How does teamwork improve value. Dr Nils E How does teamwork improve value? Dr Nils E. Billo Medical Officer 8th IPCRG World Conference, Amsterdam, 2016

Outline Burden Challenges WHO Global Action Plan 2013-2020 Sustainable Development Goals Teamwork Framework Convention on Tobacco Control Global Alliance against Chronic Respiratory Diseases (GARD)

Chronic Respiratory Diseases (CRDs) A major public health problem?? 1 billion people suffer from CRDs including asthma, respiratory allergies, COPD, occupational lung diseases, sleep apnea and pulmonary hypertension CRDs account for about 5 million deaths annually COPD to become the 3rd leading cause of death by 2030 Indoor air pollution kills more than 4 million people each year

Indoor air pollution 4.3 million people die prematurely: 12% are due to pneumonia 34% from stroke 26% from ischaemic heart disease 22% from chronic obstructive pulmonary disease (COPD), and 6% from lung cancer.

Global challenges CRDs not high on global health agenda, lack of funding at all levels, in particular in LMIC Lack of reliable data on CRDs 30% of patients at PHC present with cough but Prevention and treatment opportunities missed Effective treatment not available or not accessible Medicines not affordable

Global challenges Many guidelines available at PHC level: National WHO PEN guidelines International Professional Societies Industry sponsored Mixed Lack of simple, standardized guidelines which are implementable by small teams

How can we overcome these challenges? With hard teamwork

WHO Global Strategy for the Prevention and Control of NCDs GARD

9 global NCD targets to be attained by 2025 (against a 2010 baseline) A 25% relative reduction in risk of premature mortality from cardiovascular disease, cancer, diabetes or chronic respiratory diseases At least a 10% relative reduction in the harmful use of alcohol A 10% relative reduction in prevalence of insufficient physical activity A 25% relative reduction in prevalence of raised blood pressure or contain the prevalence of raised blood pressure A 30% relative reduction in prevalence of current tobacco use A 30% relative reduction in mean population intake of salt/sodium At least 50% of eligible people receive drug therapy and counselling to prevent heart attacks and strokes An 80% availability of the affordable basic technologies and essential medicines, incl. generics, required to treat NCDs Halt the rise in diabetes and obesity

Global challenges (2) Most of CRD related deaths occur in low-and middle income countries Country NCD plans seldom include good plans for prevention and management of CRDs Lack of political commitment Many competing priorities

Teamwork works and has impact if Common goal Good communication with all partners (governmental and non-governmental) At local level National Global level Agreement on goals and milestones Concrete tasks to be completed

Teamwork works and has impact if Good communication Monitoring and evaluation of progress Interpretation of results Fight for the cause and not for personal glory

Teamwork is hard work at many levels In the community Among primary health care personnel Between the subnational and national level Within countries (Ministries, Civil Society, private sector, professional societies etc) Between countries Between countries and WHO With donor agencies Within Global Alliances

What does the Global Alliance against Respiratory Diseases (GARD) offer?

GARD GARD provides a network through which collaborating parties can combine their strengths and knowledge, thereby achieving results that no single partner could attain alone. GARD also improves coordination between existing governmental and nongovernmental programmes, which avoids duplication of efforts and wasting of resources.

GARD strategic objectives Advocacy Partnership National Plans on Prevention and Control Surveillance

GARD achievements since 2006 GARD has been introduced in 21 high and 24 low and middle income countries Considerable progress in countries where government involvment is strong (Turkey, Portugal, Netherlands, Brazil and others) GARD has contributed in developing national CRD programmes Dutch GARD leadership contributed to a collaborative National Action Plan on CRDs in NL

GARD in the future Reinforced teamwork needed to maintain and improve integrated national CRD programmes both in high and low income countries GARD collaboration in low income countries will be key to reduce the burden of CRDs in high prevalence areas (example: FRESH AIR Uganda project supported by IPCRG) GARD needs to contribute to pragmatic and effective teamwork between all major stakeholders interested in CRDs and global health

Health systems Work with Essential Medicines & Technologies on essential list, access, affordability and availability Contribute case studies of people-centred care and service delivery that are relevant not just for CRD but also for other diseases Develop further and provide case studies on the care of people with co-morbidities Assist in the implementation and further development of PEN in resource- /setting-appropriate ways

Teamwork: who cares? Teamwork: WHO cares

Thank you!