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



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


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


Middle income


High income

Beds


1.5

1.5

4.3

7.4

World average 3.3

1.2

Physicians


1.8

1.8

1.0

1.5

0.9

1.6

1.9

7.5


3.3


Urban/ Metro Areas

India

Low income


Middle income


High income

Beds


1.5

1.5

4.3

7.4

World average 3.3

1.2

Physicians


1.8

1.8

1.0

1.5

0.9

1.6

1.9

7.5


3.3


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




Providers: Treatment and Rehabilitation



�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




Providers: Education, Research and Financing



�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



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).

session 3 health professionals cazap

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