1. UN High-Level Meeting puts NCDs on the map

2. Presentation 4 chapters 1. Who are/is behind is ? (stakeholders) – who is missing 2. What is at stake ? – size of the needs – negative impact on development in general – profits/attention – risks & threats 3. What was the result of the UN Meeting – UN Declaration – Review UN 2014 4. Opinions / Strategic directions

3. 1. Who were behind this ? (stakeholders) who was missing ? Carribean initiative NCD Alliance Core Group: Diabetes, Cancer, Heart, Lung Others: left out of core group: Mental Health, Asthma wide & varied participation by others… – industry, anti-Nestlé lobby, WHO, Lancet, all except tobacco patients under-represented cf. HIV-AIDS warm cloak of unity of purpose covered us all

5. 2. What is at stake ? – size of the needs : cause 2 out of 3 deaths – Lost output EPIC measures Lost Output as 7 trillion $ in LMIC 2011-2015: LMIC has 83% of NCD UMI 70% LMI 28% LI 4% – negative impact on development in general MDG Tuberculosis – opportunities primary prevention cost effective – risks & threats : cost/waste/ineffectiveness/capture

6. What was the result of the UN Meeting UN Declaration: 13 pages with 64 articles http://www.ncdalliance.org/sites/default/files/rfiles/UN%20HLM%20Political%20 Declaration%20English.pdf http://www.ncdalliance.org/sites/default/files/rfiles/UN%20HLM%20Political%20 Declaration%20English.pdf Comparison between desired outcome and outcome: http://www.ncdalliance.org/sites/default/files/rfiles/NCD%20Alliance%20Languag e%20compared%20to%20Political%20Declaration.pdf http://www.ncdalliance.org/sites/default/files/rfiles/NCD%20Alliance%20Languag e%20compared%20to%20Political%20Declaration.pdf Final Country Commitments at HLM plenaries and round tables.pdf drive for accountability continues..!

7. 2 examples of country recommendations Brazil President Dilma Rousseff: 1.Increased access to medication for patients with hypertension and diabetes 2.Reformulating public spaces for healthy lifestyles 3.Better eating habits through promoting breastfeeding, healthy eating in schools and food labeling 4.Voluntary agreements with food industry to eliminate transfats and reduce sodium in products 5.Raised tobacco taxes with national pricing legislation 6.Zero tolerance on drink driving 7.Access to preventative tests, mammograms and better treatment for breast and cervical cancer USA: Sebelius: Clinton Global Initiative to promote a smoke-free workplace around the world Initiatives: healthy people 2020 prevention strategy, targets and goals for prevention and public health with funding 2009 legislation giving government regulatory authority over tobacco products – e.g. 2012 have graphic warning in tobacco packs Lets Move Campaign – health in all policies approach Aim to introduce healthy food into schools and childcare settings Funding community efforts to combat tobacco and obesity – community transformation grants

8. Proposed Priority Actions Lancets Goal: reduce mortality 2% per year 1.Leadership 2.Prevention 3.Treatment 4.International Cooperation 5.Monitoring progress & Accountability $ 9 billion/year WHO & WEF Best Buys 1.Tobacco (tax+bans) 2.Alcohol (tax+bans) 3.Food intake + physical activity 4.CVD+Diabetes (counsel+drugs) 5.Cancer (HepB+Cervical) $12 billion (=$ 2 Prim.Prev+ 10 Sec Prev)

9. Opinions / Strategic directions Primary Prevention Empowerment and community involvement Multi sector Financing: taxing tobacco..alcohol..transfat…sugar conflicts of interests Secondary Prevention Diagonal approach Primary care Details: Use Existing systems reformed for Delivering services to include NCD Who pays ?