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Outcomes of UN Summit on NCDs

Outcomes of the UN Summit or UN High-level Meeting (HLM) on Non-communicable diseases (NCDs)

As a product of the pre-HLM meetings and discussions that occurred during the HLM itself, the UN Political Declaration on the Prevention and Control of Non-communicable Diseases was agreed upon by world leaders on 19 September 2011.  While not binding under international law, a Political Declaration is considered to be one of the most powerful tools within the UN for international cooperation and action.  This is a significant milestone that has raised the level of awareness of CVD and NCDs to unprecedented levels.  

More detail on the Declaration is available under the following categories:

For the cardiovascular disease community, the declaration puts a clear emphasis on prevention through a health in all policies and life course approach to health. This means the promotion of healthy diets and physical activity through urban and development planning that reaches across sectors and includes transportation, agriculture, finance, trade and education. Although no specific targets were made at the HLM, governments have acknowledged the need to reduce salt in the food industry and to reduce sugar, saturated fats, and eliminate industrially produced trans-fats in foods. There is a strong focus on reducing childhood obesity, and governments have committed to implementing WHO recommendations to restrict the marketing to children of foods high in fats, sugar and salt.

Integration with other programs:
The Declaration effectively positions heart disease and NCDs as a maternal and newborn child health issue and acknowledges the specific vulnerabilities of women and children. It identifies the link between prenatal malnutrition and that child’s predisposition to high blood pressure and heart disease later in life. This encourages a life course approach to NCDs and the inclusion of NCDs in reproductive, maternal and newborn child health programs.  Also noted within the Declaration are the possible linkages between NCDs and communicable diseases.  It calls for responses to HIV/AIDs and NCDs to integrate where appropriate.

In addition to calling for greater priority for early detection and the integration of HIV/AIDs and NCD responses, the Declaration acknowledges the need to promote the production, training and retention of skilled health workers.  It also recognizes the need to improve diagnostic services by increasing capacity of laboratory services and collaborating with the private sector to improve the affordability, accessibility and maintenance of diagnostic equipment and technologies. The Declaration also highlights the role governments need to play in increasing access to affordable, safe, effective and quality-assured medicines and technologies. Included in this is specific language on the use of generics and patent licensing flexibilities to improve access, availability and affordability. 

Health Systems:
The Declaration recognizes the importance of a well-functioning health system to deliver care to people with NCDs. Significantly, it recognizes the importance of universal coverage in national health systems, particularly through primary healthcare and social protection mechanisms. This use of the term ‘universal’ is important. Many governments are still abusing the rights of those with NCDs by not providing access to care to everyone that needs it. 

National NCD Plans:
One of the few targets in the Declaration commits governments to establish or strengthen multisectoral national policies and plans on NCDs by 2013. Within these national plans, there is an opportunity to ensure that specific CVD targets are included. Encouraging governments to commit to specific CVD targets within a broader NCD framework, will encourage other countries to do the same. 

Goals and Targets:

An overarching goal of reducing NCD mortality and a set of time-bound targets was not included in  the actual Declaration.  However, at the 65th World Health Assembly in May 2012, WHO Member States endorsed a target to reduce premature deaths due to NCDs by 25% by 2025.  As demonstrated a decade ago by the HIV/AIDS Political Declaration of 2001, bold goals and targets inspire and sustain political leadership, ensure action beyond the health sector, and create a global political action plan for Member States, civil society and people with NCDs to unite around and measure progress against. 

While the Declaration recognizes that resources devoted to dealing with NCDs are not commensurate with the magnitude of the problem, it falls short of any concrete commitments and only requests Member States to investigate options for potential sources of funding. For low- and middle-income countries (LMCs) overwhelmed by the burden of both communicable and non-communicable diseases, the Declaration acknowledges the importance of international cooperation and assistance in NCD prevention and control. It encourages the inclusion of NCDs in development cooperation agendas and initiatives and urges international organizations to provide technical assistance and capacity building for NCDs to developing countries. The Declaration also encourages the quality of development aid to be enhanced through harmonization and alignment with recipient country national priorities.

NCD Partnership:
The Declaration recognizes the importance of multisectoral action throughout, but governments failed to commit to a high-level NCD partnership initiative that involves UN agencies, governments, and civil society to coordinate and drive follow-up action. Instead they are requesting the UN Secretary-General to present them with recommendations in the 4th quarter of 2012 outlining options for such a UN partnership. It is critical that NGOs be involved in this process.

Download the UN Political Declaration on NCDs