1. ECOSOC Western Asia Ministerial Meeting “Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century” Multistakeholder approaches to meet the challenges of noncommunicable diseases and injuries Dr Fiona Adshead Director, Chronic Diseases and Health Promotion World Health Organization 10-11 May 2009 Doha, Qatar

2. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 2 |2 | Multistakeholder NCD prevention: a whole of society approach Cross-sectoral, whole-of-society action involves: –Government leadership, –Empowering people to make healthy choices by building health literacy and capacity across society, –Collaborative work: government, industry and civil society, –Creation of enabling environments that promote health, –Measuring outcomes and ensuring it works.

3. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 3 |3 | MULTISTAKEHOLDER, CROSS-SECTORAL APPROACH Government – civil society – private sector – media BEHAVIOUR CHANGE ENABLINGENVIRONMENT HEALTH LITERACY Empowerment HEALTHOUTCOME Access to information, knowledge reinforcement, and opportunity to act Feedback and policy change GOVERNMENT leadership

4. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 4 |4 | Building multistakeholder approach to NCD prevention into our daily lives Within a programme Within a campaign Across a campaign Healthy schools Salt reduction Physical activity

5. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 5 |5 | Within a programme – Healthy Schools

6. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 6 |6 | Within a Campaign – Salt Reduction Nongovernmental Organizations Blood Pressure Association British Heart Foundation Consensus Action on Salt and Health Diabetes UK Food Commission Manchester Food Futures Partnership Men's Health Forum National Children's Bureau (NCB) Net mums National Federation of Women's Institutes (NFWI) Trading Standards Institute (TSI) Retailers Asda, Marks and Spencer, Sainsbury's, Tesco, Morrisons, Waitrose, Iceland, Co-op, Somerfield, Budgens and Spar Manufacturers McCain, Heinz, Bernard Matthews, Premier Foods, Cadbury Schweppes, Kraft, Kellogs, Pepsico, Procter & Gamble, Northern Foods, Nestlé, United Biscuits and Unilever Trade Associations Association of Cereal Food Manufacturers (ACFM), and the Snacks, Nuts and Crisps Manufacturers Association Food Standards Agency (FSA)

7. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 7 |7 | Across a Campaign – Ciclovia program development, continuity and effectiveness

8. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 8 |8 | Health In All Policies: common action for shared benefits By taking a Health In All Policies approach, a government can ensure: –NCD risk factors and determinants are addressed by policy- makers and stakeholders in non-health sectors, –Costs and benefits can be shared across all sectors, –Co-benefits can be achieved among sectors that otherwise might not have worked together: Example: common action on climate change + NCD prevention and control.

9. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 9 |9 | Buildings Indoor air pollution Heat and cold protection Choosing healthy paths to a low carbon future Energy supply & conversion Occupational risks; Construction and transport Agriculture Nutrition, Water / vector-borne disease Transport Air pollution Traffic injuries Physical inactivity Industry Occupational risks, mining and transport Waste Occupational, chemical Greenhouse Gas Emissions And NCD risk factors

10. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 10 | Transport and health Kenworthy, 2003 Atlanta Zurich Paris Singapore Hong Kong Houston Beijing Bangkok Cairo Riyadh

11. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 11 | Climate change, NCDs and achieving MDGs Indoor air pollution: Annually kills about 1.5 million of the poorest women and children, Significant contributor to climate change, Interventions are cost- effective both for health and climate, Failure to incentivize "common cause"?

12. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 12 | Empowered Citizen Health Literacy Health Promotion Self care Chronic disease self-management Patient and citizen involvement The Self Care Circle © Harry Cayton Co-producing and co-benefiting: chronic disease prevention and control Self care: A great example of partnership between public and health service. $100 spent on self care = $150 worth of benefits delivered in return. A sense of control over one's destiny = PRICELESS.

13. ECOSOC Western Asia Ministerial Meeting, Doha, Qatar | 10-11 May 2009 Addressing noncommunicable diseases and injuries: major challenges to sustainable development in the 21st century 13 | Cross-sectoral approach: at the centre of public health and development A cross-sectoral approach leads to an enabling environment for common action for shared benefits, For the greatest benefits, NCDs, their risk factors and their determinants should be considered, Examples show that it can work: –healthy schools, salt reduction, Cyclovia, self-care cycle, climate change, The lessons learned can be applied to broader public health delivery including achievement of the MDGs.