WHO Technical Briefing Seminar on Essential Medicines & Health Products, October 2013 Noncommunicable Diseases –Action Plan Dr Shanthi Mendis Director, Department of NCD Management a.i. World Health Organization Geneva, Switzerland

NCDs - Development Challenge (2008 estimates) 0 M 5 M 10 M 15 M 20 M 25 M 30 M 35 M Low-income Countries Lower- Middle-income Countries Upper- Middle-income Countries High-income Countries Communicable conditionsNCDs < 60InjuriesNCDs > 60 Premature Deaths 9 M Total NCD deaths 36 M

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 Global Strategy to Reduce the Harmful Use of Alcohol WHO Global Status Report on NCDs Political Declaration on NCDs Global Mile stones : Prevention and Control of NCDs WHO Action Plan for the Prevention and Control of NCDs for

WHO Global NCD Action Plan Adopted by 194 Ministries of Health at the World Health Assembly 2013 The plan aims to operationalize the commitments from Heads of State and Government included in the Political Declaration of the High-level Meeting of the United Nations General Assembly on NCDs

Objective 1: To strengthen international cooperation and advocacy to raise the priority accorded to prevention and control of NCDs in the development agenda and in internationall y-agreed development goals Objective 2: To strengthen national capacity, leadership, governance, multisectoral action and partnerships to accelerate country response for prevention and control of NCDs Objective 3: To reduce exposure to modifiable risk factors for NCDs through creation of health- promoting environment s Objective 4: To strengthen and reorient health systems to address prevention and control of NCDs through people- centered primary health care and universal coverage Objective 5: To promote and support national capacity for high quality research and development for prevention and control of NCDs Objective 6: To monitor trends and determinants of NCDs and evaluate progress in their prevention and control WHO Global NCD Action Plan –objectives

لنتحد في مكافحة الأمراض غير السارية Immediate actions for Member States in Action Area Governance Risk factors Health systems Surveillance 1.Set national targets for 2025 in 2013, taking into account the 9 global targets

لنتحد في مكافحة الأمراض غير السارية Prevention of Heart Attacks and Strokes : At least 50% of eligible people receive drug therapy and counseling (including glycemic control) to prevent heart attacks and strokes Availability and affordability An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major NCD in both public and private facilities

لنتحد في مكافحة الأمراض غير السارية Immediate actions for Member States in Action Area Governance Risk factors Health systems Surveillance 2.Develop national multisectoral plans in 2013 to achieve targets, taking into account the WHO Global NCD Action Plan The global action plan comprises a set of actions which, when performed collectively by Member States, international partners and WHO, will attain the 9 global targets, including a 25% reduction in premature morality in NCDs by 2025

لنتحد في مكافحة الأمراض غير السارية Immediate actions for Member States in Action Area Governance Risk factors Health systems Surveillance 1.Implement interventions identified by WHO as "very cost effective interventions " using WHO tools: Tobacco use Unhealthy diet and physical inactivity Harmful use of alcohol

Cost effective interventions Cancer Prevention of liver cancer through hepatitis B immunization Prevention of cervical cancer through screening (visual inspection with acetic acid (VIA), with timely treatment of pre-cancerous lesions

لنتحد في مكافحة الأمراض غير السارية Immediate actions for Member States in Action Area Governance Risk factors Health systems Surveillance 1.Implement interventions identified by WHO as "best buys" into the basic primary health care package using WHO tools: Integrated approach to cardiovascular diseases and diabetes: –Multidrug therapy to individuals who have had a heart attack or stroke and to persons with a high risk of a cardiovascular event in the next 10 years –Providing aspirin to people having an acute heart attack

لنتحد في مكافحة الأمراض غير السارية Immediate actions for Member States in Action Area Governance Risk factors Health systems Surveillance 2.Implement other very cost-effective and affordable interventions identified in Appendix 3 of the Global Action Plan into the basic primary health care package using WHO tools

لنتحد في مكافحة الأمراض غير السارية Immediate actions for Member States in Action Area Governance Risk factors Health systems Surveillance 2.Implement other very cost- effective and affordable interventions identified in Appendix 3 of the Global Action Plan using WHO tools

How much will it cost to scale-up very cost effective NCD interventions? For all LMIC, US$ 11.4 billion per year on average Population-based measures: close to US$ 2 billion per year Low- and lower-middle-income countries: < US$ 0.20 per head Upper-middle income countries: < US$ 0.50 per head Individual-based measures: US$ 9.4 billion per year Low- income countries: < US$ 1.00 per head Lower middle-income countries:< US$ 1.50 per head Upper-middle income countries: ~ US$ 2.50 per head

لنتحد في مكافحة الأمراض غير السارية Immediate actions for Member States in Action Area Governance Risk factors Health systems Surveillance 1.Strengthen NCD surveillance, covering a) monitoring of risk factors and determinants, b) outcomes (mortality and morbidity) and c) health system response and integrate into the national health information systems

لنتحد في مكافحة الأمراض غير السارية Immediate actions for Member States in Action Area Governance Risk factors Health systems Surveillance 2.Develop national targets and indicators, based on the WHO recommendations and WHA Resolutions WHA WHA WHA

لنتحد في مكافحة الأمراض غير السارية A global coordination mechanism on NCDs (2014) Formal meeting of Member States to conclude the work on the terms of reference for a global coordination mechanism on the prevention and control of noncommunicable diseases (Geneva, 11–12 November 2013) Proposed functions – A forum for Partners to: Broker knowledge and information: Encourage innovation: Promote multisectoral action: Promote accountability: Advocate and raise awareness: Proposed partners: Member States UN organizations and other intergovernmental organizations Non-State actors for discussion on November 2013

Thank you