The UN High-Level Meeting on Non-Communicable Diseases: Raising Awareness But Little Else

| October 19, 2011 | 0 Comments

Dr. Betsy Nabel (right), President of the Brigham and Women and Women’s Hospital, speaks at the UN General Assembly’s High-Level meeting on NCDs in September 2011. Photo courtesy of the UN (www.unmultimedia.org)

This September, representatives of UN member states convened in New York to discuss the prevention and control of non-communicable disease (NCDs) through action and research. This was the second UN General Assembly meeting on a global health topic, but it failed to achieve much beyond raising awareness of one of the most pressing and understated problems of global health this century.

Four NCDs were the main focus of September’s meeting: cardiovascular disease, diabetes, cancer, and chronic respiratory disease. Together the diseases account for 63% of global mortality and will drain an estimated US$ 63 trillion from the world economy in the next ten years.[1]  By 2020 the US Centers for Disease Control (CDC) anticipates that NCDs will kill four times as many people as infectious diseases. Despite this, less than 3% of all global health research is related to NCDs.[2]

The UN meeting echoed the goals articulated by the World Health Organization (WHO) in its 2008-2015 NCD Action Plan but didn’t set specific benchmarks or commit additional resources to the WHO plan. The WHO calls for an increase in research and surveillance of NCDs, a prioritization of NCD-related problems, a push to strengthen relevant policy, and the promotion of behaviors such as physical activity, reduced consumption of fats and sugars, and a decreased use of tobacco and alcohol products.[3]

High-income nations provide examples of effective public health strategies in fighting some NCDs. The United States saw great success in reducing respiratory illness related to tobacco by raising taxes on tobacco products and educating the public on the dangers of smoking.[4]  Today Michele Obama leads a similar effort against childhood obesity and some private companies have even instituted incentive programs for employees to lose weight or quit smoking.[5]

But some corporations have met such measures with stiff resistance. In 2003 the WHO published a report encouraging reduction of sugar intake. In response, the World Sugar Organization and the US Council for International Business, which represents corporations such as Coca-cola and Pepsi, lobbied Congress to reduce funding for the WHO.[6]  In July of this year the American Beverage Association targeted dozens of US county health departments in an effort to slow anti-soda campaigns.[7]  More troubling is the stake many NGOs have in the global food and tobacco industry. For example, the Bill and Melinda Gates Foundation holds substantial stock in both Coca-cola and Philip Morris.[8]  Effective intervention will likely be hindered by corporate and in some cases national interests.

Though the economic cost of NCDs is greatest in high-income countries, NCDs are no longer “diseases of affluence.” Eighty percent of all NCD-related mortality occurs in low- and middle-income countries, and in sub-Saharan Africa women aged 15 – 49 are four times more likely to die or become disabled due to an NCD than women in high-income countries.[9] The disparate contexts of disease only further complicates policy; health priorities in high-income nations will vary from low-income nations and bridging interests will be no small feat. A commitment of economic capital and political will is neccesary to realize a vision of global health without NCDs. A vision exists but the leadership has not yet materialized and without it, the potential for immediate change is small.


Sources:

  1. Bloom, D.E., Cafiero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A., & Weinstein, C (2011). The Global Economic Burden of Non-communicable Diseases. Geneva: World Economic Forum.
  2. Pokharel K. India’s efforts on TB, tobacco control lauded. Wall Street Journal 2011.
  3. World Health Organization. “2008 – 2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases.” Switzerland. 2008.
  4. Wagenaar A, Maldonado-Molina MM, Wagenaar BH. Effects of alcohol tax increases on alcohol-related disease mortality in Alaska: time-series analyses from 1976 to 2004. Am J Pub Health2009;99:1464-70.
  5. Bloom, D.E., Cafiero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A., & Weinstein, C (2011). The Global Economic Burden of Non-communicable Diseases. Geneva: World Economic Forum.
  6. Boseley, Sarah. “Sugar industry threatens to scupper WHO.” The Guardian. 21 April 2003.
  7. Baertlein, Lisa., Levine, Dan. “Soda makers escalate attacks over obesity.” Reuters. 20 Jul 2011.
  8. Stuckler, D., Basu, S., Mckee M. “Global health and institutional relationships: how should conflicts of interest be addressed?” PLoS Med. 2011 Apr;8(4):e1001020.
  9. Alwan A, Galea G, Stuckler D. Development at risk: addressing noncommunicable diseases at the United Nations high-level meeting.Bull World Health Organization 2011;89:546.

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