Dr Ala Alwan Assistant Director-General Noncommunicable Diseases and Mental Health World Health Organization Scope, Objectives and Agenda

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Noncommunicable Diseases and Injuries Magnitude Four major noncommunicable diseases (NCDs): –Cardiovascular diseases –Diabetes –Cancers –Chronic respiratory diseases Four shared modifiable risk factors: –Tobacco use –Unhealthy diet –Physical inactivity –Harmful use of alcohol 60% of deaths globally – 70% if injuries are included -80% in developing countries 40-50% are premature Magnitude has a major socio-economic impact on developing countries  NCDs and injuries are still excluded from global discussions on development

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Injuries Cause 10% of all deaths and 16% of all disability Road traffic crashes alone are the leading cause of death for young people aged years

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Global Risk Assessment 2009 World Economic Forum Asset price collapse Retrenchment from globalization Oil and gas price spike NCDs Flu pandemic Fiscal crisis Food crisis Infectious disease

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Noncommunicable Diseases & Injuries Projected global deaths (2030) Cancers Stroke Road traffic accidents HIV/AIDS TB Malaria Acute respiratory infections Ischaemic heart disease Perinatal

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) (cumulative) Geographical regions (WHO classification) Total deaths (millions) NCD deaths (millions) Trend: Death from infectious disease Trend: Death from NCD Africa %+27% Americas %+17% Eastern Mediterranean %+25% Europe %+4% South-East Asia %+21% Western Pacific % Total %+17% Noncommunicable Diseases Death trends (2015) WHO projects that over the next 10 years, the largest increase in deaths from cardiovascular disease, cancer, respiratory disease and diabetes will occur in low- and middle-income countries.

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Source: World Health Survey 2006 Range: from Q1 = poorest quintile to Q5 = Highest income quintile Noncommunicable Diseases The poorest people in developing countries are the ones who smoke the most

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Noncommunicable Diseases Macro-economic impact (cumulative)2005 Lost national income from premature deaths due to heart disease, stroke and diabetes Lost national income (billions) Countries 493 Brazil China 2379 India 80.4 Nigeria 311 Pakistan Russian Federation 30.1 Tanzania WHO: "Heart disease, stroke and diabetes alone are estimated to reduce GDP between 1 to 5% per year in developing countries experiencing rapid economic growth" (WHO Chronic Disease Report, 2005)

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Noncommunicable Diseases The vicious cycle of poverty and NCDs

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) NCDs are emerging as a serious threat to Arab countries and are undermining development

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Cardiovascular diseases (27%) Infectious and parasitic diseases (17%) Respiratory infections (10%)Perinatal conditions (10%) Malignant neoplasms (7%) Respiratory diseases (4%) Unintentional injuries (7%) Digestive diseases (4%) Intentional injuries (4%) Neuropsychiatric disorders (2%) Total deaths: 4.3 million Noncommunicable conditions: 50% Communicable diseases*: 39% Injuries: 11% Total deaths: 4.3 million Noncommunicable conditions: 50% Communicable diseases*: 39% Injuries: 11% * Including maternal and perinatal conditions and nutritional deficiencies Diabetes (2%) Noncommunicable Diseases Magnitude in the Middle East

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Top-10 countries in diabetes prevalence in the world (2007) Age- adjusted prevalence of diabetes in yr age group (%) Rank and country Nauru United Arab Emirates Saudi Arabia Bahrain Kuwait Oman Tonga Mauritius Egypt Mexico

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) NCDs and injuries are preventable We know what works We have cost-effective interventions: Tobacco control interventions Measures to improve healthy dietary and physical activity patterns Early detection and effective treatment of cancer Treatment of hypertension, diabetes Treatment of heart disease and stroke Intersectoral injury prevention measures

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) The global response to address noncommunicable diseases

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) 1. Integrating NCD prevention into the development agenda, and into policies across all government departments 2. Establishing/strengthening national policies and programmes 3. Reducing/preventing risk factors 4. Prioritizing research on prevention and health care 5. Strengthening partnerships 6. Monitoring NCD trends and assessing progress made at country level Under each of the 6 objectives, there are sets of actions for member states, WHO Secretariat and international partners Action Plan for the Global Strategy Six Objectives of the Action Plan

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Noncommunicable Diseases The NCD gap in the development agenda (Health ODA* Commitments 2006 by major subsector) US$ Billions Total = $20.9 billion * ODA = Official Development Assistance provided by 24 OECD/DAC donor countries, as well as the EC

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) … … MDGs … failed to identify noncommunicable conditions, in spite of the fact that these diseases account for fully 70% of the global mortality… most of the morbidity and mortality caused are preventable … a serious omission … I propose we seriously consider an MDG+, which would set goals for the NCCs, as we have done for other … challenges. President of the 61st World Health Assembly

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) Objective 1: To raise the priority accorded to noncommunicable diseases in development work at global and national level Global NCD Action Plan Milestones Regional Ministerial Meeting on Health Literacy (Beijing, April 2009) Regional Ministerial Meeting on NCDs, Poverty and Development (Qatar, May 2009) ECOSOC High Level Segment on Global Health (Geneva, 6- 8 July 2009)

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) What do we want to achieve from this meeting? Review the magnitude and trends of NCDs and injuries with special emphasis on socio-economic impact Discuss s uccessful approaches and interventions to address NCDs and injuries and identify cost- effective measures to improve access of the poor and vulnerable populations to proper health care Discuss w ays and means of integrating the prevention of NCDs and injuries into national, regional and global development initiatives

ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting Addressing noncommunicable diseases and injuries (Doha, Qatar, May 2009) What do we want to achieve from this meeting?... Recommend key actions for countries to incorporate NCD prevention into poverty reduction strategies and relevant social and economic policies Recommend mechanisms to involve all government departments to ensure that NCD and injury prevention receives a cross-sectoral response A Call for action by the international community and development agencies to respond to the needs of countries in scaling up action against NCDs and injuries