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12 15 March 2019Saitama, Japan

Meeting Report

SIXTH REGIONAL WORKSHOP ON LEADERSHIP AND ADVOCACY

FOR THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES (LEAD NCD)

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WORLD HEALTH ORGANIZATION

REGIONAL OFFICE FOR THE WESTERN PACIFIC

RS/2019/GE/05(JPN) English only

MEETING REPORT

SIXTH REGIONAL WORKSHOP ON LEADERSHIP AND ADVOCACY

FOR THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES

(LEAD-NCD)

Convened by:

WORLD HEALTH ORGANIZATION

REGIONAL OFFICE FOR THE WESTERN PACIFIC

NATIONAL INSTITUTE OF PUBLIC HEALTH, JAPAN

Saitama, Japan

12-15 March 2019

Not for sale

Printed and distributed by:

World Health Organization

Regional Office for the Western Pacific

Manila, Philippines

May 2019

NOTE

The views expressed in this report are those of the participants in the Sixth Regional Workshop

on Leadership and Advocacy for the Prevention and Control of Noncommunicable Diseases

(LeAd-NCD) and do not necessarily reflect the policies of the Organization.

This report has been prepared for the World Health Organization Regional Office for the

Western Pacific for the use of governments from Member States in the Region and for those who

participated in the Sixth Regional Workshop on Leadership and Advocacy for the Prevention and

Control of Noncommunicable Diseases (LeAd-NCD) in Saitama, Japan from 12 to 15 March

2019.

CONTENTS

SUMMARY ................................................................................................................................... 1

1. INTRODUCTION ..................................................................................................................... 3

1.1 Background ..................................................................................................................... 3

1.2 Objectives ........................................................................................................................ 3

1.3 Participants ...................................................................................................................... 4

1.4 Organization .................................................................................................................... 4

2. PROCEEDINGS ....................................................................................................................... 4

2.1 Opening session, Part 1 ................................................................................................... 4

2.2 Overview of NCDs and law ............................................................................................ 5

2.3 Country experiences in legislating for NCD prevention and control .............................. 6

2.4 Reinforcing legal frameworks for NCDs ........................................................................ 6

2.5 How can I improve the current approach to legislating for NCDs? ................................ 7

2.6 Advancing legislation for NCDs ..................................................................................... 8

2.7 Local governance for health promotion in Wako city ..................................................... 8

2.8 Who are my critical stakeholders in legislating for NCDs? ............................................ 8

2.9 Closing session, Part 1 .................................................................................................... 8

2.10 Opening ceremony, Part 2 ............................................................................................... 9

2.11 Overview of LeAd-NCD ................................................................................................. 9

2.12 Country reflections on LeAd NCD ............................................................................... 10

2.13 Moving forward: Recommendations on next steps for LeAd-NCD ............................. 11

3. CONCLUSIONS AND RECOMMENDATIONS ................................................................ 11

3.1 Conclusion .................................................................................................................... 11

3.2 Recommendations ......................................................................................................... 11

3.2.1 Recommendations for Member States ......................................................................... 11

3.2.2 Recommendations for WHO ........................................................................................ 12

ANNEXES .................................................................................................................................... 13

ANNEXES:

Annex 1. List of participants, temporary advisers, resource persons and Secretariat

Annex 2. Programme of activities

Annex 3. Participant’s workbook

Annex 4. Country-specific actions for identified NCD legislative priorities

Annex 5. Workshop evaluation

Annex 6. Final outcome statement

Key words

Chronic disease - prevention and control / Noncommunicable diseases - prevention and

control / Health promotion / Regional health planning

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SUMMARY

Since 2005, the World Health Organization (WHO) Regional Office for the Western Pacific, with the

National Institute of Public Health (NIPH) in Japan, has developed a course to build and strengthen

capacity for noncommunicable disease (NCD) prevention and control. In 2012, due to increasing

demand to enhance the capacity of national institutes, WHO and experts, in collaboration with the

NIPH, developed an updated workshop for the prevention and control of NCDs called Leadership and

Advocacy for the Prevention and Control of NCDs (LeAd-NCD) based on the previous course.

The LeAd-NCD workshop was first launched in 2013. Each year, in line with emerging priorities, a

thematic area is selected for the workshop. This year, the sixth LeAd-NCD workshop focused on

strengthening legal frameworks for NCDs. A separate session was organized to review achievements

from the past five LeAd-NCD workshops and deliberate on future action for NCD leadership

capacity-building.

The Sixth LeAd-NCD Workshop was held at the NIPH in Saitama, Japan, from 12 to 15 March 2019.

Twenty-one participants represented nine countries during the workshop: Cambodia, Fiji, Japan,

Micronesia (Federated States of), Philippines, Republic of Korea, Solomon Islands, Tonga and Viet

Nam. Ten observers from Australia, Cambodia, China, Fiji, Japan and Thailand, two resource persons,

four temporary advisers, and six WHO staff also attended.

Leadership and advocacy are key elements in attaining progress in NCD prevention and control.

Didactic lectures and interactive discussions at this year’s workshop highlighted the fundamental role

of legislative interventions to reduce NCD risk, introduce and familiarize participants with existing

legislative resources and tools, share country experiences, and identify country-specific legislative

priorities to accelerate progress in countering the NCD epidemic.

Participants, including high-level officials from parliament and health ministries, reviewed the

accomplishments and impact of the previous workshops and drafted an Outcome Statement outlining

recommendations for future capacity-building efforts. They concluded that LeAd-NCD has proven

throughout the past six years to be an effective regional programme that has enhanced the knowledge,

skills, attitudes, commitment and leadership mindset for effective NCD prevention and control. It also

has empowered participants to pursue actions that resulted in organizational, community and/or

national progress in addressing NCDs.

Recommendations

Member States are encouraged to consider the following:

(1) Continue engagement with the LeAd-NCD programme and foster greater involvement of

representatives from other sectors.

(2) Examine the utility of adapting this type of capacity-building model for national and

subnational NCD capacity-enhancement activities and implement suitably adapted versions to

expand the NCD workforce within countries.

(3) Explore mechanisms to create a community of practice/learning community comprising

LeAd-NCD alumni, potentially through social media platforms.

(4) Share national success stories resulting from LeAd-NCD participation with WHO, and

document the contribution of this capacity-building initiative on progress against NCDs.

WHO is requested to consider the following:

(1) Continue collaborating with the NIPH in organizing LeAd-NCD workshops to sustain

regional capacity-building, with an emphasis on leadership to promote cost-effective,

evidence-based, integrated approaches to NCD prevention and control.

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(2) Align LeAd-NCD with objectives and strategies outlined in the WHO Global Action Plan for

the Prevention and Control of NCDs 2013–2020 and the Western Pacific Regional Action

Plan for the Prevention and Control of NCDs (2014–2020), and build on existing global and

regional initiatives, such as Healthy Settings, Healthy Cities and Healthy Islands.

(3) Explore how to utilize this type of regional mechanism to foster the development of a

systematic strategy to monitor and assess the progress of Member States in achieving the

goals and objectives of the global and regional NCD plans of action.

(4) Consider how to further improve the LeAd-NCD curricula, including by allotting more time

to interactive sessions.

(5) Create a higher-level NCD training course targeting senior-level officials and programme

officers, emphasizing leadership competencies to effectively meet the challenges in

accelerating NCD prevention and control and to attain the global voluntary NCD targets and

2030 Sustainable Development Goal targets.

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1. INTRODUCTION

1.1 Background

Beginning in 2005, the World Health Organization (WHO) Regional Office for the Western Pacific,

with the National Institute of Public Health in Japan (NIPH), conducted an annual capacity-building

course for the prevention and control of noncommunicable diseases (NCDs) among participants from

countries with a high burden of NCDs. In 2012, due to increasing demand to enhance the capacity of

national institutes, WHO and experts, in collaboration with the NIPH, developed an updated

workshop for the prevention and control of NCDs called Leadership and Advocacy for the Prevention

and Control of NCDs (LeAd-NCD) based on the previous course.

The new workshop curriculum was first launched in 2013 and aimed to equip participants with the

skills and capacity to become champions of NCD prevention and control in their countries. Each year,

in line with emerging priorities, a thematic area was selected for the workshop; the themes for

previous years included an overview of NCD prevention and control (2013), global coordination

mechanisms for NCDs (2014), workers’ health (2015), childhood obesity (2016), and physical

activity (2017). This year, the sixth workshop focused on strengthening legal frameworks for NCDs.

Several NCD “best buys”, or very cost-effective interventions, involve legislative measures. The

effective use of legal frameworks for health, comprising the instruments of law and the institutions

responsible for developing, implementing and evaluating the laws, requires strong leadership and

coordination of stakeholders across government, especially between ministries of health and

parliaments. Parliamentarians advance health by passing laws, approving budgets and mobilizing

resources, and maintaining oversight of implementation. Parliamentary staff play a critical facilitating

role throughout these processes.

The Asia-Pacific Parliamentarian Forum on Global Health, established in 2015 with support from the

WHO Regional Office for the Western Pacific, is a platform for parliamentarians to exchange ideas,

build political will, strengthen capacities and foster collaboration in driving sustainable action for

health. Ongoing support from the WHO Regional Office for the Forum provides opportunities for

ministries of health to engage in dialogue with parliamentarians. Four annual meetings have been

convened on: health security (Seoul, 2015), health in the Sustainable Development Goals (Seoul,

2016), NCDs and ageing (Tokyo, 2017), and financing and legislating for universal health coverage

(Manila, 2018).

The Sixth LeAd-NCD Workshop served as a platform to: (1) highlight NCD-related issues that have

been discussed at the four meetings of the Asia-Pacific Parliamentarian Forum on Global Health,

(2) identify NCD-related legislative priorities for participating countries, and (3) delineate the

multisectoral leadership roles required to ensure political commitments for these priorities are

translated into action.

1.2 Objectives

The objectives of the Sixth Regional Workshop on Leadership and Advocacy for the Prevention and

Control of Noncommunicable Diseases (LeAd-NCD) were:

1) to identify areas to facilitate ongoing cooperation between health ministries and parliaments

towards strengthening legal frameworks for NCDs;

2) to share experience and lessons learnt on strengthening legal frameworks for NCDs in

countries;

3) to develop skills and competencies in leadership and advocacy to strengthen legal frameworks

for NCDs; and

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4) with high-level health ministry officials, to review achievements made during the past five

LeAd-NCD workshops and discuss the future direction and support needed to strengthen

national leadership capacity for NCD prevention and control.

1.3 Participants

Three categories of participants were invited from each country: (1) one Ministry of Health (or

equivalent) officer overseeing NCD prevention and control and (2) one parliamentary staff involved

in health-related legislative activities. They were requested to attend the entire workshop. And (3) one

additional senior/high-level officer of the Ministry of Health was asked to attend the final meeting

sessions to determine the future of LeAd-NCD.

Twenty-one participants represented nine countries during the workshop: Cambodia, Fiji, Japan, the

Federated States of Micronesia, the Philippines, the Republic of Korea, Solomon Islands, Tonga, and

Viet Nam. Four temporary advisers from Japan, the Philippines and the United States of America, two

resource persons from Guam (United States of America) and Japan, nine observers and six WHO staff

from the Regional Office and the Cambodia country office also attended the workshop.

Temporary advisers, resource persons, staff members from the WHO Regional Office for the Western

Pacific and Cambodia country office, and the NIPH provided Secretariat support for the consultation.

A list of participants, temporary advisers, resource persons and Secretariat members is available in

Annex 1.

1.4 Organization

The workshop was comprised of eight sections during the workshop proper, and four sessions during

the high-level meeting. Workshop sections were designed to address strengthening legal frameworks

for NCD prevention and control. They included a mix of didactic presentations, interactive group

work, sharing of national and subnational progress, and a walking tour to experience local governance

for health promotion in Wako City. A full outline of the programme is provided in Annex 2.

A workbook was also developed to support the sessions and to guide the group work and skill-

building activities (Annex 3).

2. PROCEEDINGS

2.1 Opening session, Part 1

Dr Yasumasa Fukushima, President of the NIPH, Japan, welcomed the participants and presented a

brief review of the burden of NCDs in the Western Pacific Region and within Japan. NCDs are the

leading cause of death globally, and their prevalence and incidence are increasing, making prevention

an urgent task for countries. In Japan’s second term of Health Japan 21 (10-year plan 2013–2022),

prevention of NCDs is an extremely important target, and the plan’s focus is primary and secondary

prevention through healthy lifestyle promotion, decreasing tobacco use, and early detection and

treatment. Participants are requested to use the workshop as an opportunity to identify better solutions

to strengthen legislation for NCD prevention and control, by increasing leadership skills and

promoting multisectoral collaboration with relevant stakeholders.

Dr Toru Kajiwara, Director, Office of Global Health Cooperation, International Affairs Division,

Ministry of Health, Labour and Welfare, Japan highlighted NCDs as a global and regional

development challenge. NCD prevention and control are key to sustained economic progress. The

2018 United Nations General Assembly high-level meeting on NCDs reaffirmed the heightened

political commitment of heads of state to addressing this critical health and development threat. Japan

and other Member States in the Western Pacific Region are facing a rapidly ageing population; thus,

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NCD prevention and control need to be integrated with healthy ageing. The Healthy Japan 21

framework contains various initiatives that embody legal frameworks for NCD prevention. These

could serve as examples for other countries in the Region. Finally, participants should take stock of

the accomplishments of the LeAd-NCD capacity-building workshop over the past six years and

deliberate on next steps to sustain support for leadership for NCD prevention and control.

Ms Kate Lannan, Acting Coordinator, NCD and Health Promotion, WHO Regional Office for the

Western Pacific, expressed appreciation to the Ministry of Health, Labour and Welfare of Japan and

NIPH for their continued support in the capacity-building programme for NCD prevention and control

in the Western Pacific. The New WHO Regional Director, Dr Takeshi Kasai, has selected NCD

prevention and control as a top priority for the Region. Several legal and regulatory measures are

efficient NCD “best buys”, and countries and communities must strengthen their legal frameworks to

counter the rising epidemic of NCDs. Multisectoral cooperation between health ministries and

parliamentarians is essential to achieve this.

2.2 Overview of NCDs and law

The new “five-by-five” NCD framework incorporates mental health and air pollution to NCDs and

risk factors. The Sustainable Development Goals address reducing premature mortality from NCDs

by one third by 2030 as a specific target, yet within the Western Pacific Region, deaths from NCDs

are rising. At the current level of effort for NCD prevention and control, the Region will fail to reach

this target, and intensified efforts are required to attain Sustainable Development Goal target 3.4. Four

areas of action are better governance, risk factor reduction, strengthened health systems and

surveillance. Under governance, multisectoral NCD action plans play a key role. The national NCD

Directors Meeting in May 2018 called for a greater focus on legal frameworks for an enhanced

response to NCDs, with an emphasis on legislative implementation, regulation and enforcement.

Universal health coverage is a unifying platform to achieve health across the continuum of care. Law

has a critical role to play in ensuring universal health coverage in all its aspects. However, laws

relating to health often lie outside the health portfolio. In October 2018, Member States in the Region

endorsed an action agenda to strengthen legal frameworks for health, acknowledging the integral

nature of law for health in the era of the Sustainable Development Goals and the undeniable increased

need for technical assistance on health law. This was further reinforced at the Fourth Asia-Pacific

Parliamentarian Forum on Global Health in August 2018, involving 25 countries from the Western

Pacific Region; the fifth meeting will be held in Fiji in August 2019.

Much of the progress in tobacco control has come from legislation and lawmaking; the experience

from the tobacco control community can guide work in the other NCD risk factor areas. The Western

Pacific Region has the greatest number of smokers at 388 million, the highest male smoking

prevalence, the greatest number of smoking-related deaths for both sexes, and one of the highest rates

of second-hand smoke exposure. The Western Pacific Region by 2025 will have a decline in smoking

prevalence from 24% to 22%, far short of its 18% target. The projected regional reduction in smokers

by about 20 million from 2015 to 2025 will occur in part because of effective use of law and

regulation for tobacco control. International treaties, national and subnational legislation, other

executive instruments, court decisions and enforcement are all forms of legislative interventions in

operation for tobacco control.

The WHO Framework Convention on Tobacco Control (FCTC) provides much of the mandate for

legislative interventions for tobacco control; guidelines and protocols are firm commitments and

obligations that Parties must comply with. There are currently 181 Parties and the European Union

(EU); the Western Pacific is the only Region where 100% of Member States are Parties. The power of

law extends beyond the WHO FCTC. For example, plain packaging challenges have been countered

successfully with legal strategies, and litigation against the tobacco industry is another legal

intervention that has been used to reduce tobacco use and to support tobacco control.

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Legislative interventions to counter the high prevalence of alcohol consumption in the Region are at

their incipient stage. While there are no international treaties addressing unsafe alcohol use at present,

several of the proven “best buys” to reduce alcohol consumption are legislative or regulatory in

nature. These include: (1) increasing alcohol taxes; (2) restricting availability, (3) minimum age

provisions, (4) reducing marketing exposure, and (5) measures against drunk–driving.

Childhood obesity is rising, and marketing of unhealthy foods has a significant impact on obesity risk,

especially when marketing targets children and their caretakers. There exists a considerable array of

policy and legislative approaches, and potential settings-based regulatory interventions to minimize

marketing exposure. There are fewer legal mandates for healthy eating; WHO has published a

framework and Set of Recommendations on the Marketing of Foods and Non-alcoholic Beverages to

Children. Other potential legal approaches could utilize provisions contained in the International Code

of Marketing of Breast-milk Substitutes, World Health Assembly and United Nations resolutions, and

the Convention on the Rights of the Child.

2.3 Country experiences in legislating for NCD prevention and control

Countries are at different stages in their attempts to counter NCDs using legal and regulatory

measures. Overall, legislative efforts are strongest in the area of tobacco control, while legal

initiatives are least likely when addressing physical activity. Some of the common findings across the

various countries include the following observations:

Formal laws are not the only NCD legislative intervention. The experience across the Region

indicates that institutional policies, codes of conduct, edicts from traditional and religious

leaders, and other cultural interventions can be effective, within the appropriate local context,

in shaping and changing population behaviour to reduce NCD risk.

Some circumstances require the force of law. When this is the case, technical issues need to

be fully addressed to ensure a successful legislative process, and effective implementation

and compliance monitoring. Technical assistance to countries can be a critical component in

enhancing local capacity to achieve these.

Industry influence and interference require timely and accurate countermeasures. However,

not all industry is “big” industry. Countries also need to address how to tackle home-grown

industries, such as “grow your own” tobacco, home brews, sales of unhealthy food by “mom

and pop” retailers, and so on.

Multisectoral partnerships are crucial in ensuring successful legislative interventions.

Stakeholder mapping, effective communication and strategic advocacy to “frame” messages

for specific audiences are some of the leadership skills needed to augment technical skills in

reducing NCD risk. When dealing with politicians and parliamentarians, the timing and

framing of messages to convey the win–win perspective in legislating NCD prevention and

control are essential.

2.4 Reinforcing legal frameworks for NCDs

Countries cannot control NCDs without strong regulatory systems; governments and communities

need to make health the easy choice. Five environments for legal approaches to NCD prevention and

control are:

1) Information environment. Most people believe information is the key to health; this is a

pervasive myth. Having information is important, but insufficient to sustain behaviour

change.

2) Economic environment. Humans are triggered to make decisions on how much things cost;

the higher the cost, the less likely they are to buy, especially for young and low-income

groups. Taxation can have a significant health benefit when applied to unhealthy products.

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3) Built environment. The physical environment can influence behaviour and health. Where

you live affects your health.

4) Direct regulation. Law is not primarily about coercion, but direct regulation is important.

For example, mandating helmets for motorbike riders can save lives. In Viet Nam, head

injuries and deaths from motorbike accidents decreased significantly one year after helmets

were required by law.

5) Indirect regulation. Through a tort system; this can be a mixed bag. In the United States of

America, the Master Settlement Agreement resulted from tobacco industry litigation. But

what hurt the tobacco industry was not the money they were required to pay states; it was the

discovery of the secret tobacco documents that changed the public’s perception about the

industry. For the alcohol and food industry, uncovering their hidden documents may have

enormous influence on public perception. The WHO FCTC addresses sharing strategies for

tort litigation; however, litigation is a two-edged sword and industry can use litigation

against governments to fight back. Thus, governments need to be equipped and supported to

respond effectively to tobacco industry legal challenges.

The open forum raised the following discussion points:

Law can change behaviour, but not by itself. You need education for enforcement and

compliance, and you must closely involve communities when creating and implementing

laws.

How does one address the conflict between regulation and traditional culture? In general,

traditional cultural practices tend to be healthier than Western practice. Laws should nurture

healthy traditional practices and change those that are unhealthy.

How do small countries counter large corporate interests? Even small countries need to do the

right thing. Countries can join forces and share strategies and watch each other’s backs to

provide solidarity against industry. Another venue is through international law to protect

countries from multinational companies, using international norms to protect against powerful

industries.

How do you regulate social media? With social media, it is easy for evidence to reach the

population, but also easy for fake news to reach people. Regulation is not clear for social

media. Big industry uses social media for marketing, and research shows false health

information travels faster and is more influential on social media than accurate information.

Some strategies to consider include: (1) ask governments to work with social media platforms

to take down false information; (2) use social corporate responsibility with social media

companies; and (3) have governments fund and encourage reputable sources to run health

information campaigns and monitor social media.

2.5 How can I improve the current approach to legislating for NCDs?

The participants identified the following priorities for their countries:

Country NCD-related legislative priority

Cambodia Tax sugar-sweetened beverages.

Fiji Restrict unhealthy food marketing to children.

Japan Raise tobacco taxes.

Micronesia

(Federated States of)

Tax sugar-sweetened beverages.

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Philippines Establish the implementing rules and regulations for the

Universal Health Care Act.

Republic of Korea Mandate nutrition labelling.

Solomon Islands Tax sugar-sweetened beverages.

Tonga Regulate advertisement of alcohol and sugar-sweetened

beverages.

Viet Nam Ban advertising and marketing of alcohol to those under 18 years

of age.

2.6 Advancing legislation for NCDs

Based on the results of the prioritization exercise in the previous session, participants identified the

specific actions required to advance their legislative priority using a matrix that considered impact,

capacity and political support. The results for each country are included in Annex 4.

2.7 Local governance for health promotion in Wako city

Participants, faculty and Secretariat members undertook a walking tour of Wako City to learn about

their local government initiative to promote regular exercise. Wako City is a health-promoting city

with a population of about 81 000. Based on surveys on safe living of citizens, an analysis of medical

expenses and public consultation through community workshops, a local ordinance was promulgated

to enhance the quality of life and promote health throughout all life stages. Using community

volunteers comprised of retired local residents, the workshop participants experienced a sample of the

city’s exercise programme, using the “Radio Exercise” series of exercises, which were devised by

municipal staff who were physical therapists or public health nurses. A tour of the park gymnasium

and a description of the city’s incentive-based walking scheme showcased the importance of

accessible, available, safe, affordable, culturally acceptable and socially attractive exercise

programmes that promote community health and wellness.

2.8 Who are my critical stakeholders in legislating for NCDs?

Mobilizing support for these priorities requires the skilful identification and management of critical

stakeholders and strategic communications and advocacy. Participants familiarized themselves with

principles of stakeholder mapping and effective advocacy in developing key benefits and messages

for critical stakeholders.

2.9 Closing session, Part 1

Participants completed a written evaluation of the workshop using a structured questionnaire

(Annex 5). The overall impression of the workshop was positive. Participants valued the information,

skills and new tools acquired in the various sessions, the sharing of experiences from other countries,

and the observations and insights generated by the field visit. They noted that the LeAd-NCD format

and curriculum are effective in eliciting a higher level of understanding about NCD prevention and

control, by broadening the focus from the purely technical aspects to also encompass the mind-set and

leadership skills necessary to catalyse action and commitment at the national level. They strongly

supported its continuation as a regional capacity-building strategy for NCD prevention and control,

and suggested expanding into national workshops using the curriculum.

Dr Hai-rim Shin encouraged participants to use the lessons from the workshop and the workshop tools

to strengthen national and subnational capacity for NCD prevention and control in the participants’

home countries, and encouraged them to seek technical support from WHO should they desire to

replicate the LeAd-NCD workshop locally. Certificates of attendance were handed to all participants.

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2.10 Opening ceremony, Part 2

Dr Sone described the history of LeAd-NCD, highlighting the successful partnership between the

NIPH, Ministry of Health, Labour and Welfare and WHO since 2005. The representative of the

Ministry of Health, Labour and Welfare of Japan commended participants for sharing knowledge and

experiences on legal frameworks to address the NCD epidemic at the workshop. Measures to counter

NCDs are common across countries, and LeAd-NCD has facilitated information exchanges on these

measures across the years. Dr Shin outlined the priorities of the new WHO Regional Director, which

include NCDs and ageing. NCDs are a top priority for WHO’s work, and the partnership with the

NIPH and Ministry of Health, Labour and Welfare is greatly appreciated, as it contributed to elevating

the profile of NCDs in the Region. With the culmination of the Sixth LeAd-NCD Workshop, WHO

and its partners, and participants for Member States need to innovate and create the next level of

capacity-building for NCD prevention and control.

2.11 Overview of LeAd-NCD

Since 2005, the WHO Regional Office for the Western Pacific, Ministry of Health, Labour and

Welfare and NIPH have collaborated to enhance the capacity for NCD prevention and control in the

Region. From 2005 to 2009, the Japan–WHO International Visitors Programme on

Noncommunicable Disease Prevention and Control (JWIVP) served as a venue for training senior

programme managers in the technical aspects to counter the NCD epidemic. In 2012, a new

curriculum was jointly developed by the WHO Regional Office for the Western Pacific and NIPH,

highlighting technical competencies and leadership and advocacy skills, calling it the Leadership and

Advocacy for NCD Prevention and Control (LeAd-NCD). A total of 110 participants from 25

countries and areas in the Western Pacific Region have attended the five LeAd-NCD training

workshops between 2013 and 2017.

A mixed methods approach, comprised of a desk review of workshop documents, an online survey

and video interviews of participants, was used to assess the impact of the LeAd-NCD curriculum. The

survey had a 62% response rate. Participant feedback indicated that the LeAd-NCD workshops

provided an effective regional mechanism to strengthen capacity and build leadership for NCD

management in the Western Pacific. Seventy-five per cent of the respondents stated that the LeAd-

NCD workshops led to changes in their work practices. After attending the workshop, participants

were empowered to contribute to policy, programme and systems changes in their institutions (70%),

communities (64%) and national government (60%).

In several countries, the LeAd-NCD curriculum has been adapted for in-country use and integrated

into a formal graduate-level academic programme in a national university (Brunei Darussalam) or

expanded into a national capacity-building initiative for health professionals (Malaysia). In Malaysia,

LeAd-NCD graduates have created an alumni network and incorporated into an officially recognized

nongovernmental organization for NCD prevention and control. Beyond national borders, the Pacific

LeAd-NCD alumni have generated a subregional peer learning community known as the Pacific

Ending Childhood Obesity (ECHO).

The LeAd-NCD training workshops have facilitated capacity enhancement for NCD prevention and

control among a key set of influential national and subnational NCD stakeholders and decision-

makers, with noticeable outcomes and impact at the individual, local, institutional, national and

subregional levels. Participants recommended expanding the workshop to include representatives of

other sectors, engaging past participants to coalesce into a learning community of NCD best practices,

and expanding interactive sessions with an emphasis on systems thinking and leadership/advocacy

skills acquisition.

In parallel with the development of LeAd-NCD, the Asia-Pacific Parliamentarian Forum on Global

Health was established in 2015 as a platform for parliamentarians to exchange ideas, build political

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will, strengthen capacity and foster collaboration towards sustainable action for health. The Forum

embodies WHO support to Member States in achieving health under the 2030 Agenda for Sustainable

Development through a whole-of-government approach.

2.12 Country reflections on LeAd NCD

Countries shared feedback from past LeAd-NCD participants regarding tangible impacts of the

training workshop on their efforts to control and prevent NCDs. All the countries acknowledged the

valuable and concrete results arising from involvement in the LeAd-NCD capacity-building

workshops.

Country NCD-related impact of LeAd-NCD participation

Cambodia Securing political commitment for NCD prevention and control at the

highest level of government

Fiji Wellness policy endorsed by the Parliament and promoted by health

ministry leaders by example

Food and school canteen policy adopted in 2016 to combat childhood

obesity

Micronesia

(Federated States of) Workshop lessons and skills shared through the Annual FSM NCD

Summit, which is a vehicle to promote and disseminate NCD best

practices

From the 2017 LeAd-NCD, the Federated States of Micronesia has

been encouraged to create exercise and play stations in areas where

families can safely engage in physical activity.

Philippines Creation of a national curriculum for health workers based on the

LeAd-NCD curriculum, implemented by the University of the

Philippines;

Integration of healthy lifestyle and NCD interventions in occupational

settings following the 2015 LeAd-NCD workshop on workers’ health

by the Dept. of Health

Solomon Islands Better collaboration and connection between clinicians, public health

officers and legislators

Improved advocacy and educational strategies based on the LeAd-

NCD communications skills

Promotion of a locally adapted version of the tool, Package of

Essential NCD Services (PEN), called Sol-PEN

Tonga Stronger partnerships and multisectoral approach to reducing tobacco

use through multiple interventions, including raising tobacco taxes,

expanding smoke-free public law, providing cessation support,

improved enforcement of the tobacco control law and greater public

awareness campaigns, leading to a decrease in tobacco use prevalence

from around 30% in 2012 to around 25% in 2017

Viet Nam Launch of the Viet Nam health program in 2019 by the Prime

Minister, incorporating interventions to reduce the NCD risk factors

Mr Jonathan Liberman acquainted the participants with the work of the McCabe Centre for Law and

Cancer, which serves as the WHO Collaborating Centre for Law and Noncommunicable Diseases and

the designated WHO Framework Convention on Tobacco Control Knowledge Hub on legal

challenges to the Convention’s implementation. The Centre offers technical assistance and training in

legal aspects related to NCD prevention and control and is a resource for countries within the Region.

11

2.13 Moving forward: Recommendations on next steps for LeAd-NCD

Participants reviewed and discussed a set of recommendations that outline future steps for capacity-

building in NCD prevention and control. The group unanimously endorsed an outcome statement,

included in Annex 6.

3. CONCLUSIONS AND RECOMMENDATIONS

3.1 Conclusion

Leadership and advocacy are key elements in attaining progress in NCD prevention and control. This

year’s LeAd-NCD workshop highlighted the fundamental role of legislative interventions to reduce

NCD risk, introduce and familiarize participants with existing legislative resources and tools, share

country experiences and identify country-specific legislative priorities to accelerate progress in

countering the NCD epidemic.

A review of the LeAd-NCD workshops from 2013 to 2017 was conducted in March 2018 through an

online survey and follow-up interviews. All 110 past participants from 25 countries and areas in the

Region were invited to participate in the survey. The results revealed that participation in LeAd-NCD

workshops contributed to significant enhancements in policy and/or practice at the personal,

institutional and, in several instances, national level.

During the Sixth LeAd-NCD Workshop, a separate session was convened to review achievements

from these past five LeAd-NCD workshops and deliberate on future action for NCD leadership

capacity-building. This session provided an opportunity for Member States, the WHO Regional

Office for the Western Pacific, NIPH and the Japan Ministry of Health, Labour and Welfare to reflect

on the utility of the workshop, and to consider how best to improve the LeAd-NCD curriculum and

format to meet emerging and future country needs.

Participants, including high-level officials from parliament and health ministries, reviewed the

accomplishments and impact of the previous LeAd-NCD workshops and endorsed an outcome

statement outlining recommendations for future capacity-building efforts. They concluded that LeAd-

NCD has proven throughout the past six years to be an effective regional programme that has

enhanced the knowledge, skills, attitudes, commitment and a leadership mind-set for effective NCD

prevention and control, and empowered participants to pursue actions that resulted in organizational,

community and/or national progress in addressing NCDs.

3.2 Recommendations

3.2.1 Recommendations for Member States

Member States are encouraged to consider the following:

1) Continue engagement with the LeAd-NCD programme and foster greater involvement of

representatives of other sectors.

2) Examine the utility of adapting this type of capacity-building model for national and

subnational NCD capacity-enhancement activities and implement suitably adapted versions

to expand the NCD workforce within countries.

3) Explore mechanisms to create a community of practice/learning community comprising

LeAd-NCD alumni, potentially through social media platforms.

4) Share national success stories resulting from LeAd-NCD participation with WHO, and

document the contribution of this capacity-building initiative on progress against NCDs.

12

3.2.2 Recommendations for WHO

WHO is requested to consider the following:

1) Continue collaborating with the NIPH in organizing LeAd-NCD workshops to sustain

regional capacity-building, with an emphasis on leadership to promote cost-effective,

evidence-based and integrated approaches to NCD prevention and control.

2) Align LeAd-NCD with the objectives and strategies outlined in the Global and Regional

NCD Plans of Action, and build on existing global and regional initiatives, such as Healthy

Settings, Healthy Cities and Healthy Islands.

3) Explore how to utilize this type of regional mechanism to foster the development of a

systematic strategy to monitor and assess Member States’ progress in achieving the goals

and objectives of the Global and Regional NCD Plans of Action.

4) Consider how to further improve the LeAd-NCD curriculum, including by allotting more

time to interactive sessions.

5) Create a higher-level NCD training course targeting senior-level officials and programme

officers, emphasizing leadership competencies to effectively meet the challenges in

accelerating NCD prevention and control and attain the global voluntary NCD targets and

2030 Sustainable Development Goal targets.

13

ANNEXES:

Annex 1. List of participants, temporary advisers, resource persons and Secretariat

Annex 2. Programme of activities

Annex 3. Participant’s workbook

Annex 4. Country-specific actions for identified NCD legislative priorities

Annex 5. Workshop evaluation

Annex 6. Final outcome statement

ANNEX 1

LIST OF PARTICIPANTS, TEMPORARY ADVISERS, RESOURCE PERSONS,

REPRESENTATIVES/OBSERVERS AND SECRETARIAT

1. PARTICIPANTS

Dr KOL Hero, Director, Preventive Medicine Department , Ministry of Health

No 80, Samdech Penn Nouth Blvd (289), Sankat Boeungkak 2, Toul Kork District

Phnom Penh, Cambodia, Telephone: +855 238 85904/5

Email: [email protected], [email protected]

H.E Mrs LORK Kheng, Member of Parliament and Permanent Committee, Chairwoman of the

Commission on Public Health Social Work, Veteran, Youth Rehabilitation, Labor, Vocational

Training and Women’s Affair, National Assembly of the Kingdom of Cambodia

Kham Chamkar Morn, Phnom Penh, Cambodia, Telephone: + 016 999986

Email: [email protected]

H.E Mrs MAK Vansitha, Parliamentarian, National Assembly of the Kingdom of Cambodia

Kham Chamkar Morn, Phnom Penh, Cambodia, Telephone: + 855 12542827

E-mail: [email protected]

Mr Andrew Salendra Uma PRASAD, Advocacy Officer

Divisional Noncommunicable Programme – Central/Eastern, Ministry of Health and Medical

Services 88 Amy Street, Toorak, Fiji, Telephone: + 3320844


Mrs Kalo Tubuna TAKAPE, Head of Legislative Services, Parliament of Fiji Islands, Government

Buildings Suva, Fiji, Telephone: + 67 9908181, Email: [email protected]

Dr Yoshin NAKAMURA, Deputy Director, Health Service Division, Health Service Bureau

Ministry of Health, Labour and Welfare, Tokyo, Japan, E-mail: [email protected]

Dr Douangprachanh SATHATHONE, Medical Doctor, Cancer Registration, Mittaphab Hospital,

Cancer Center, Ministry of Public Health, Vientiane, Lao People's Democratic Republic

Telephone: + 856-20-77571922, Facsimile: + 856-20-28349882


Mr Wincener DAVID, Health Planner, Department of Health and Social Affiars

PO Box PS70 Palikir, Pohnpei, Federated States of Micronesia, Telephone: + 691 320 8404


Mr X-ner LUTHER, NCD section manager, Department of Health and Social Affiars

PO Box PS70 Palikir, Pohnpei, Federated States of Micronesia, Telephone: + 691 320 8525


Director Ruby CONSTANTINO, OIC – Director IV, Disease Prevention and Control Bureau

Department of Health, San Lazaro Compound, Tayuman, Sta. Cruz, Manila, Philippines,

Telephone: + 632 9177150553, E-mail: [email protected]

Dr Carmela GRANADA, Medical Officer IV, DPCB-Lifestyle Related Diseases Division

Department of Health, San Lazaro Compound, Tayuman, Sta. Cruz, Manila, Philippines

Telephone: +632 7322493, E-mail: [email protected]

Ms Windalyn BALUIS, Nurse V, Center for Health Development Bicol, Department of Health

Bagtang, Daraga, Albay, Philippines, Telephone: +632 74211731


Dr Hyung Seon YEOM, Researcher, Division of Chronic Disease Prevention

Centers for Disease Control and Prevention, 187 Osongsaengmyeong2-ro, Heugdeok-gu

Cheongju-si, Chungcheongbuk-do, Republic of Korea, Telephone: + 82 437197441


Dr Jones GHABU, Head of Internal Medicine, National Referral Hospital, Director,

National Diabetes Center, Ministry of Health and Medical Services HQ P.O. Box 349, Honiara,

Solomon Islands, Telephone: + 677 7498424 , E-mail: [email protected]

Dr Geoffrey KENILOREA, Director, Noncommunicable Diseases, Ministry of Health and Medical

Services HQ P.O. Box 349, Honiara, Solomon Islands, Telephone: +677 875 4080


Mr Wilson ANII, Secretary to the Parliamentary Health and Medical Services Committee

Secretary to the Parliamentary Bills and Legislation Committee, National Parliament Office

P.O. Box G19, Honiara, Solomon Islands, Telephone: +28520/24323


Dr Ofakiokalani TUKIA, Medical Officer Special Grade In-charge, Health Promotion Unit, Ministry

of Health P.O. Box 59, Nuku’alofa, Tonga, Telephone: +676 23200, E-mail: [email protected]

Mrs ‘Ofeina meihe langi FILIMOEHALA, Chief Executive Officer, Tonga Health Promotion

Foundation P.O. Box 2026, Nuku’alofa, Tonga, Telephone: +676 25721


Mr Inoke FINAU, Assistant Crown Counsel, Kingdom of Tonga’s Attorney General’s Office

P.O. Box 85, First Floor, Taumoepeau Building, Corner of Fatafehi and Salote Roads, Nuku’alofa,

Tonga Telephone: +676 7712884, E-mail: [email protected]

Dr TRUONG Dinh Bac, Deputy Director, General Department of Preventive Medicine,

Ministry of Health No. 135 Nui Truc Street Ba Dinh District, Ha Noi, Viet Nam


Dr TRAN Quoc Bao, Head of Division of NCD Control, General Department of Preventive

Medicine, Ministry of Health, No. 135 Nui Truc Street, Ba Dinh District, Ha Noi, Viet Nam

Telephone: + 84 912170778, E-mail: [email protected]

Dr NGUYEN Manh Cuong, Deputy Director, International Cooperation Department, Ministry of

Health No. 135 Nui Truc Street, Ba Dinh District, Ha Noi, Viet Nam, Telephone: + 84 462732218


2. TEMPORARY ADVISERS

Dr Tomofumi SONE, Vice President, National Institute of Public Health

2-3-6, Minami, Wako-shi Saitama, Japan 351-0197, Telephone: +8148 458 6159


Dr Hiroko MIURA, Director, Department of International Health and Collaboration

National Institute of Public Health, 2-3-6, Minami, Wako-shi, Saitama, Japan 351-0194

Telephone: +8148 458 6277, Email: [email protected]

Professor Lawrence GOSTIN, University Professor, Georgetown University

Director, O'Neill Institute for National and Global Health Law, (WHO Collaborating Centre for

Public Health Law and Human Rights), 600 New Jersey Avenue, NW, McDonough 568 Washington

DC 20001, USA, Email: [email protected]

Mr Ramon DJ. NAVARRA, Jr, Director for Policy & Political Affairs

Office of Senator Risa Hontiveros, Room 527 Senate of the Philippines, Financial Center

Diokno Boulevard, Pasay City, Philippines, Telephone: +632 8078156


3. RESOURCE PERSONS

Dr Annette DAVID, Senior Partner for Health Consulting Services, Health Partners, LLC

P.O. Box 9969, Tamuning, Guam 96931, Telephone: (1671) 6465227 or 5228


Dr Teiji TAKEI, Director , Health Service Division, Health Service Bureau, Ministry of Health,

Labour and Welfare, Tokyo, Japan

4. REPRESENTATIVES/OBSERVERS

Dr Nobuo NISHI, Chief, International Center for Nutrition and Information

National Institute of Health and Nutrition; National Institutes of Biomedical Innovation Health and

Nutrition (WHO Collaborating Centre for Nutrition and Physical Activity), 1-23-1 Toyama,

Shinjuku-ku, Tokyo 162-8636, Japan, Telephone: +81-3-3203-5389, E-mail: [email protected]

Mr Jonathan LIBERMAN, Director, McCabe Centre for Law and Cancer (WHO Collaborating

Centre for Law and Noncommunicable Diseases), Cancer Council Victoria

615 St Kilda Road, Melbourne VIC 3004, Australia, E-mail: [email protected]

Dr Si Thu Win TIN, Team Leader - NCDs Prevention and Control Programme, Public Health

Division Pacific Community (SPC), Level 2 Lotus Building, Ratu Mara Road, Nabua, Suva, Fiji

Telephone: +(679)3379429, E-mail: [email protected]

Dr Minwon LEE, Senior Fellow, World Health Organization, 401, Dongwai Diplomatic Office

Building, 23, Dongzhimenwai Dajie, Chaoyang District 100600, Beijing, China

Telephone: (8610) 6532-7189, E-mail: [email protected]

Mr Kanit SANGSUWAN, Assistant Director, National Health Security Office

118 Phitsanulok Post Office Building, 4th Floor, Phuttabucha Rd., Naimuang, Muang

Phitsanulok 65000 Thailand, E-mail: [email protected]

Dr Marika NOMURA, Senior Adviser (Nutrition and Health),

Japan International Cooperation Agency (JICA), 1-6th floor, Nibancho Center Building

5-25 Niban-cho, Chiyoda-ku, Tokyo 102-8012, Japan, E-mail: [email protected]

Mr YOS Phanita, Assistant, National Assembly of the Kingdom of Cambodia

Kham Chamkar Morn, Phnom Penh, Cambodia, E-mail: [email protected]

Mr Toru KAJIWARA, Director of Office of Global Health Cooperation,

International Affairs Division Minister's Secretariat, Ministry of Health, Labour and Welfare, 1-2-2

Kasumigaseki, Chiyoda-ku Tokyo 100-8916, Japan, E-mail: [email protected]

Dr Tomoko KODAMA, Chief Senior Researcher, Department of International Health and

Collaboration, National Institute of Public Health, 2-3-6, Minami, Wako-shi Saitama, Japan


Dr Midori ISHIKAWA, Chief Senior Researcher, Department of Health Promotion

National Institute of Public Health, 2-3-6, Minami, Wako-shi Saitama, Japan


5. SECRETARIAT

Dr Hai-Rim SHIN, Director, Division of NCD and Health through the Life-Course (DNH), World

Health OrganizationRegional Office for the Western Pacific, United Nations Avenue, Ermita ,

Manila, Philippines, Telephone: +632 528 9860, Facsimile: +632 526 0279, Email: [email protected]

Dr Warrick Junsuk KIM (Co-responsible Officer), Medical Officer, Noncommunicable Diseases and

Health Promotion, Division of NCD and Health through the Life-Course (DNH), World Health

Organization, Regional Office for the Western Pacific (WPRO), United Nations Avenue, Ermita,

Manila, Philippines, Telephone: +632 528 9860, Facsimile: +632 526 0279, Email: [email protected]

Dr Ki-Hyun HAHM (Co-responsible Officer), Technical Officer , Legislation and Regulation,

Division of Health Systems, World Health Organization, Regional Office for the Western Pacific

United Nations Avenue, Ermita, Manila, Philippines, Telephone: +632 528 9826


Ms Kathleen LANNAN, Coordinator, Tobacco Free Initiative, Division of NCD and Health Through

the Life-Course, World Health Organization Regional Office for the Western Pacific

United Nations Avenue corner Taft Avenue, Manila 1000, Philippines, Telephone: +632 528 9870

Facsimile: +632 526 1036, E-mail: [email protected]

Dr Saki NARITA, Consultant, Noncommunicable Diseases and Health Promotion

Division of NCD and Health Through the Life-Course, World Health Organization

Regional Office for the Western Pacific, United Nations Avenue corner Taft Avenue, Manila 1000

Philippines, Telephone:+632 528 9888, Facsimile: +632 526 1036, E-mail: [email protected]

Dr Nargiza KHODJAEVA, Technical Lead, NCD and Health through the Life Course

World Health Organization, No. 61-64, Preah Norodom Blvd. (corner Street 306), Sangkat Boeung

Keng Kang I, Khan Chamkamorn, Phnom Penh, Cambodia, Telephone: +855 23 216610


ANNEX 2

PROGRAMME OF ACTIVITIES

------------------------------------------------------ Part I ------------------------------------------------------

Tuesday, 12 March 2019

08:30-09:00 Registration

Pre-workshop assessment

09:00-09:30 (1) Opening ceremony (Part I)

Welcome address

Dr Yasumasa FUKUSHIMA

President, National Institute of Public Health

(NIPH), Japan

Mr Toru KAJIWARA

Director, Office of Global Health Cooperation,

International Affairs Division, Minister’s

Secretariat, Ministry of Health, Labour and

Welfare, Japan

Opening address Ms Kathleen LANNAN

Coordinator, Tobacco Free Initiative

Acting Coordinator, NCD and Health

Promotion, World Health Organization (WHO)

Regional Office for the Western Pacific

(WPRO)

09:30-10:30 Introduction of course

Self-introductions of participants

Introduction of health promotion

activity during the workshop

Group photo

Dr Warrick Junsuk KIM

Medical Officer, NCD and Health Promotion,

WHO/WPRO

10:30-10:45 Mobility Break

10:45-12:15 (2) Overview of NCDs and law

Overview of NCD prevention and

control and opportunities to

strengthen legal frameworks in the

Western Pacific Region


Dr Ki-Hyun HAHM

Technical Officer, Health Law and Ethics

WHO/WPRO

Ms Kathleen LANNAN

12:15-13:30 Lunch Break

13:30-15:00 (3) Country experiences in legislating for NCD prevention and control

Gallery tour of country posters

Facilitator: Dr Annette DAVID

Senior Partner, Health Consulting Services

Health Partners LLC, Guam


15:15-16:45 Gallery tour of country posters

(cont.)

Plenary discussion


Wednesday, 13 March 2019

09:00-10:30 Recap

Dr Annette DAVID

(4) Reinforcing legal frameworks for NCDs

Advancing the right to health

Plenary discussion

Professor Lawrence GOSTIN

Professor, Georgetown University

Director, O’Neill Institute for National and

Global Health Law, USA

10:30-10:45 Mobility break

10:45-12:15 (5) How can I improve the current approach to legislating for NCDs?

Group work 1: Prioritization Dr Annette DAVID

12:15-13:30 Lunch break

13:30-15:00 (6) Advancing legislation for NCDs

Group work 2: Priority actions to

strengthen legal frameworks for

NCDs and collaboration with

partners in my country

Dr Annette DAVID


15:15-16:45 (7) Local governance for health promotion in Wako City

Introductory presentation

Walking tour

Mr Takeshi ABE

Head, Community Care Unit, Division of Health

and Welfare, Wako City, Japan

Coordinators for walking tour:

Wako City, NIPH

Thursday, 14 March 2019

09:00-10:30 Recap

Reflections

Dr Nargiza KHODJAEVA

Technical Lead

WHO Cambodia


(9) Who are my critical stakeholders in legislating for NCDs?

Group work 3: Stakeholder

mapping

Dr Annette DAVID


10:45-12:15 Group work 4: Advocating to

critical stakeholders in my country

Closing remarks (Part I)

Dr Annette DAVID

12:15-13:30 Lunch break

------------------------------------------------------ Part II ------------------------------------------------------

13:30-15:00 (1) Opening ceremony (Part II)

Welcome address

Dr Tomofumi SONE

Vice President, NIPH, Japan

Dr Teiji TAKEI

Director, Health Service Division

Health Service Bureau, Ministry of Health,

Labour and Welfare, Japan

Opening address Dr Hai-Rim SHIN

Director, Division of NCD and Health through

the Life-Course, WHO/WPRO

Self-introductions of participants

Group photo



15:15-16:45 (2) Overview of LeAd-NCD

Programme history and

achievements of previous

LeAd-NCD workshops


Dr Saki NARITA

Consultant, NCD and Health Promotion,

WHO/WPRO

Dr Ki-Hyun HAHM

Dr Tomofumi SONE

17:00-19:00 Welcome reception (hosted by

NIPH)

Friday, 15 March 2019

09:00-10:30 Reflections and inspirations


(3) Country reflections on LeAd-NCD

Panel: Success stories and lessons

learned through LeAd-NCD

workshops

Plenary discussion



10:45-12:15 (4) Moving forward

Plenary discussion:

Recommendations on next steps for

LeAd-NCD

Closing remarks

Facilitator: Dr Hai-Rim SHIN

Dr Hai-Rim SHIN

ANNEX 3

PARTICIPANT'S WORKBOOK

ANNEX 4

COUNTRY-SPECIFIC ACTIONS FOR IDENTIFIED NCD LEGISLATIVE PRIORITIES

Cambodia

NCD legislative priority: Tax sugar-sweetened beverages (SSB).

Actions:

1. Draft SSB reduction bill.

2. Educate and increase awareness in the Parliament and mobilize support and funding.

3. Build capacity for monitoring and evaluation of SSB consumption.

Fiji

NCD legislative priority: Restrict unhealthy food marketing to children.

Actions:

1. Map, revisit and organize stakeholder meetings.

2. Organize symposium for healthy food for children.

3. Champion and advocate healthy foods at high-level meetings.

4. Involve ministries of education, health, trade and economy.

5. Advertise healthy foods and non-alcoholic beverages to children in Fiji.

Japan

NCD legislative priority: Increase the tobacco tax.

Actions:

1. Create a multisectoral Board comprised of relevant stakeholders to engage and negotiate with

the Ministry of Finance for the proposed tax increase.

2. Include electronic cigarettes in the proposed tax increase.

3. Regulate political donations from tobacco companies to the government and political parties.

4. Pursue full implementation of the WHO FCTC.

Micronesia, Federated States of


Actions:

1. Convene a policy work group to review and update the draft SSB bill.

2. Sensitize the members of the Health Committee on the updated bill.

3. Engage diverse stakeholders to support the bill through a media campaign.

4. Submit the draft bill to the new leadership for congressional action in the next regular session

of Congress.

Philippines

NCD legislative priority: Develop implementing rules and regulations (IRRs) for the Universal Health

Care Act.

Actions:

1. Create a conceptual framework and integrated service packages for NCDs (from prevention to

treatment, rehabilitation and palliation.)

2. Have a special focus on the health promotion section of the law.

3. Create a multisectoral task force of diverse stakeholders to advocate and finalize the IRRs.

Republic of Korea

NCD legislative priority: Mandate nutrition labelling.

Actions:

1. Educate and advocate for the legislation.

2. Conduct an analysis of the current legislation on food labelling.

3. Expand nutrition targets to include adults, not just children.

4. Develop an incentive scheme for companies that comply with the proposed nutrition

labelling.

Solomon Islands


Actions:

1. Form/reconvene the NCD Technical Advisory Group.

2. Meet with health executive/parliamentarians HMSC.

3. Conduct situational analysis/feasibility study/impact assessment.

4. Develop policy paper – study report, proposal, policy directions - policy brief.

5. Meet with Ministry of Finance to engage and advocate for the proposed tax.

6. Develop draft policy and present the draft to the Cabinet for their approval.

7. Conduct stakeholder consultations on the draft bill.

8. Develop drafting instructions to the Attorney General’s chambers.

9. Initiate public consultations on the draft bill.

10. Present the draft to the Bills and Legislations Committee of Parliament.

Tonga

NCD legislative priority: Regulate advertisement of alcohol and SSBs.

Actions:

1. Consult relevant stakeholders.

2. Submit Cabinet papers on the proposed legislation.

3. Draft a law based on Cabinet decision.

Viet Nam

NCD legislative priority: Ban alcohol advertising and marketing to children and youth under 18 years

of age.

Actions:

1. Recruit champions to support the proposed legislation from famous persons and celebrities.

2. Engage and involve different social organizations in the mobilization of support for the bill.

3. Develop the evidence-based rationale for the bill (policy briefs, fact sheets, etc.).

4. Disseminate these materials to key decision-makers and stakeholders within the National

Assembly and government.

5. Set up advocacy meetings with to key decision-makers and stakeholders within the National

Assembly and government.

6. Mobilize political support through an information and education campaign using multiple

mass media channels.

ANNEX 5

WORKSHOP EVALUATION

Twenty-one participants overseeing NCD prevention and control in Ministry of Health (or equivalent)

or involved in health-related legislative activities in parliament attended the workshop. The

participants represented nine countries in the Western Pacific Region: Cambodia, Fiji, Japan,

Micronesia (Federated States of), Philippines, Republic of Korea, Solomon Islands, Tonga, and Viet

Nam. The programme was evaluated using a questionnaire where participants gave scores on a scale

of 1 to 10 (10 being the highest, 1 being the lowest in terms of satisfaction) for operational

arrangements and for the technical sessions. The distribution of the scores is provided below.

QUESTIONNAIRE 1 - Overall impression

10 9 8 7 < 6

The participation in this meeting was 58% 8% 33% 0% 0%

The facilitation in this meeting was 75% 17% 0% 8% 0%

The leadership in this meeting was 58% 33% 8% 0% 0%

Travel arrangements for the meeting was 17% 50% 8% 17% 8%

Facilities of this meeting were 50% 42% 8% 0% 0%

Accommodation for this meeting was 25% 8% 50% 17% 0%

Meals provided during this meeting were 33% 17% 17% 25% 8%

The overall impression of this meeting was 67% 17% 17% 0% 0%

QUESTIONNAIRE 2 - Technical sessions

Session 2: Overview of NCDs and law 10 9 8 7 < 6

a. to understand the objectives of the session 42% 33% 17% 8% 0%

b. to exchange views and information in the discussions 67% 17% 8% 8% 0%

Session 3: Country experiences in legislating for NCD

prevention and control



Session 4: Reinforcing legal frameworks for NCDs



Session 5: How can I improve the current approach to

legislating for NCDs?



Session 6: Advocating legislation for NCDs



Session 7: Local governance for health promotion in Wako

City



Session 8: Who are my critical stakeholders in legislating for

NCDs?



ANNEX 6

OUTCOME DOCUMENT

We, representatives from Cambodia, Fiji, Japan, Federated States of Micronesia, the Philippines, the Republic of Korea, Solomon Islands, Tonga, and Viet Nam,

Having participated in the High-Level Meeting on Leadership and Advocacy on NCDs,

Acknowledge:

1. The National Institute of Public Health and the Government of Japan for providing excellent administrative, logistical, and technical support for the meetings;

2. The City of Wako for hosting a highly informative field visit to illustrate local governance for health promotion; and

3. The World Health Organization Regional Office for the Western Pacific for coordinating overall arrangements and supporting the participation of Member States, experts, and observers.

Recognize:

1. NCDs are a critical and growing health and development burden for the Western Pacific Region;2. Addressing NCDs is not only the responsibility of the ministry of health but requires a whole-of-

government and whole-of-society approach; and3. Adequate capacity is needed at the national level to implement effective strategies for NCD

prevention and control, and leadership and technical competence are fundamental components of capacity-building.

Outcome Statement: High-Level Meeting on Leadership and Advocacy on NCDs

Participants of the High-Level Meeting on Leadership and Advocacy on NCDs held on 14-15 March 2019 in Japan

RegionPacificWesternOrganizationWorld Health

Affirm:

The vital role of leadership in securing political commitment and on-the-ground action in implementing cost-effective interventions to mitigate the health and socio-economic burden of NCDs in the Western Pacific.

Conclude:

1. LeAd-NCD has proven throughout the past 6 years to be an effective regional program that has enhanced the knowledge, skills, attitudes, commitment and leadership mind-set for effective NCD prevention and control among participants, and led to participants driving action in their countries that resulted in organizational, community and/or national progress in addressing NCDs; and

2. Although training opportunities to enhance technical competence in NCD prevention and control exist, the leadership capacity-building framework of LeAd-NCD is unique (as compared with other WHO regions) in that it focuses on leadership in multisectoral action and planning, as well as effective legislation and strategic advocacy for comprehensive NCD prevention.

Recommend that countries:

1. Continue engagement with the LeAd-NCD program and foster greater involvement of representatives of other sectors;

2. Examine the utility of adapting this type of capacity-building model for national and subnational NCD capacity-enhancement activities and implement suitably adapted versions to expand the NCD workforce within countries;

3. Explore mechanisms to create a community of practice/learning community comprising LeAd-NCD alumni, potentially through social media platforms; and

4. Share national success stories resulting from LeAd-NCD participation with WHO, and document the contribution of this capacity-building initiative on progress against NCDs.

Request WHO to:

1. Continue collaborating with NIPH and the Government of Japan, as well as with other partners including WHO Collaborating Centres, in organizing LeAd-NCD workshops to sustain regional capacity-building, with an emphasis on leadership to promote cost-effective, evidence-based, integrated approaches to NCD prevention and control;

2. Align LeAd-NCD with objectives and strategies outlined in the Global and Regional NCD Plans of Action, and build on existing global and regional initiatives, such as Healthy Settings, Healthy Cities and Healthy Islands;

3. Explore how to utilize this type of regional mechanism to foster the development of a systematic strategy to monitor and assess Member States’ progress in achieving the goals and objectives of the Global and Regional NCD Plans of Action;

4. Consider how to further improve the LeAd-NCD curricula, including by allotting more time to interactive sessions; and

5. Create a higher-level NCD training course targeting senior-level officials and programme officers, emphasizing leadership competencies to effectively meet the challenges in accelerating NCD prevention and control and attain the global voluntary NCD targets and 2030 Sustainable Development Goal targets.

www.wpro.who.int

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