Oleg Chestnov

Costs, Benefits, and Effectiveness of Interventions for the Prevention, Treatment, and Control of Cardiovascular Diseases and Diabetes in Africa

If a combination of cost-effective health-care interventions and population-wide prevention interventions is implemented in a sustainable manner, a significant impact can be made on the cardiovascular disease and diabetes burden. Given the limited resources, weak health systems and competing health issues in Africa, the focus should be on interventions prioritized on the basis not only of cost effectiveness but also of affordability, feasibility and high impact. The Global Action Plan for prevention and control of noncommunicable diseases 2013-2020 identifies such a core set. Financing the effective delivery of this core set as part of the basic health care package through a strengthened health system is a pragmatic approach to address cardiovascular disease and diabetes in Africa. Cost of implementation of this core set of interventions represents an annual investment of under US

Policy reform to realize the commitments of the Political Declaration on noncommunicable diseases

1 in low income countries, US

Towards the world we want

1.50 in lower middle income countries and US

Addressing the Global Burden of Noncommunicable Diseases; Challenges of Achieving Global Targets

3 in upper middle income countries.

Emerging Issues in Adolescent Health and the Positions and Priorities of the World Health Organization

BACKGROUND Noncommunicable diseases (NCDs) caused an estimated 36 million deaths in 2008. Recognizing that NCDs are a global health and development priority, Heads of State and government adopted the Political Declaration on NCDs (resolution A/RES/66/2) at the United Nations General Assembly in September 2011. SOURCES OF DATA The Political Declaration of the United Nations High Level meeting on NCDs, World Health Organization (WHO) reports on NCDs and WHO Country Cooperation Strategy documents. AREAS OF AGREEMENT NCDs are a growing threat to health and development. Cost of action and inaction are known. AREAS OF CONTROVERSY Accountability of all stakeholders including the private sector is essential for an effective global public health response. More clarity is needed on the private sector contribution to the response to safeguard public health from any potential conflict of interest. GROWING POINTS A country-led public health policy response should include, at a minimum, national scale-up of very cost-effective, high impact NCD interventions to improve health outcomes and health equity with universal coverage as a long-term public health goal. AREAS TIMELY FOR DEVELOPING RESEARCH Policy reform and accelerated national scale-up action, particularly in low-and-middle-income countries, must be guided by translation research and feedback information from monitoring and evaluation.

Addressing NCDs: A unifying agenda for sustainable development

Globalization offers great opportunities, but its benefits are at present very unevenly shared. Inequity in health at the population level is affected by global changes in marketing and trade, rapid urbanization and population ageing. The social, economic and physical environments in low- and middle-income countries often afford their populations much lower levels of protection from the risks and consequences of noncommunicable diseases (NCDs).1 Such factors contribute to the 12 million premature deaths and estimated economic losses of US

Liberating data: the WHO response

500 billion from NCDs that occur in these countries every year. However, lives and resources can be saved by investing in better prevention, control and treatment measures.2 In 2011, the World Health Organization (WHO) was assigned a leadership and coordination role in supporting national efforts to address noncommunicable diseases by the Political Declaration of the high-level meeting of the General Assembly on the prevention and control of non-communicable diseases.3 Three years later, there is a global road map in place based on nine concrete global targets for 2025, organized around the WHO Global action plan for the prevention and control of NCDs 2013–2020. The global action plan, when implemented collectively by Member States, international partners and WHO, will help to attain a global target of a 25% reduction in premature deaths from NCDs by 2025.4 The United Nations Interagency Task Force on NCDs, which the United Nations Secretary-General established in July 2013 and placed under the leadership of WHO, has started to provide support to national efforts to build solutions to address NCDs. The WHO Global Coordination Mechanism on NCDs, established in May 2014, will facilitate contributions from non-State actors. Progress within countries matters most. Some striking achievements emerge from a survey conducted by WHO in 2013. Of the 172 countries reporting data, 95% have a unit or department in the Ministry of Health responsible for NCDs. Half now have an integrated operational plan with a dedicated budget. The number of countries conducting recent surveys of risk factors jumped from 30% in 2011 to 63% in 2013. In other words, more countries are getting the basics in place. However, in July 2014 at the United Nations General Assembly ministers from across the world found that overall progress is insufficient and highly uneven. The United Nations review saw no lack of commitment, but witnessed a lack of capacity to act, especially in low- and middle-income countries, due to a lack of access to expertise which is only available through international cooperation. To move forward, the outcome document adopted by the United Nations review presents a highly focused agenda for strengthening international cooperation. The outcome document also contains next priorities in clear steps that will guide action until 2018, when the United Nations General Assembly will convene a third high-level meeting on NCDs. These include five commitments from Member States;5 setting national NCD targets for 2025, developing national multisectoral plans and implementing the WHO Global action plan for the prevention and control of NCDs 2013–2020 to reduce risk factors and strengthen health systems. WHO has three major assignments; the first is to prepare a framework for country action aimed at supporting national efforts to improve health through action across sectors on risk factors for NCDs. The second is to develop an approach to register and publish contributions of non-State actors to the achievement of the nine global targets and the third is to submit a progress report to the United Nations General Assembly. The Organisation for Economic Co-operation and Development has been tasked with developing a code to track official development assistance for NCDs. In July 2014, ministers in New York also agreed to give due consideration to addressing NCDs in the elaboration of the post-2015 development agenda, taking into account that NCDs constitute one of the major challenges for development in the twenty first century.6 A proposed target to reduce premature mortality from NCDs by one third by 2030 will be considered by Member States in September 2014 at the United Nations General Assembly. This milestone will provide critical guidance to the September 2015 United Nations Summit, which will adopt the post-2015 agenda. The discussions in July 2014 provided a timely opportunity for rallying political support for bolder measures in the post-2015 era. To build a future in which globalization becomes a positive force for all the world’s peoples, political commitment is needed. Only with such commitment can WHO orchestrate the broad collaboration required to make progress.

A plea for a global communication platform for paediatric cancer networks

Noncommunicable diseases (NCD) caused an estimated 36 million deaths in 2008. Recognizing that NCD are a global health and development priority, Heads of State and Government adopted the Political Declaration on NCD at the United Nations General Assembly in September 2011. The six objectives focus on international cooperation and advocacy, country led multisectoral response, risk factors and determinants, health systems and universal health coverage, research development and innovation and surveillance and monitoring. The overall aim of the action plan is to operationalize the commitments of the UN Political Declaration on Noncommunicable Diseases, building on what has already been initiated and achieved.

The Global Burden of Cardiovascular Diseases: A Challenge to Improve

There has been increased attention to adolescent health during the past few years. We now have a much better understanding of the causes of mortality and morbidity during adolescence, and why it is important to focus on this period of the life course: for adolescents themselves, but also for public health in general. This Special Supplement is timely, as it brings together researchers working in the fields of neuroanatomy, neurobiology, and epigenetics, with those responsible for policies and programmes. The focus of the Supplement is on low- and middle-income countries, where most adolescents live.

Rallying United Nations organizations in the fight against noncommunicable diseases

ABSTRACT Despite the mounting evidence that they impede social and economic development, increase inequalities, and perpetuate poverty, Noncommunicable diseases (NCDs) remain largely absent from the agendas of major development assistance initiatives. In addition, fundamental changes are developing in patterns of development assistance for health, and more of the burden for fighting NCDs is being placed on domestic budgets, thus increasing pressure on the most vulnerable countries. The paper argues, however, that a new day is coming. With the inclusion of NCDs and related targets in the 2030 Agenda for Sustainable Development, there is an unprecedented opportunity to explore linkages among the sustainable development goals, enhance policy coherence and advance the NCD agenda as part of sustainable development. International development partners (bilateral and multilateral) can help in this important effort to address NCDs and their shared risk factors by providing catalytic support to countries that are particularly vulnerable in terms of the disease burden but lack the resources (human, financial) and institutional arrangements to meet their commitments at national, regional, and global levels.