and control of NCDs and its action plan, which include multisectoral and innovative approaches in prevention and care.

The conference has three main goals:
* to highlight the magnitude and socio-economic impact of NCDs;
* to review international experience on NCD prevention and control; and
* to provide evidence on the pressing need to strengthen global and national initiatives to prevent NCDs".

The Moscow ministerial is predicated upon the WHO Global Strategy for the Prevention and Control of Noncommunicable Diseases [3] endorsed at WHA 53 in May 2000 and the Action Plan passed at WHA 61 in May 2008.

The Moscow ministerial will also serve as an incubator for the WHO to test out its multi-stakeholder concept that will be deployed at the Global Health Forum in 2012. Although the details of the Global Health Forum are still nebulous, certain informed observers have noted the Forum is a response of the WHO secretariat to the "Committee C [4]" concept proposed in 2008 in the Lancet by Gaudenz Silberschmidt  (Switzerland), Don Matheson (University of Otago),and Ilona Kickbusch (Graduate Institute of International and Development Studies). As WHO is reeling from an expected shortfall of $200 million to $600 million in the 2010-2011 budget, it is seeking creative ways of leveraging unearmarked voluntary contributions from donor governments, foundations and the private sector. Whether the Global Health Forum can bridge this gap or be subject to "Trojan multilateralism" (Devi Sridhar, Oxford Global Health Governance) remains to be seen.

The High-level Meeting of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases [1] at the UN General Assembly in New York from 19-20 September 2011 is the landmark NCD event of 2011. According to the UN website,

"General Assembly Resolution A/RES/64/265, adopted on 13 May 2010, calls for a High-level Meeting of the General Assembly on Non-Communicable Diseases with the participation of Heads of State and Government in September 2011. This resolution was tabled by Trinidad and Tobago on behalf of the Caribbean Community (CARICOM) and was sponsored by over 100 countries. It is foreseen that the consultations on the scope, modalities, format and organization of this High-level meeting should preferably be concluded before the end of 2010.

The resolution calls upon Member States to include in their discussions at the High-level Plenary Meeting on the Millennium Development Goals the rising incidence and the socioeconomic impact of the high prevalence of non-communicable diseases worldwide.

The Secretary-General is requested to submit during the sixty-fifth session of the General Assembly a report on the global status of non-communicable diseases, with a particular focus on the developmental challenges faced by developing countries."

The draft scope, modalities, format and organization resolution submitted by the President of the UN General Assembly can be found here [5].

Here are some key elements from the draft modalities resolution: "Formal plenary meetings on 19 September, chaired by the President of the General Assembly and featuring opening statements by the President  of the General Assembly, the Secretary-General, the Director-General of the World Health Organization and a representative of civil society who will be chosen from non-governmental organizations with consultative status with the Economic and Social Council and in consultation with Member States; and a closing plenary meeting on 20 September, comprising the presentation of summaries of the round tables and the adoption of a concise action-oriented outcome document;

Encourages Member States to consider, as appropriate and where relevant, including in their national delegations to the high-level meeting parliamentarians, representatives of civil society, including  non-governmental organizations, academia and networks working on the control and prevention of non-communicable diseases;

Also decides that the report of the Secretary-General, in collaboration with Member States, the World Health Organization and the relevant funds, programmes and specialized agencies of the United Nations system, on the global status of non-communicable diseases, with a particular focus on the developmental challenges faced by developing countries, requested by the Assembly in its resolution 64/265, shall be submitted no later than May 2011 and shall serve as an input to the preparatory process for the high-level meeting;

Requests the President of the General Assembly to organize, no later than June 2011 and in consultation with representatives of non-governmental organizations in consultative status with the Economic and Social Council, civil society organizations, the private sector and academia, an informal interactive hearing with non-governmental organizations, civil society organizations, the private sector and academia to provide an input to the preparatory process for the high-level meeting;

Invites United Nations funds and programmes, the specialized agencies, in particular the World Health Organization, regional commissions, the Bretton Woods institutions, the World Trade Organization, the regional development banks, the United Nations Conference on Trade and Development and intergovernmental organizations and entities having observer status in the General Assembly to participate in the preparatory activities and in the high-level meeting, in accordance  with the rules of procedure as established by the Assembly;

Decides that the President of the General Assembly shall consult with representatives of non-governmental organizations in consultative status with the Economic and Social Council, civil society organizations, the private sector and academia, and with Member States, as appropriate, on the list of representatives of non-
governmental organizations, civil society organizations, the private sector and academia, taking into account to the extent possible the principle of equitable geographic representation, and to submit the list to Member States for consideration and for a final decision by the Assembly on participation in the high-level meeting, including round tables."In the context of the Moscow and New York summits, Barbados, New Zealand, Norway, Russian Federation and Trinidad and Tobago tabled a draft resolution on "Prevention and control of noncommunicable diseases" (EB/128/Conf. Paper No. 10 Rev.1) [6] with the sub-heading of "WHO`s role in the preparation, implementation and follow-up to the high-level meeting of the United Nations General Assembly on the prevention and control of noncommunicable diseases". Bangladesh introduced language on accessibility on pricing which was added to the revised text. Here below are Bangladesh`s additions in bold.

PP10bis Underscoring the need to ensure access to affordable diagnostic tools and medical products including medicines and other equipment for the diagnosis and treatment of people suffering from 
noncommunicable diseases [Bangladesh];OP1(2) bis to develop and implement legal and policy tools, as 
appropriate, to ensure access to  affordable care and treatment by ensuring availability of necessary diagnostic tools and medical products including medicines and other equipment for the diagnosis and 
treatment of noncommunicable diseases [Bangladesh];2. REQUESTS the Director-General

(2) bis to prepare a publicly available database containing information on various diagnostic tools and medical products including medicines and equipment for the diagnosis and treatment of noncommunicable diseases [Bangladesh];


OP2(3) bis to conduct a survey among WHO Member sates regarding the availability and cost of diagnosis and treatment of noncommunicable diseases, especially cardiovascular diseases, cancers, chronic respiratory diseases and diabetes [Bangladesh];

(7) to review WHO?s current capacity at all levels vis-?-vis Member States` needs for technical assistance and normative advice concerning the prevention, control and management of noncommunicable diseases, in 
the context of health system strengthening and making available access to affordable diagnosis and treatment of noncommunicable diseases  [Bangladesh]; During the 128th EB, the EU reportedly used procedural concerns  regarding the timing of the Bangladesh text on affordability and pricing of diagnostics and medicines for NCDs to block a consensus approval of the resolution. It is expected that this draft resolution, with the Bangladesh amendments will be considered by the 64th World Health Assembly in May 2011.

Source URL:
[4] Committee C The Lancet 3 May 08.pdf