What's This Global Discussion On "NCD's" and Do You Have a Role? An Update on Noncommunicable Disease Prevention and Control Efforts

What are “NCDs?”

NCD – or noncommunicable disease – is a term that you may have been hearing more and more about, and it is very likely that you already know someone who has an NCD.  In a nutshell, NCDs include “the big four”: cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases.  According to the World Health Organization, these NCDs cause 60% of all deaths globally, with more than 80% occurring in developing countries and are attributed to poor diet, physical inactivity, tobacco use, and harmful use of alcohol.  Other diseases that contribute to the NCD burden include Alzheimer’s disease, other neurological and mental health disorders, gastrointestinal diseases, renal diseases, oral diseases, and eye diseases.

What is the World Health Organization?

The World Health Organization (WHO) is the directing and coordinating authority on international health within the United Nations (UN) system.  WHO provides leadership on global health matters, shapes the health research agenda, sets norms and standards, articulates policy options, provides technical support to nations, and monitors/assesses health trends. The current WHO Director-General is Dr. Margaret Chan, and there are more than 8000 public health experts working for WHO around the world, including at the headquarters in Geneva, Switzerland, six regional offices, and 147 country offices. 

What is the Pan American Health Organization?

The Pan American Health Organization (PAHO) is the regional office for the Americas of WHO.  Its mission is to promote and coordinate efforts of the countries of the Western Hemisphere to combat disease, lengthen life, and promote the physical and mental health of the people.  There currently are 47 Member States (countries), including the U.S., that belong to PAHO.  The current PAHO Director is Dr. Carissa F. Etienne and the PAHO headquarters is in Washington, DC.

What is the World Health Assembly?

The World Health Assembly (WHA) is the decision-making body of WHO that determines the policies of WHO.  The WHA meeting occurs annually in late-May, when health ministers from around the world (including  U.S. Health and Human Services Secretary—currently Kathleen Sebelius), global health leaders, NGOs, civil society, private sector, academia, and other stakeholders gather in Geneva to focus on a specific health agenda. 

What is the United Nations General Assembly?

Heads of State and Government meet each September at the United Nations headquarters in New York City for the United Nations General Assembly, often referred to as “UNGA” (“Un-Gah”).  UNGA, which is comprised of all 193 members of the United Nations, is the main deliberative, policymaking and representative body of the UN.

Why are the United Nations, WHO, PAHO, and WHA focused on NCDs? 

In September 2011, the United Nations brought the topic of NCDs to the forefront during its UN General Assembly when it held the historic High-level Meeting on NCDs.  Heads of State and Government from the around the world unanimously adopted a Political Declaration  to stand united in a global fight against NCDs.  The Declaration assigned a number of responsibilities to WHO, and, since then, WHO and the WHA have made NCDs a key part of their agendas. 

In May 2012, the WHA adopted the goal of reducing preventable deaths from NCDs by 25% by the year 2025, which is also known as“25 x 25”. 

To help implement “25 x 25”, in May 2013, the WHA endorsed the WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020 and adopted a Global Monitoring Framework on NCDs with 9 global targets and 25 indicators, including the following:

 

Indicators:

¨ Age-standardized prevalence of persons (aged 18+ years) consuming less than five total servings (400 grams) of fruit and vegetables per day.

¨ Prevalence of insufficiently physically active adolescents (defined as less than 60 minutes of moderate to vigorous intensity activity daily).

¨ Age-standardized prevalence of insufficiently physically active persons aged 18+ years (defined as less than 150 minutes of moderate-intensity activity per week, or equivalent).

¨ Age-standardized mean population intake of salt (sodium chloride) per day in grams in persons aged 18+ years.

¨ Age-standardized mean proportion of total energy intake from saturated fatty acids in persons aged 18+ years.

 

Targets:

¨ 10% relative reduction in prevalence of insufficient physical activity.

¨ 30% relative reduction in mean population intake of salt/sodium.  (WHO’s recommendation is less than 5 grams of salt or 2 grams of sodium per person per day.)

¨ 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure according to national circumstances.

¨ Halt the rise in diabetes and obesity.  (Countries will select indicator(s) appropriate to national context.)

 

This year, the WHA also committed to developing a global coordination mechanism to coordinate activities and promote engagement of all actors in the global NCD response, including governments and, where appropriate, civil society, NGOs, and the private sector.  As such, Member States (110 nations) formally established the United Nations Interagency Task Force on the Prevention and Control of NCDs.  The Task Force, which expands the mandate of the existing UN Ad-Hoc Interagency Taskforce on Tobacco Control, will be convened and led by WHO, and will coordinate the entire UN system to respond to the growing NCD epidemic. 

The opening session of the 68th session of UNGA, which will convene on September 17, 2013, is shortly upon us.  While UNGA serves as a forum for a wide spectrum of international issues each year, this year’s General Debate is: "Post-2015 Development Agenda: Setting the Stage."  The IFIC Foundation will participate in one of the side-events sponsored by the United States Government, Permanent Missions of the Caribbean Community and Common Market (CARICOM) to the UN, NCD Alliance, and NCD Roundtable: Healthy Planet, Healthy People: Building Synergies for Sustainable Development.  This multi-stakeholder dialogue will convene participants from multilateral organizations, government, civil society, and the private sector at a critical juncture for global health and development.  A panel discussion will be moderated by Richard Horton, editor-in-chief of The Lancet, and will discuss the importance of health and NCDs in the post-2015 development agenda, and explore the linkages between health/NCDs and the three dimensions of sustainable development.

The discussions that take place at the 68th session of the UNGA in just a few weeks will help set the stage for 2014, when the UN will revisit the NCD issue again so that governments can discuss their progress on 25x25.

The UN will revisit the NCD issue again in 2014, when governments will discuss their progress on 25x25.

 

What’s the financial cost of NCDs?

WHO Director-General Margaret Chan stated that NCDs are “the diseases that break the bank.” The World Economic Forum estimates that NCDs will cost $500 billion/year between now and 2025 if a “business as usual” approach is taken and disease rates continue to soar. 

IFIC Foundation Research Ties to NCDs

Our annual IFIC Foundation Food and Health Survey highlights consumer insights into understanding the contributing factors to NCDs, such as obesity, and mitigating strategies, such as improved diet and increased physical activity.

For example, the 2013 Survey asked American consumers to indicate "Which of the following medical conditions, if any, do you or any member of your household currently have or are at risk of having?" and listed ten medical conditions, including cancer, diabetes, heart disease, high blood pressure, and stroke.  Through subpopulation analysis considering these medical conditions, we found that Americans reporting NCDs in their household compared to those who don’t are more likely to:

  • Say their health is fair/poor & report being overweight or obese.
  • Report that they are trying to lose weight.
  • Say they have tried to cut back on foods higher in added sugar and those higher in salt.
  • Look for information on packages when purchasing foods and beverages and to look at the Nutrition Facts panel. 

Consumer insights like these are key to informing appropriate NCD prevention and control responses. 

 

What’s the role of the International Food Information Council (IFIC) Foundation in the NCD discussion?

For the past three years, the IFIC Foundation has been involved in the global NCD discussion. In September 2011, we complemented the UN High-level Meeting on NCDs by having 150+ people representing 34 countries join together for our IFIC Foundation Global Diet and Physical Activity Communications Summit: “Insights to Motivate Healthful, Active Lifestyles.” 

Leading experts from around the world shared their insights and best practices for the use of science-based, behavior-focused communications in order to motivate individuals and families to achieve healthful, active lifestyles, with the goal of helping to reduce the incidence of NCDs. 

As U.S. Surgeon General Regina Benjamin so appropriately noted, NCD prevention and control "messaging has to include effective science based behavior focused communication; communications that are clear, useful and motivating to the intended audiences.”

We also have participated in the WHA as a civil society delegate to the UN Civil Society Hearing on NCDs, and to PAHO’s Pan American Forum for Action on NCDs. In response to WHO’s call for comments from civil society organizations on key NCD topics, the IFIC Foundation provided overarching comments on two discussion papers: “Options for Strengthening Multi-Sectoral Action” and “Lessons Learnt from Existing Multi-Sectoral Partnerships that May Inform the Global Response to NCDs.” 

Our response, which furthers the IFIC Foundation mission, in each of these venues emphasizes the importance of using science-based communication strategies to help reduce the prevalence of NCDs.  Simple science-based messages on nutrition and health can be an effective and affordable way to help citizens from around the globe take steps to reduce risk factors associated with NCDs. This cost-effective approach can be easily tailored for different audiences based on location and need, and, therefore, should be a simple, yet important, intervention that every country could consider.

What’s YOUR role in the NCD discussion and solution?

As noted in a May 2012 peer-reviewed Nutrition Reviews article, we believe that “\[w\]hen considering next steps and how to move ahead on NCD-related communication strategies . . . it is important that all stakeholders – including those from government, civil society, research and clinical academia, and industry – become partners, not adversaries. To be successful, health officials, health professionals, communicators, and other stakeholders cannot work in silos. Instead, the public and private sectors must work together to develop and deliver consistent messaging.”

And, there are more opportunities for many of our stakeholders, partners, experts, and perhaps YOU to be involved in this NCD effort, especially as we head into 2014, when the UN will again address the issue of NCD, and as we work together on the “25x”25” goal. 

We invite you to start the discussion and become a part of the NCD solution by reading and sharing our IFIC Foundation one-page fact sheet on communication strategies to help reduce the prevalence of NCDs, which is available in the six official United Nations languages: English, Arabic, Chinese, French, Russian, and Spanish. We also offer a variety of resources on our NCD webpage, including the English version of this article.