Download - Session 3 Health Professionals Cazap
WHO Global Forum: Addressing the Challenge of
Non-communicable Diseases
Concurrent Session 3 Health Sector
Dr Eduardo Cazap
President, Union for International Cancer Control (UICC)
and UN Civil Society Task Force Co-Chair
Wednesday 27th April 2011
Background
Causes and Prevention of NCDs
NCDs are the world’s leading cause of death, accounting for 60% of all global
deaths, or 35 million deaths per year. 80% of NCD deaths (28 million) occur in
low- and middle-income countries.
The four main risk factors
are:
• tobacco use
• unhealthy diet
• physical inactivity
• harmful use of alcohol.
NCDs can be prevented or mitigated:
• reducing tension and stress
• improving diet and reducing sodium intake
• regular sufficient physical activity
• avoiding obesity
• supporting optimal mental health
• implementing preventive care (eg vaccinations)
and screening for preventable disease/illness
• avoiding tobacco and harmful alcohol
consumption
Source: World Health Professions Alliance Policy Statement on NCDs
and Social Determinants of Health
An Explosion About to Happen
2005 2006-2015 (cumulative)
Geographical regions (WHO classification)
Total deaths
(millions)
NCD deaths
(millions)
NCD deaths
(millions)
Trend: Death from infectious
disease
Trend: Death from NCD
Africa 10.8 2.5 28 +6% +27%
Americas 6.2 4.8 53 -8% +17%
Eastern Mediterranean
4.3 2.2 25 -10% +25%
Europe 9.8 8.5 88 +7% +4%
South-East Asia 14.7 8.0 89 -16% +21%
Western Pacific 12.4 9.7 105 +1 +20%
Total 58.2 35.7 388 -3% +17%
(WHO, Chronic Disease Report, 2005)
The Need for a Holistic and Multi-sectoral
Approach
�Prevention and control of NCDs requires action on the broader factors which
influence people’s behaviour including: the conditions in which they are born,
grow, live, work and age, and the influence of society
�Strategies to prevent chronic disease demand the collaborative engagement of
multiple sectors including: agriculture finance, trade, transport, urban planning,
education and recreation.
�A holistic health system built on a primary health care model and including
prevention, rehabilitation and specialised health services is vital if the NCD
epidemic is to be tackled.
�Governments must ensure that we increase the global supply of adequately
trained health professionals to meet the growing burden of NCDs
Source: World Health Professions Alliance Policy Statement on NCDs
and Social Determinants of Health
Disease Burden and Resources
Physicians, Nurses per 1000
0
0,5
1
1,5
2
2,5
3
3,5
4
Mali
Nep
alYem
enTa
nzan
ia
India
Vietn
amColom
bia
Mex
ico
Swed
en
USA
Doctors NursesWorld Health report 2006
Recruitment Drives
Indian nurses' American dreamBy Habib BearyBBC correspondent in Bangalore
Nursing students come from across India to train
Melody D'sa is ecstatic. Her dream has come true - a new life in America.
Melody is among hundreds of Indian nurses heading to the States, cashing in on a growing demand for trained nurses in the US. The US, UK and Australia have all looked to India to provide nurses because of shortages of staff. The dream of working abroad has spawned a slew of training centres in India.
Melody was taught at one of the popular training schools, Nurses Anytime in Bangalore, which recruits for hospitals in the US.
Sept 2003
Why is Africa losing its best brains?
African students prefer foreign universities
Thousands of Africa's professionals and students are leaving the continent for better prospects in Europe, USA or India. For instance, it is estimated that more than 10,000 South Africans for instance left the country for America and Europe in the last year alone. A majority of professionals who leave the continent include lecturers, nurses, doctors are leaving for greener pastures away from home. Most of them are reluctant to go back home, they would rather seek jobs abroad.
According to statistics, the so-called brain drain costs the continent an estimated 4 billion dollars per year - in what has been pronounced as a slow death for Africa
Mar 2004
Global Health Care Infrastructure
Countries
India
Low income
(e.g., sub -Saharan Africa)
Middle income
(e.g., China, Brazil)
High income
(e.g., US, Western Europe)
Beds
Per ’000 population
1.5
1.5
4.3
7.4
World average 3.3
1.2
Physicians
Per ’000 population
1.8
1.8
1.0
1.5
0.9
1.6
1.9
7.5
NursesPer ’000 population
3.3
Distribution is skewed towards
Urban/ Metro Areas
Countries
India
Low income
(e.g., sub -Saharan Africa)
Middle income
(e.g., China, Brazil)
High income
Beds
Per ’000 population
1.5
1.5
4.3
7.4
World average 3.3
1.2
Physicians
Per ’000 population
1.8
1.8
1.0
1.5
0.9
1.6
1.9
7.5
NursesPer ’000 population
3.3
Distribution is skewed towards
Urban/ Metro Areas
India
Low income
(e.g., sub -Saharan Africa)
Middle income
(e.g., China, Brazil)
High income
Beds
Per ’000 population
1.5
1.5
4.3
7.4
World average 3.3
1.2
Physicians
Per ’000 population
1.8
1.8
1.0
1.5
0.9
1.6
1.9
7.5
NursesPer ’000 population
3.3
Distribution is skewed towards
Urban/ Metro Areas
Proposals
The NCD Alliance Proposed Outcomes
Document - 8 Focus areas
�34 targets which in combination address
the full challenge faced with NCDs
�Recognises the importance of
partnerships – government, civil society,
health care workers, private sector,
development agencies.
�We all have a role to play.
Unique Role of Health Professionals & Service
Providers: Health Promotion & Disease Prevention
From a public health perspective health professionals can play a significant role in reducing
the global NCD burden
�Raise awareness of NCD risk factors including tobacco and alcohol use, and stress the
benefits of a healthy lifestyle.
�Encourage traditional and social media to send positive health messages about healthy
diet, drug use, optimal mental health etc particularly to young people.
�Advocate for and facilitate the provision of high quality health services including
immunisations/vaccinations, safe water supplies, good nutrition, unpolluted atmosphere and
opportunities for exercise.
�Identify those at high risk of NCDs and organise screening interventions for susceptible
populations, and facilitate implementation of prevention programmes.
Focus on keeping the healthy, healthy and reduce the number of people developing illnesses and diseases
Source: World Health Professions Alliance Policy Statement on NCDs
and Social Determinants of Health
Unique Role of Health Professionals & Service
Providers: Treatment and Rehabilitation
From a public health perspective health professionals can play a significant role in reducing
the global NCD burden
�Refer chronically ill patients to appropriate health and social services
�Work collaboratively in multi-disciplinary health professional teams to ensure optimum
outcomes from all interventions and ensure continuity of care
�Advocate for a national plan to ensure the supply of essential medicines and vaccines and
the monitoring of adherence to standard treatment guidelines
�Work with others willing and able to support in all countries eg NGOs
Health system approaches should be integrated to maximise efficiencyframed in a country context
Source: World Health Professions Alliance Policy Statement on NCDs
and Social Determinants of Health
Unique Role of Health Professionals & Service
Providers: Education, Research and Financing
From a public health perspective health professionals can play a significant role in reducing
the global NCD burden
�Advocate for regular collection and evaluation of health data as part of routine health
screening.
�Ensure that standard diagnosis, treatment, care and other interventions for NCDs remains
part of continued professional development programmes for health professionals.
�Establish an evidence base on the cost-effectiveness of health professional interventions in
reducing the NCD burden, to support decisions made on financing NCD programmes.
�Call on national governments to take steps to minimise the root causes of premature ill
health.
We need excellent management information to know what to do andhow we are progressing to be more efficient
Source: World Health Professions Alliance Policy Statement on NCDs
and Social Determinants of Health
One Key Challenge. One High Priority Outcome and
One Specific Commitment – My Suggestions…
Challenge
There is an insufficient number of trained and skilled health professionals to cope with the
anticipated growth in NCDs globally………
Priority Outcome
“Develop and implement strategies to strengthen human resources for health, including public
health and community health workers, to ensure equitable access to NCD prevention, early
detection, treatment and care.” NCD Alliance POD
Specific Commitment
NCDs create new challenges – health professionals have a fundamental role in keeping the
healthy, healthy; to diagnose earlier and to work together to start treatment quickly, cost-
effectively and efficiently.
“Every patient – regardless of
where he or she is born –
deserves an equal chance at a
long life and good health.”
(Seffrin, 2008).