WHO Technical Briefing Seminar on Essential Medicines Health

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) 35 M Premature Deaths 9 M Total NCD deaths 36 M 30 M 25 M 20 M 15 M 10 M 5 M 0 M Low-income Countries Lower. Middle-income Countries Communicable conditions Upper. Middle-income Countries NCDs < 60 NCDs > 60 High-income Countries Injuries

Global Mile stones : Prevention and Control of NCDs 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 Global Strategy to Reduce the Harmful Use of Alcohol 2009 2010 WHO Global Status Report on NCDs 2011 Political Declaration on NCDs 2013 2020 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

WHO Global NCD Action Plan 2013 -2020 –objectives Objective 1: Objective 2: Objective 3: Objective 4: Objective 5: Objective 6: To strengthen international cooperation and advocacy to raise the priority accorded to prevention and control of NCDs in the development agenda and in internationall y-agreed development goals To strengthen national capacity, leadership, governance, multisectoral action and partnerships to accelerate country response for prevention and control of NCDs To reduce exposure to modifiable risk factors for NCDs through creation of healthpromoting environments To strengthen and reorient health systems to address prevention and control of NCDs through peoplecentered primary health care and universal coverage To promote and support national capacity for high quality research and development for prevention and control of NCDs To monitor trends and determinants of NCDs and evaluate progress in their prevention and control

Immediate actions for Member States in 2013 -2014 Action Area 1. Set national targets for 2025 in 2013, taking into account the 9 global targets Governance Risk factors Health systems Surveillance ﻟﻨﺘﺤﺪ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻤﺮﺍﺽ ﻏﻴﺮ ﺍﻟﺴﺎﺭﻳﺔ

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 ﻟﻨﺘﺤﺪ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻤﺮﺍﺽ ﻏﻴﺮ ﺍﻟﺴﺎﺭﻳﺔ

Immediate actions for Member States in 2013 -2014 Action Area Governance Risk factors Health systems Surveillance 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 ﻟﻨﺘﺤﺪ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻤﺮﺍﺽ ﻏﻴﺮ ﺍﻟﺴﺎﺭﻳﺔ

Immediate actions for Member States in 2013 -2014 Action Area Governance Risk factors Health systems 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 Surveillance ﻟﻨﺘﺤﺪ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻤﺮﺍﺽ ﻏﻴﺮ ﺍﻟﺴﺎﺭﻳﺔ

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

Immediate actions for Member States in 2013 -2014 Action Area Governance Risk factors Health systems Surveillance 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 ﻟﻨﺘﺤﺪ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻤﺮﺍﺽ ﻏﻴﺮ ﺍﻟﺴﺎﺭﻳﺔ

Immediate actions for Member States in 2013 -2014 Action Area Governance Risk factors 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 Health systems Surveillance ﻟﻨﺘﺤﺪ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻤﺮﺍﺽ ﻏﻴﺮ ﺍﻟﺴﺎﺭﻳﺔ

Immediate actions for Member States in 2013 -2014 Action Area Governance Risk factors Health systems 2. Implement other very costeffective and affordable interventions identified in Appendix 3 of the Global Action Plan using WHO tools Surveillance ﻟﻨﺘﺤﺪ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻤﺮﺍﺽ ﻏﻴﺮ ﺍﻟﺴﺎﺭﻳﺔ

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

Immediate actions for Member States in 2013 -2014 Action Area Governance Risk factors 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 Health systems Surveillance ﻟﻨﺘﺤﺪ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻤﺮﺍﺽ ﻏﻴﺮ ﺍﻟﺴﺎﺭﻳﺔ

Immediate actions for Member States in 2013 -2014 Action Area Governance 2. Develop national targets and indicators, based on the WHO recommendations and WHA Resolutions Risk factors Health systems Surveillance 2015 WHA 68 2020 WHA 73 ﻟﻨﺘﺤﺪ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻤﺮﺍﺽ ﻏﻴﺮ ﺍﻟﺴﺎﺭﻳﺔ 2025 WHA 78

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) for dis cussion on 11 -12 Nove mber 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 ﻟﻨﺘﺤﺪ ﻓﻲ ﻣﻜﺎﻓﺤﺔ ﺍﻷﻤﺮﺍﺽ ﻏﻴﺮ ﺍﻟﺴﺎﺭﻳﺔ

Thank you