ECOSOC Western Asia Ministerial Meeting Addressing noncommunicable diseases

ECOSOC Western Asia Ministerial Meeting “Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21 st century” Multistakeholder approaches to meet the challenges of noncommunicable diseases and injuries l Dr Fiona Adshead l Director, Chronic Diseases and Health Promotion l World Health Organization 10 -11 May 2009 Doha, Qatar

Multistakeholder NCD prevention: a whole of society approach l Cross-sectoral, whole-of-society action involves: – Government leadership, – Empowering people to make healthy choices by building health literacy and capacity across society, – Collaborative work: government, industry and civil society, – Creation of enabling environments that promote health, – Measuring outcomes and ensuring it works. 2| ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries:

GOVERNMENT leadership Government – civil society – private sector – media ENABLING ENVIRONMENT HEALTH LITERACY Empowerment BEHAVIOUR CHANGE 3| Access to information, knowledge reinforcement, and opportunity to act HEALTH OUTCOME ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries: Feedback and policy change MULTISTAKEHOLDER, CROSS-SECTORAL APPROACH

Building multistakeholder approach to NCD prevention into our daily lives Within a programme Healthy schools Within a campaign Salt reduction Across a campaign 4| ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries: Physical activity

Within a programme – Healthy Schools 5| ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries:

Within a Campaign – Salt Reduction Blood Pressure Association British Heart Foundation Consensus Action on Salt and Health Diabetes UK Food Commission Manchester Food Futures Partnership Men's Health Forum National Children's Bureau (NCB) Net mums National Federation of Women's Institutes (NFWI) Trading Standards Institute (TSI) 6| Food Standards Agency (FSA) Nongovernmental Organizations Retailers Asda, Marks and Spencer, Sainsbury's, Tesco, Morrisons, Waitrose, Iceland, Co-op, Somerfield, Budgens and Spar Manufacturers Mc. Cain, Heinz, Bernard Matthews, Premier Foods, Cadbury Schweppes, Kraft, Kellogs, Pepsico, Procter & Gamble, Northern Foods, Nestlé, United Biscuits and Unilever ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries: Trade Associations Association of Cereal Food Manufacturers (ACFM), and the Snacks, Nuts and Crisps Manufacturers Association

Across a Campaign – Ciclovia program development, continuity and effectiveness 7| ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries:

Health In All Policies: common action for shared benefits l By taking a Health In All Policies approach, a government can ensure: – NCD risk factors and determinants are addressed by policymakers and stakeholders in non-health sectors, – Costs and benefits can be shared across all sectors, – Co-benefits can be achieved among sectors that otherwise might not have worked together: • Example: common action on climate change + NCD prevention and control. 8| ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries:

Choosing healthy paths to a low carbon future Buildings Transport Indoor air pollution Heat and cold protection Industry Occupational risks, mining and transport Air pollution Traffic injuries Physical inactivity Greenhouse Gas Emissions And NCD risk factors Agriculture Nutrition, Water / vector-borne disease 9| ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries: Energy supply & conversion Occupational risks; Construction and transport Waste Occupational, chemical

Transport and health Atlanta Bangkok Houston Riyadh Zurich Paris Singapore Hong Kong Beijing Cairo Kenworthy, 2003 10 | ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries:

Climate change, NCDs and achieving MDGs Indoor air pollution: l. Annually kills about 1. 5 million of the poorest women and children, l Significant contributor to climate change, l Interventions are costeffective both for health and climate, l Failure to incentivize "common cause"? 11 | ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries:

Co-producing and co-benefiting: chronic disease prevention and control Health Literacy Self care: Empowered Citizen Health Promotion The Self Care Circle Self care Patient and citizen involvement Chronic disease self-management © Harry Cayton 12 | ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries: • A great example of partnership between public and health service. • $100 spent on self care = $150 worth of benefits delivered in return. • A sense of control over one's destiny = PRICELESS.

Cross-sectoral approach: at the centre of public health and development l A cross-sectoral approach leads to an enabling environment for common action for shared benefits, l For the greatest benefits, NCDs, their risk factors and their determinants should be considered, l Examples show that it can work: – healthy schools, salt reduction, Cyclovia, self-care cycle, climate change, l The lessons learned can be applied to broader public health delivery including achievement of the MDGs. 13 | ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10 -11 May 2009 Addressing noncommunicable diseases and injuries: