Global Targets, Indicators, and Expectations for the 2012 World Health Assembly
Remarks by Chargé d’Affaires Douglas Griffiths
Geneva, April 25, 2011
I’d like to welcome you to the U.S. Mission. We’re delighted to host this roundtable discussion with the goal of developing global targets and indicators ahead of the World Health Assembly in honor of John Seffrin’s visit to Geneva. As CEO of the American Cancer Society, he will share with us the activities taken by his organization to develop indicators from the civil society perspective.
I’m pleased to co-host this event with Ambassador Tom Mboya Okeyo of the Kenyan Mission. And we are also grateful to have the presence of the South African Minister of Health Dr. Lindiwe Makubalo.
Today we’re also graced with the presence of Her Royal Highness Princess Dina Mired of Jordan who has worked tirelessly on these issues in her leadership at the King Hussein Cancer Foundation.
For decades, the international community has joined forces to battle infectious diseases. Working together, we have eliminated smallpox and reduced the devastating toll taken by illnesses like malaria and HIV/AIDS. While much work remains to be done, we have shown that when the nations of the world come together, we can achieve great improvement in health.
Chronic, non-communicable diseases (NCDs) have emerged as a growing health problem for countries of every size, in every corner of the globe and at every stage in development. Rapid population aging, urbanization and lifestyle changes have only increased the urgency of addressing the rising tide of chronic disease.
Around the world, chronic diseases like heart disease, cancer, and stroke rob families and communities of millions of loved ones. The United States is no exception. Chronic diseases account for seven out of ten deaths in our country, cutting lives short by decades, often after prolonged disability.
Last year’s High-Level Meeting (HLM) on Non-communicable Diseases (NCDs) at the United Nations General Assembly (UNGA) was an opportunity to enhance our domestic response to NCDs, to spur collective global health action to address NCDs, and to accelerate the implementation of evidence-based NCDs policies and programs across the globe.
Among the Meeting’s major outcomes was the charge to WHO to develop a comprehensive global monitoring framework, including indicators, and to recommend a set of voluntary global targets. As you know, the Declaration calls for those to be developed through WHO with its Member States, by the end of 2012. WHO is also exploring options to strengthen multi-sectoral action on NCDs.
The intense work leading up to last year’s UN High-Level Meeting, continuing through the Member State consultations and leading up to the World Health Assembly have made clear that there is genuine commitment to coordinating our efforts to battle chronic diseases.
Tomorrow, Member States will meet to consider a proposal including targets and a list of core indicators to form that global monitoring framework; Civil society and private sector representatives will have an opportunity to share their views next week.
Today, we’ve gathered together, across sectors, to share our perspectives on the targets and indicators, and discuss expectations for the World Health Assembly.
We will hear from several speakers representing different perspectives and then we will open up the floor for discussion.
I will now turn this over to my colleague Ambassador Jimmy Kolker, Deputy Director for Global Affairs at Health and Human Services.
Remarks by Ambassador Jimmy Kolker
Deputy Director for Global Affairs,
Health and Human Services
Global Targets, Indicators, and Expectations for the 2012 World Health Assembly
April 25, 2011
Today in the United States, chronic diseases account for 70% of deaths, limit the activities of millions of Americans, and cost our economy billions every year. Many of these premature deaths and years living with disability are preventable. Through research and collaboration, we’ve expanded our knowledge about what works to prevent NCDs and how to mitigate their consequences. And as with many communicable diseases, we know prevention and early detection are essential to address the NCDs burden.
The Obama Administration is deeply committed to addressing domestic and global health issues, including the four leading causes of death and disability focused on by the High-Level Meeting (cardiovascular diseases, cancers, chronic respiratory disease, and diabetes), along with their primary modifiable risk factors. These are a high priority at all levels. Through the Affordable Care Act signed by President Obama, we’re expanding access to key preventive services and making NCD treatment and care more affordable. Last year, Secretary Sebelius of the Department of Health and Human Services launched the Million Hearts initiative—a five-year program to prevent one million heart attacks and strokes. And the Office of the First Lady is implementing the Let’s Move! Initiative, which aims to solve the problem of childhood obesity in a generation.
Complex global health challenges like those posed by NCDs require sustained efforts, commitment, and cooperation by the international community. Within the USG, we recognize that this calls for a whole-of government approach, and action well beyond the health sector. This means not only other agencies of the government, but our partners from civil society, academia and the private sector. The Global Smoke-Free Worksite Challenge and the US National Heart, Lung and Blood Institute’s Collaborating Centers of Excellence to Combat Chronic Diseases in Developing Countries are just two examples of our multi-sectoral collaborations on NCDs.
We also have to build on the lessons learned from our past investments in global health to address changing realities. Many countries are now facing a double burden of infectious and non-communicable diseases, and looking to lessons from the scale-up of HIV services to manage other chronic illnesses. One example is the Pink Ribbon Red Ribbon initiative, which will leverage the PEPFAR platform to combat cervical and breast cancer. Diabetes and cardiovascular services are also using lessons from the HIV field as they scale up clinical care, psychosocial support, and self-care programs.
The process leading up the UN High-Level Meeting created a broader base of support to build on these existing activities and frameworks, including WHO’s 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Non-communicable Diseases. It also gave us a chance to explore additional mechanisms to foster a collective global response and to share best practices and lessons learned.
WHO’s work now underway is a critical component of those efforts. At the January WHO Executive Board meeting, we had the honor to introduce on behalf of cosponsors a resolution to confirm a clear process throughout the critical year of 2012 on three aspects of WHO’s work on NCDs: the monitoring framework, global targets, and options to strengthen multi-sectoral engagement.
A key feature of the process from our point of view is to make use of the World Health Assembly in May to capture progress and consensus, and then take the remaining time in 2012 to finalize any remaining components of the work.
This global monitoring framework should be well aligned with existing efforts and strategies and reflect Member State consensus. Indicators included in the framework must be clearly defined, focus on the core elements, and acknowledge country capacities to minimize adverse impact on countries’ monitoring and surveillance capacities.
Three of the five proposed targets – mortality, tobacco smoking and raised blood pressure – have been vetted during Member State consultations and gained support with only minor changes. These three form a rational and cohesive set, establishing an ambitious goal to reduce premature NCDs deaths by 25%, and focusing on the leading causes of preventable deaths worldwide (tobacco use and high blood pressure).
Reaching consensus on an initial target set – particularly the overarching mortality goal – will provide countries and regions with a foundation to build upon as they establish or strengthen their national plans and strategies by 2013. These core indicators selected will also inform the 2013-2020 WHO action plan on NCDs prevention and control, and influence country efforts to strengthen their own surveillance systems.
In our perspective, agreeing to resolution EB130.R7 commits us as Member States to participate actively, constructively, and with a view to enabling WHO to meet its deadlines in the Political Declaration. This will require a lot of technical and diplomatic work, and we are ready to do our part. We continue to be strongly committed to raising the profile of non-communicable diseases as a major public health concern and look forward to working together to reach global targets on NCDs.