NCD Update: Policies and Programs for the

Prevention and Control of NCDs

Jeffrey MeerSpecial Advisor for Global Health

CORE Group

April 23, 2013Baltimore, MD

What are NCDs?

• Cardiovascular Disease

• Cancers

• Diabetes

• Chronic Obstructive Pulmonary Disease

• [Mental Health]

Context

• NCDs are responsible for 63 percent of all deaths globally.

• NCD deaths are projected to increase by 15% globally between 2010 and 2020

Causes of Death in Rural Bangladesh

Links Between NCDs and MCH

• Cervical cancer and HPV• Breast cancer• Gestational and Type-I diabetes

Burden of Disease 2004 - 2030

Courtesy: WHO

Common Risk Factors

• Smoking Tobacco

• Inappropriate use of alcohol

• Inadequate exercise

• Poor nutrition

The NCD Pyramid

Courtesy: WHO

What Else Affects NCDs?

• Genetics

• Environment

• Lifestyles

Myths about NCDs

• Less common than infectious diseases (HIV, TB, malaria, diarrhea)

• Unrelated to infectious diseases

• Only for the rich and aged• Too expensive and

complex to treat• Take $ and focus away

from infectious diseases

Development Implications

• Premature death

• Disability

• Loss of productivity

• Cost of treatment and care

• Less opportunity for education

Resources?

Less than 3 percent of all international development assistance for health ($21 billion annually) goes to NCD prevention

or treatment

NCD Prevention and Treatment Matter!

US death rates from several diseases 1900-1996

Courtesy: Richard Cooper, MD

United Nations High Level Meeting on NCDs

September 19-20, 2011 New York, NY

The UN Political Declaration on NCDs

• Description and scope of the issue• Whole of government, whole of society• Reducing risk factors• Strengthening national policies and health

systems• International cooperation and partnerships• Research, M&E, follow up

Political Declaration (continued)

• Prevention is the key• Social determinants and

poverty• Doha/TRIPS• Engaging the private

sector (except tobacco)• Women• Children and adolescents• Reproductive health• Climate Change

NCD Child -- March 19-20, 2012

World Health Assembly May 2012

• First global agreement on an NCD target

• 25 percent reduction in mortality from NCDs by 2025

• Continuing process for additional targets

• Member states meeting prior to “end of October 2012”

WHO Ad Hoc Meeting November 2012

• Reaffirmation of “25 x 25”

• Eight additional goals

• 25 new targets

Who’s in Charge for the USA?

• Health and Human Services• USAID• State Department• US Mission to the United Nations• Centers for Disease Control and

Prevention

Now Under Discussion by UN and WHO

• Draft Action Plan on NCDs

• Multisectoral engagement for NCDs

• NCDs in the “Sustainable Development Goals” post-2015

Thank You!

• www.ncdroundtable.org• www.ncdchild.org• www.ncdalliance.org