UNITE IN THE FIGHT AGAINST NCDs: PROTECT HEALTH AND PROMOTE DEVELOPMENT

THE UN HIGH-LEVEL MEETING ON NON-COMMUNICABLE DISEASES IS A HISTORIC, POWERFUL OPPORTUNITY FOR GLOBAL CHANGE

• TheUnitedNationsiscallingallMemberStatestoahigh-levelmeetingonthepreventionandcontrolofNon-communicableDiseases(NCDs),tobeheld19–20September2011inNewYorkCity.

• Thisoffersanunprecedentedopportunityforheadsofstateandotherworldleaderstodiscusstheprob-lemandhelpchangehowtheworldaddressesNCDs,theirriskfactorsanddeterminants.

• Thisisarareopportunityforactorsfromdifferentsectorstodiscussdevelopment,economicandhealthaspectsofNCDsfordevelopinganddevelopedcountrycontexts.

• Apoliticaldeclarationofcommitmentforamulti-sectorresponsetoNCDsisexpectedfromthishigh-levelmeeting.

NCDs AFFECT EVERYONE AND ARE A DEVELOPMENT PROBLEM THAT THREATENS THE MDGs

• NCDskillmorepeopleintheAmericasthananyothercauseofdeathandinflictgreatsocioeconomichardship,particularlyinpoorerpopulations.

• Tobaccouse,especiallyamongyouthsandincreasinglygirls,istheprincipalriskfactoraffectingtheNCDepidemicintheAmericas.

• Theriseintheprevalenceofobesity,especiallyamongchildren,willleadtoanincreaseinobesity-relateddiseasesandintheburdenofNCDs.

• Women,menandchildrenareaffecteddifferentlybyNCDsbecauseoftherolesthatbiology,gender,ethnicity,andtheenvironment,aswellassocialandeconomiccircumstances,playinshapinghealthandNCDs. Health statistics should be disaggregated and analyzed to understand these differences, andprevention,interventionandcareneedtotakeintoconsiderationthesevariedneedsandcircumstances.

• ThegrowingburdenofNCDsaffectsthepooranddisproportionatelywomen.Whereinterventionsareweakornon-existent,NCDsforcepeopleintopovertythroughhighout-of-pocketexpendituresfortreat-ment.Moreover,mostofthecareisunpaidandprovidedinthehome,predominantlybywomenwitheconomicconsequences.Thiswillsloworthreatenattainmentofthehealth-relatedMDGs.

NCDs REQUIRE A RESPONSE FROM ALL SECTORS, NOT JUST THE HEALTH SECTOR

• Thehealthsector,actingalone,cannotcurbtheNCDepidemic.Allsectorsofgovernmentandsocietymustworktogether.

• Actionisrequiredfromsectorsincludingeducation,media,agriculture,trade,transport,environment,urbanplanning,consumers,economicsandfinance.

• Governments,civilsocietyandtheprivatesectorallplayimportantrolesincreatinghealthyenvironmentsandmakinghealthychoicesavailabletoconsumers.ThustheyallneedtobeengagedinthedialogueonNCDstoidentifymutuallybeneficialsolutionstotogetherpreventandmanagechronicdiseases.

SUCCESS AGAINST NCDs IS POSSIBLE, AND PREVENTION IS KEY

• PreventingtheprimaryriskfactorsofNCDs,namelytobaccouse,poordiets,harmfuluseofalcoholandphysicalinactivity,isatopprioritytoreversetherisingtrendsinNCDs.

• Preventionisnotonlyaboutindividualbehaviorchangebutalsoaboutestablishingsustainableandsys-temicchangesinpolicies,physicalandsocialenvironmentsandhealthservicestopromotehealthandwell-being.

• Schools,workplaces,andcommunitysettingscanserveasplacestocreatehealthyenvironmentsandpromotehealthybehaviors,forexample,byofferinghealthyfoodsandprovidingincentivesforphysicalactivity.

• LegislationandregulationsarealsoneededtoprotectpeoplefromtherisksthatcauseNCDs.Devel-opingcountriesaresofttargetsandeasymarkets,andmanyneedbasicregulatorycapacityforhealth-promotingpolicies.

• PriorityNCDstrategiesinclude:

TOBACCO REDUCTION,byacceleratingimplementationoftheWHOFrameworkConventiononTo-baccoControl,whichincludestaxation,restrictionsonmarketingandsalesoftobaccoproducts,aswellasbanningsmokinginpublicplaces.

IMPROVE DIETS AND PHYSICAL ACTIVITY,throughpoliciesthatpreventobesity,promotehealthylivingandencourageconsumptionofmorefruitsandvegetablesandlessprocessedfoodshighinfat,saltandsugar.

SALT REDUCTION,throughfoodproductreformulationandpublicawareness,toimprovepreventionandcontrolofhypertension.

REDUCE HARMFUL USE OF ALCOHOL,includingthroughtaxationandregulationsonalcoholpro-motionandmarketing.

IMPROVE CARE AND ESSENTIAL DRUGS AND TECHNOLOGIES, includingmultidrugcombina-tionandoralhypoglycemicsforcardiovasculardisease,insulinfordiabetes,off-patentdrugsforcancertreatment,andHPV(HumanPapilomaVirus)vaccinesforcervicalcancerprevention.

KEY MESSAGES ON NON-COMMUNICABLE DISEASES | WWW.PAHO.ORG | NCDBULLETIN@PAHO.ORG

A STRONGER HEALTH SYSTEM IS ESSENTIAL AND WILL BENEFIT ALL ASPECTS OF HEALTH CARE

• Healthsystemstrengtheningisvitaltoprovidelong-term,continuousandhigh-qualitycareforpersonswithchronicconditions.

• Primaryhealthcareservicescanbestrengthenedtoprovidescreening,earlydetection,and follow-upcareforpersonswithchronicconditions,aswellascounselingandcommunitysupporttoreducerisksandmaintainhealth.

• StrengtheningprimarycareforNCDscancreatesynergieswithimprovedcareforpersonslivingwithHIV/AIDS,TB,andmalariaandwithchildandmaternalhealth.

• Healthservicesneedto involveandtake intoconsiderationtheneedsofthevariouspopulationsandcommunities, recognizing, forexample, theneed forgender-sensitive careandculturally appropriateservices.

ACTION IS URGENTLY NEEDED NOW. NCDs ARE COSTLY AND, AS THE EPIDEMIC KEEPS RISING, WILL BECOME A MAJOR ECONOMIC ISSUE FOR COUNTRIES AND FAMILIES

• NCDsdriveupthecostsofhealthcareatanunsustainablerateandforcepeopleintopoverty.Preventionandcost-effectivetreatmentarekeystoensuringthathealthsystemscansupportpeoplelivinglonger,healthierlives.

• TheNCDsepidemicalreadystretchesfarbeyondthecopingcapacitiesoflower-incomecountries.With-outurgentaction,therisingfinancialburdenofthesediseaseswillreachlevelsbeyondthemeansofevenwealthycountries.

THE NCD BURDEN IN THE AMERICAS

• THE LEADING NCDS IN THE REGION ARE:

CARDIOVASCULAR DISEASE • CANCER • DIABETES • CHRONIC RESPIRATORY DISEASE

• DEATHS:

3.9 MILLION PEOPLEintheAmericasdieannuallyfromNCDs,accountingfor76% OF ALL DEATHS.

thanofthesedeathsarepremature(peopleunder70)AND LARGELY PREVENTABLE.

TheoverallportionofwomenandmendyingfromNCDsisequal,yetMANY MORE MEN DIE PREMATURELY.

• KEY DRIVERS FOR THE NCD PROBLEM IN OUR REGION ARE: URBANIZATION • POPULATION GROWTH • CHANGES IN AGE STRUCTURE • LIFESTYLES ThishasleadtoanepidemiologictransitioninwhichNCDshaveovertakeninfectiousandotherdiseasesasleadingcausesofdeath.

• RISK FACTORS:

TheAmericasregionischaracterizedbysomeofthehighestratesofobesity,with50–60% OF ADULTS CONSIDERED OVERWEIGHT OR

OBESE, puttingthemathigherriskforNCDs.

TheregionisalsocharacterizedbyHIGH RATES OF SMOKING,

ESPECIALLY IN ADOLESCENT GIRLS, amongwhomratesnowexceedthoseforboysinmanycountries.

NCDs AND MDGs

NCDS THREATEN THE ATTAINMENT OF GLOBALLY ENDORSED DEVELOPMENT TARGETS SUCH AS THE MDGS. Someexamplesinclude:

• MDG 1 ON POVERTY AND NUTRITION: TheNCDepidemicisgrowingfasterinpoorcountriesandpoorercommunities.

• MDG 4 ON REDUCING CHILD MORTALITY: Tobaccousebymothersincreasesthechancesoflowbirthweight;infantswhosemotherssmokeweighonaverage200gramslessthaninfantsofnon-smokingmothers.

• MDG 1 ON NUTRITION AND MDG 5 ON IMPROVING MATERNAL HEALTH: Moneyspentontobacco,alcoholuse,andcostlyout-of-pocketexpenditureonmedicinesforchronicdiseasesmeanslessmoneyavailableforfeedingchildren.

• MDG 5 ON IMPROVING MATERNAL HEALTH: Tobacco,obesityanddiabetescreatehigh-riskconditionsforpregnantwomen.

• MDG 6 ON HIV/AIDS, TB AND MALARIA: SomepeoplewithdiabetesareatanincreasedriskofcontractingTB.HIV/AIDSisassociatedwithhigherratesofsometypesofcancer.

• MDG 8 ON PARTNERSHIPS: Onlyone-thirdofNCDessentialmedicinesareavailableinpublichealthfacilitiesindevelopingcountries.

KEY MESSAGES ON NON-COMMUNICABLE DISEASES | WWW.PAHO.ORG | NCDBULLETIN@PAHO.ORG