GARD/NCD Action Plan & 2011 UN Summit on NCDs Niels H. Chavannes MD PhD Associate Professor LUMC GARD Planning Committee Member

4 000 000 PEOPLE DIED FROM CHRONIC RESPIRATORY DISEASES What is the global burden of chronic respiratory diseases? 4 000 000 PEOPLE DIED FROM CHRONIC RESPIRATORY DISEASES IN 2005

What is the global burden of chronic respiratory diseases? Hundreds of millions of people have chronic respiratory diseases including 300 million people with asthma, 210 million people with chronic obstructive pulmonary disease (COPD) and millions of others with pulmonary hypertension, occupational disease, allergic rhinitis, and other chronic respiratory diseases, which are often undiagnosed.

WHO global strategy on noncommunicable diseases 2008-2013 (World Health Assembly, 2008) To raise the priority accorded to noncommunicable disease in development work at global and national levels, and to integrate prevention and control of such diseases into policies across all government departments. To establish and strengthen national policies and plans for the prevention and control of noncommunicable diseases. To promote interventions to reduce the main shared modifiable risk factors for noncommunicable diseases: tobacco use, unhealthy diets, physical inactivity and harmful use of alcohol. To promote research for the prevention and control of noncommunicable diseases. To promote partnerships for the prevention and control of noncommunicable diseases.

What does the Alliance focus on? Focus on the following areas: Surveillance of chronic respiratory diseases and their risk factors Advocacy for action Health promotion and prevention Diagnosis of chronic respiratory diseases Control of chronic respiratory diseases and drug accessibility Paediatric asthma

Prioritized Research Agenda1 Effective interventions can control CRD, and reduce morbidity and mortality Dissemination of relevant information and training of primary healthcare providers should be part of the research program ..strengthening of health systems through education and optimal use of resources A global fund for CRD research in LMICs should be developed 1Eur Respir J 2010

NCD Action Plan 2008-13 Global Strategy for the Prevention and Control of Noncommunicable Diseases Working in partnership to prevent and control the 4 noncommunicable diseases — cardiovascular diseases, diabetes, cancers and chronic respiratory diseases and the 4 shared risk factors — tobacco use, physical inactivity, unhealthy diets and the harmful use of alcohol © World Health Organization 2008

NCD Action Plan 2008-13 Implement programmes that tackle the social determinants of noncommunicable diseases with particular reference to the following: health in early childhood the health of the urban poor fair financing equitable access to primary health care

NCD Action Plan 2008-13 Reorientation and strengthening of health systems, enabling them to respond more effectively and equitably to the health-care needs of people with chronic diseases Incorporate evidence-based, cost-effective primary and secondary prevention interventions into the health system with emphasis on primary health care

“The 2001 HIV/AIDS Political Declaration created a shared vision between Member States, drove global and national follow-up action, and catalysed an effective use and coordination of resources The 2011 UN High-level Summit on NCDs is our once-in-a-generation opportunity to secure a similar level of global political mobilisation for NCDs”

Tobacco tax increase

Goal and Priority Targets for NCDs Outcomes Document Overarching goal: Reduce NCD death rates by at least 2% per annum*[1] [1]This target and others indicated by * are Proposals on NCD targets from a WHO Technical Working Group and, if adopted, will use 2010 as a baseline

Leadership Include NCDs in the global development goals that succeed the Millennium Development Goals in 2015 Establish a ‘Stop NCDs Partnership’ within the UN system to coordinate follow-up action on UN Summit commitments working with governments, NGOs and the private sector Establish a UN Decade of Action on NCDs 2012–2022 to implement the Outcomes Document and ensure that by 2016, 85% of the world’s population have access to information, education and services to reduce their vulnerability to NCDs

Prevention Accelerate the effective implementation of the Framework Convention on Tobacco Control Establish effective population-wide prevention, early detection, screening and awareness-raising programmes for NCDs targeting high-risk populations by 2020 Develop and implement policies for urban design to include safe open spaces and encourage walking, cycling and other physical activities.

Diagnostics and treatment Ensure universal access to affordable high-quality essential NCD medicines and medical technologies including, but not limited to: Good-quality, affordable asthma inhalers by 2012 By 2013 develop and implement strategies to address NCD treatment and care in emergencies, natural disasters and conflicts

Health systems By 2015, establish and strengthen national health information systems (including registries) for monitoring and evaluation of NCDs and risk factors and morbidity/mortality statistics by cause By 2016, 60% and by 2020 80% of countries to develop strategies to integrate health-system management of NCDs, especially at primary health care levels Strengthen national and community-based health systems to ensure continuity of care and support through to effective referral by 2020

Resources Allocate sufficient funds to the United Nations and member states to support the implementation of the UN Summit Outcomes Document Develop and implement innovative financing mechanisms for NCDs at global and country level Leverage existing essential medicine procurement mechanisms and develop new solutions to provide access to affordable NCD medicines and technologies Increase the percentage of national health budgets allocated to NCDs

Research Encourage, increase and accelerate research on NCD causes and cures, including longitudinal research into the ‘early origins’ of NCDs Encourage operational research on prevention, treatment and management of NCDs

Monitoring and follow-up By 2012, establish a high-level Commission on Accountability for Action on NCDs with representatives from government, donors, multi-lateral institutions, civil society and the private sector to ensure ongoing monitoring of commitments from the UN Summit Every year devote time at the UN General Assembly to review a report from the Secretary General on progress, and conduct a high-level review of progress in 2016