FROM GLOBAL POLICY TO NATIONAL PROGRAMMES: HOW PROGRAMME MANAGERS USE GLOBAL AND REGIONAL POLICY Dr Ruitai Shao Programme Management Adviser Department of Chronic Diseases and Health Promotion World Health Organization

Outline Main Global Initiatives Progress in national NCD prevention and control Challenges and opportunities From global policy/initiatives to national action The way forward

WHO Global Roadmap on NCDs 2000 2003 2004 2008 Global Strategy for the Prevention and Control of Noncommunicable Diseases Global Strategy on Diet, Physical Activity and Health Action Plan on the Global Strategy for the Prevention and Control of NCDs 2010 2009 2011 Global Strategy to Reduce the Harmful Use of Alcohol WHO Global Status Report on NCDs UN HLM Political Declaration on NCDs 2012 Realizing the commitments made in the Political Declaration Preventing Chronic Diseases: A vital Investment 2005

Progress in NCD prevention and control in countries Percentage of countries with specific policies, plans or strategies, 2000-2010

BASIC MEDICAL RESEARCH COMMUNITY LARGE BASED SCALE DEMONSTRATION PROJECT LARGE SCALE PREVENTION

Lessons Learned Long time-frame and sustainable funding needed…visible output requires visible input ‘Preventive dose’ not achieved…’scaling up’ Focus mainly on community mobilization, public health - health care system not fully mobilized…sustainability Link up with other targeted prevention initiatives and combine strategies whenever possible (CHD, Diabetes, Strategy on Cancer Control…)

NCD prevention and control: Challenge Environment Awareness: NCDs and risk factors Myths and confusions: treatment Vs Public health, Double burden, resource competition Commercial pressure and globalization Management/operational issues Lack of capacity for developing policy, strategies, etc. Lack of accountability for outcomes Lack of sustainable financing for NCD prevention Different health service providers provide related services to the same population Different programmes address the same risk factors with reference to each other Overburdening of generalist staff and duplication of administrative systems

NCD prevention and Control: Challenge Systems: The health systems need to be transformed to meet the new challenge Fragmented and uncoordinated care Disconnect between research and implementation Disconnect between specialist groups Monitoring and evaluation Complex of community-based programmes for NCD prevention Monitoring of implementation programmes(process evaluation) Evaluation of impact and outcomes Evidence Solid evidence on NCD prevention needed, particularly in developing countries

Action on NCDs at country level Promoting supportive environment Incorporate NCDs into development agenda NCDs in national health policy and plan Strengthen intersectoral action Strengthen Information Base Strengthen health systems Capacity building Monitoring and evaluation

How Member States can improve health care for NCDs 25/06/2019 How Member States can improve health care for NCDs Integrate NCDs into primary health care by expanding the package of PHC services to include the evidence-based most effective interventions Strengthen health systems and address the gaps in building blocks, particularly health financing, access to medicines, health information, and the health workforce 10

Example from Countries’ Investment in NCD Prevention to date… Single diseases - Heart Health Initiative, Diabetes ,Strategy, Cancer Strategy … Single risk factors - Tobacco Strategy … Specific population groups - Children Strategy … Commonality of risk factors for major NCDs Systems approach to delivery Partnerships Towards an integrated approach to NCD

Thank you

Thank you