ncds: a global view
TRANSCRIPT
Heartfile, 2012
NCDs: a global view
International Conference On Healthy Lifestyles And Non-communicable Diseases (Ncds) In The Arab World And The Middle East, Riyadh, Kingdom Of Saudi Arabia, 9-12 September 2012
Dr. Sania NishtarFounder and President
Heartfile Pakistan
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Stocktaking
• Where do we stand?• What needs to happen next? • Does the EMR have capacity?• What at the immediate next steps, at the
regional level?
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NCDs: Where do we Stand
• On a positive note– International consensus—Political declaration – Normative clarity
• Evidence based best buys • Strategies, tools and instruments• Voluntary global targets• Civil society mobilization and public private convergence
• Less auspicious – Paucity of development resources – NCDs are not (yet) fully part of domestic priorities– Capacity to cascade policy into action is limited
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NCDs and HIV and AIDS
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NCDs: Where do we Stand
• On a positive note– International consensus—Political declaration – Normative clarity
• Evidence based best buys • Strategies, tools and instruments• Voluntary global targets• Civil society mobilization and public private convergence
• Less auspicious – Paucity of development resources – NCDs are not (yet) fully part of domestic priorities– Capacity to cascade policy into action is limited
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US $ 22 Billion spent on health by International AID agencies in in LMIC
Source IDF
Global mortalityFrom NCD
Overseas health aid
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What needs to happen next
Regionally • Step up capacity to be responsive to country
needs Domestically 1. Societal change 2. Next generation public health, action outside
health 3. Reorienting health from episodic to chronic
care
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Framework for action: NCDs 1
Nishtar S. Prevention of non-communicable diseases in Pakistan. Health Res Policy Syst. 2004
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Framework of action: NCDs 2Lifestyle risks • Smoking • Un healthy diet • Lack of physical activity • Stress
Biological risks • Obesity • Dyslipidaemia• Diabetes • High blood pressure
Disease conditions • Cardiovascular disease • Diabetes• Lung conditions• Some cancers
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Societal change
Policy action at all levels
Health Systems for both acute and chronic
care
Framework of action: NCDs 3
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Societal choice• The imperative for societal change in EMRO
– Six out of 10 countries with the highest prevalence of diabetes
– Smoking amongst men ranges from 12-60% – Grossly overweight population
• 50% women in the region overweight • Escalating level of obesity in children
– Trends in per-capita sale of manufactured food and fizzy drinks
Policy action
Behavior change
Market shaping
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• Multi-sectoral action• Inter-sectoral action • Opportunity for embedding NCDs in
– Medium term development frameworks – Sustainable development goals?– Universal coverage, the 21st century Health for all – Social protection agendas– Innovations dives (technological and design)– The poverty reduction strategies
Policy action by all levels of government
Pakistan: Composition of Shocks categories of shocks
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Health systems; from acute to chronic care
• Health information systems • Financing • Service delivery• Medicines and related products• Governance • Workforce• Technology
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Learning
Innovations
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Slide courtesy: Miriam Rabkin
Leveraging innovationsLearning lessons
Heartfile, 2012© Alison Koler 2010
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HIV—Lessons to be learnt for NCDs
Rabkin, and Nishtar. J Acquir Immune Defic Syndr 2011
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Examples
Ethiopia Cambodia
Slide courtesy: Miriam Rabkin
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Does the EMR have capacity to deliver
• Tier 1—capacity and resources exist• Capacity constraints in Tier I and II
– Fiscal space – International development priorities – Health systems distortion
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What will be the Riyadh promise for NCDs ?