1

Progress on implementing the UN Political Declaration on

Noncommunicable Diseases

63rd Session of the WHO Regional Committee for the

Eastern Mediterranean36 October 2016

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• Global and regional commitments Commitments

• Reporting on regional and national progress

How we measure progress

• How are we doing?Country response

• Obstacles and the way forwardChallenges and conclusions

Overview

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2011

• UN Political Declaration on Prevention and Control Noncommunicable Diseases

2014

• UN Comprehensive Review on Noncommunicable Diseases and Outcome Document

2018

• Third High-level Meeting of the UN General Assembly on Prevention and Control of Noncommunicable Diseases

2025 & 2030

• Attainment of 9 global targets on noncommunicable diseases and achievement of the related SDGs

Background: The global chronology 20112030

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Indicators which will be used to report country data to UN General Assembly in 2017

“The 4 time-bound commitments”By 2015: Set national noncommunicable disease targets for 2025 and monitor results

By 2015: Develop a national multisectoral action plan

By 2016: Implement the "best buy" interventions to reduce risk factors

By 2016: Implement the "best buy" interventions to strengthen health systems to address noncommunicable diseases

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WHO 10 progress monitoring indicators

2

4

Mortality data

Risk factor surveys

National integrated strategy/action plan

5 Tobacco demand-reduction measure

National targets and indicators 9

101

3

67

8

Harmful use of alcohol reduction measures

Unhealthy diet reduction measures

Public awareness on diet/physical activity

Guidelines on management

Drug therapy/counselling for high-risk persons

6

2

4

1

3

Regional progress: Multisectoral plans and targets

Have developed an operational national multisectoral pol-icy/action plan

Have implemented a STEPS survey or a comprehensive health examination survey within last 5 years

Have satisfactory functioning system for generating reliable cause-specific mortality data on a routine basis

Have set time bound national targets and indicators based on WHO guidance

0 1 2 3 4 5 6 7 8 9 10

9

8

5

6

Regional progress: Plans, targets and surveillance

Number of countries in the Region (out of 22)

Source: Regional noncommunicable disease country capacity survey, 2015

7

5

Regional progress: Prevention and reduction of risk factors

R: achieved highest measure in “Raise taxes (Article 6)”

E: achieved highest measure in “Enforce bans on tobacco advertising, promotion and sponsorship (Article 13)”

W: achieved highest measure in “Warn about the dangers of tobacco (Article 11)”

P: achieved highest measure in “Protect people from tobacco smoke (Article 8)”

0 1 2 3 4 5 6 7

2

6

3

6

Progress on tobacco demand reduction “MPOWER” measures

Number of countries in the Region (out of 22)Source: Regional noncommunicable disease country capacity survey, 2015

8

Regional progress: Prevention and reduction of risk factors (2)

6

Pricing policies such as excise tax increases on alcoholic beverages

Comprehensive restrictions or bans on alcohol advertising and promotions

Regulations over commercial and public availability of alcohol

0 2 4 6 8 10 12 14 16

12

15

13

Measures to reduce harmful use of alcohol

Number of countries in the Region (out of 22)Source: Regional noncommunicable disease country capacity survey, 2015

9

7

8 Has implemented at least one recent national public awareness programme on diet and/or physical activity

Applied restrictions to markerting of foods and non-alcoholic beverages to children

Applied legislation /regulations fully implementing the International Code of Marketing of Breast-milk Substitutes

Adopted national policies that limit saturated fatty acids and virtually eliminate industrially produced trans fatty acids in the food supply

Adopted national policies to reduce population salt/sodium consumption

0 2 4 6 8 10 12 14

11

12

12

7

6

Regional progress: diet and physical activity

Number of countries in the Region (out of 22)Source: Regional noncommunicable disease country capacity survey, 2015

Regional progress: Prevention and reduction of risk factors (3)

10

Regional progress: Health care

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10 Provision of drug therapy, including glycaemic control, and counselling for eligible persons at high risk to prevent heart attacks and strokes, with emphasis on the primary care level

Evidence-based national guidelines/protocols/standards for the management of major NCDs through PHC approach, recognized/approved by government or competent authorities

0 1 2 3 4 5 6 7 8 9 10

8

9

Measures on health care – Clinical guidelines and drug therapy

Number of countries in the Region (out of 22)

Source: Regional noncommunicable disease country capacity survey, 2015

11

Summary: Number of fully achieved progress indicators

11 - 17 6 - 10 3 - 5 0 - 20

1

2

3

4

5

6

7

8

9

10National responses and progress: Eastern Mediterranean snapshot

Number of fully achieved indicator counts (out of 17 sub-indica-tors)

Num

ber o

f cou

ntrie

s (o

ut o

f 22)

Source: Regional noncommunicable disease country capacity survey, 2015

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ChallengesPolitical instability through complex and ongoing political conflicts associated with economic constraints hindering country progress

Growing influence of tobacco industry on public health policy

Lack of legal frameworks to support/enforce surveillance systems

Paucity of data to measure and monitor targets and indicators accompanied by difficulty in retaining qualified human resources

Difficulty in integrating prevention and control of noncommunicable diseases in primary health care, especially in emergencies

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ConclusionsOverall, high-level political commitment to noncommunicable disease governance manifested in the regional framework for action

Clear roadmap, but progress is still inadequate, patchy and uneven

Progress differs from country to country and within the same country

Country efforts are critical for success in all four areas: governance, risk factor prevention and reduction, surveillance and health care

Further involvement of multisectoral stakeholders (including non-state actors) is needed to accelerate progress

Thank you

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