[Ip-health] Noncommunicable diseases in the 2011 global public health agenda

Thiru Balasubramaniam thiru at keionline.org
Mon Feb 7 03:02:09 PST 2011


The following blog post discusses procedural developments leading up  
to the September 2011 High-level Meeting of the United Nations General  
Assembly on the Prevention and Control of
Noncommunicable Diseases.

Among other things, this piece how and why the EU blocked consensus  
approval at the WHO Executive Board meetoing of Bangladesh's proposed  
additions to a draft resolution on "Prevention and control of  
noncommunicable diseases" (EB/128/Conf. Paper No. 10 Rev.1) with the  
sub-heading of "WHO's role in the preparation, implementation and  
follow-up to the high-level meeting of the United Nations General  
Assembly on the prevention and control of noncommunicable diseases".

The Bangladesh proposed language addressed the pricing and  
accessibility of diagnostics and medicines.  To see the proposed  
language in bold, it is best to view it from this link:

keionline.org/node/1071

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Noncommunicable diseases in the 2011 global public health agenda
By thiru
Created 1 Feb 2011 - 12:24pm
Noncommunicable diseases (NCDs) enjoy a place of prominence on the  
global public health agenda in 2011. At the 128th WHO EB, the assembly  
was abuzz with news of a joint Russian and WHO initiative, the "First  
global ministerial conference on healthy lifestyles and  
noncommunicable disease control [1]" to be held in Moscow on 28-29  
April 2011 and the UN High-level Meeting of the General Assembly on  
Non-Communicable Diseases [2] in September 2011.

This invitation only ministerial conference is expected to attract 300  
participants. The conference website lays out the following aim and  
goals:

The aim of the conference is to "support Member States develop and  
strengthen policies and programmes on healthy lifestyles and NCD  
prevention. These efforts are based on the Global strategy for the  
prevention and control of NCDs and its action plan, which include  
multisectoral and innovative approaches in prevention and care.
The conference has three main goals:

* to highlight the magnitude and socio-economic impact of NCDs;
* to review international experience on NCD prevention and control; and
* to provide evidence on the pressing need to strengthen global and  
national initiatives to prevent NCDs".

The Moscow ministerial is predicated upon the WHO Global Strategy for  
the Prevention and Control of Noncommunicable Diseases [3] endorsed at  
WHA 53 in May 2000 and the Action Plan passed at WHA 61 in May 2008.

The Moscow ministerial will also serve as an incubator for the WHO to  
test out its multi-stakeholder concept that will be deployed at the  
Global Health Forum in 2012. Although the details of the Global Health  
Forum are still nebulous, certain informed observers have noted the   
Forum is a response of the WHO secretariat to the "Committee C [4]"  
concept proposed in 2008 in the Lancet by Gaudenz Silberschmidt  
(Switzerland), Don Matheson (University of Otago),and Ilona Kickbusch  
(Graduate Institute of International and Development Studies). As WHO  
is reeling from an expected shortfall of $200 million to $600 million  
in the 2010-2011 budget, it is seeking creative ways of leveraging  
unearmarked voluntary contributions from donor governments,  
foundations and the private sector. Whether the Global Health Forum  
can bridge this gap or be subject to "Trojan multilateralism" (Devi  
Sridhar, Oxford Global Health Governance) remains to be seen.

The High-level Meeting of the United Nations General Assembly on the  
Prevention and Control of Noncommunicable Diseases [1] at the UN  
General Assembly in New York from 19-20 September 2011 is the landmark  
NCD event of 2011. According to the UN website,

"General Assembly Resolution A/RES/64/265, adopted on 13 May 2010,  
calls for a High-level Meeting of the General Assembly on Non- 
Communicable Diseases with the participation of Heads of State and  
Government in September 2011.
This resolution was tabled by Trinidad and Tobago on behalf of the  
Caribbean Community (CARICOM) and was sponsored by over 100 countries.  
It is foreseen that the consultations on the scope, modalities, format  
and organization of this High-level meeting should preferably be  
concluded before the end of 2010.

The resolution calls upon Member States to include in their  
discussions at the High-level Plenary Meeting on the Millennium  
Development Goals the rising incidence and the socioeconomic impact of  
the high prevalence of non-communicable diseases worldwide.

The Secretary-General is requested to submit during the sixty-fifth  
session of the General Assembly a report on the global status of non- 
communicable diseases, with a particular focus on the developmental  
challenges faced by developing countries."

The draft scope, modalities, format and organization resolution  
submitted by the President of the UN General Assembly can be found  
here [5].

Here are some key elements from the draft modalities resolution:

"Formal plenary meetings on 19 September, chaired by the President of  
the General Assembly and featuring opening statements by the President  
of the General Assembly, the Secretary-General, the Director-General  
of the World Health Organization and a representative of civil society  
who will be chosen from non-governmental organizations with  
consultative status with the Economic and Social Council and in  
consultation with Member States; and a closing plenary meeting on 20  
September, comprising the presentation of summaries of the round  
tables and the adoption of a concise action-oriented outcome document;

Encourages Member States to consider, as appropriate and where  
relevant, including in their national delegations to the high-level  
meeting parliamentarians, representatives of civil society, including  
non-governmental organizations, academia and networks working on the  
control and prevention of non-communicable diseases;

Also decides that the report of the Secretary-General, in  
collaboration with Member States, the World Health Organization and  
the relevant funds, programmes and specialized agencies of the United  
Nations system, on the global status of non-communicable diseases,  
with a particular focus on the developmental challenges faced by  
developing countries, requested by the Assembly in its resolution  
64/265, shall be submitted no later than May 2011 and shall serve as  
an input to the preparatory process for the high-level meeting;

Requests the President of the General Assembly to organize, no later  
than June 2011 and in consultation with representatives of non- 
governmental organizations in consultative status with the Economic  
and Social Council, civil society organizations, the private sector  
and academia, an informal interactive hearing with non-governmental  
organizations, civil society organizations, the private sector and  
academia to provide an input to the preparatory process for the high- 
level meeting;

Invites United Nations funds and programmes, the specialized agencies,  
in particular the World Health Organization, regional commissions, the  
Bretton Woods institutions, the World Trade Organization, the regional  
development banks, the United Nations Conference on Trade and  
Development and intergovernmental organizations and entities having  
observer status in the General Assembly to participate in the  
preparatory activities and in the high-level meeting, in accordance  
with the rules of procedure as established by the Assembly;

Decides that the President of the General Assembly shall consult with  
representatives of non-governmental organizations in consultative  
status with the Economic and Social Council, civil society  
organizations, the private sector and academia, and with Member  
States, as appropriate, on the list of representatives of non- 
governmental organizations, civil society organizations, the private  
sector and academia, taking into account to the extent possible the  
principle of equitable geographic representation, and to submit the  
list to Member States for consideration and for a final decision by  
the Assembly on participation in the high-level meeting, including  
round tables."
In the context of the Moscow and New York summits, Barbados, New  
Zealand, Norway, Russian Federation and Trinidad and Tobago tabled a  
draft resolution on "Prevention and control of noncommunicable  
diseases" (EB/128/Conf. Paper No. 10 Rev.1) [6] with the sub-heading  
of "WHO's role in the preparation, implementation and follow-up to the  
high-level meeting of the United Nations General Assembly on the  
prevention and control of noncommunicable diseases". Bangladesh  
introduced language on accessibility on pricing which was added to the  
revised text. Here below are Bangladesh's additions in bold.

PP10bis Underscoring the need to ensure access to affordable  
diagnostic tools and medical products including medicines and other  
equipment for the diagnosis and treatment of people suffering from  
noncommunicable diseases [Bangladesh];
OP1(2) bis to develop and implement legal and policy tools, as  
appropriate, to ensure access to  affordable care and treatment by  
ensuring availability of necessary diagnostic tools and medical  
products including medicines and other equipment for the diagnosis and  
treatment of noncommunicable diseases [Bangladesh];
2. REQUESTS the Director-General

(2) bis to prepare a publicly available database containing  
information on various diagnostic tools and medical products including  
medicines and equipment for the diagnosis and treatment of  
noncommunicable diseases [Bangladesh];

OP2(3) bis to conduct a survey among WHO Member sates regarding the  
availability and cost of diagnosis and treatment of noncommunicable  
diseases, especially cardiovascular diseases, cancers, chronic  
respiratory diseases and diabetes [Bangladesh];

(7) to review WHO’s current capacity at all levels vis-à-vis Member  
States' needs for technical assistance and normative advice concerning  
the prevention, control and management of noncommunicable diseases, in  
the context of health system strengthening and making available access  
to affordable diagnosis and treatment of noncommunicable diseases  
[Bangladesh];
During the 128th EB, the EU reportedly used procedural concerns  
regarding the timing of the Bangladesh text on affordability and  
pricing of diagnostics and medicines for NCDs to block a consensus  
approval of the resolution. It is expected that this draft resolution,  
with the Bangladesh amendments will be considered by the 64th World  
Health Assembly in May 2011.

Source URL: http://keionline.org/node/1071
Links:
[1] http://www.who.int/nmh/events/moscow_ncds_2011/en/
[2] http://www.un.org/en/ga/president/65/issues/ncdiseases.shtml
[3] http://www.who.int/nmh/publications/who_nmh_2009_2/en/index.html
[4] http://graduateinstitute.ch/webdav/site/globalhealth/shared/1894/Article 
  Committee C The Lancet 3 May 08.pdf
[5] http://www.un.org/ga/search/view_doc.asp?symbol=A/65/L.50&referer=http://www.un.org/en/ga/president/65/issues/ncdiseases.shtml&Lang=E
[6] http://www.ip-watch.org/weblog/wp-content/uploads/2011/01/Barbados-draft-resolution-on-NCDs-Jan-2011.pdf


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Thiru Balasubramaniam
Geneva Representative
Knowledge Ecology International (KEI)
thiru at keionline.org


Tel: +41 22 791 6727
Mobile: +41 76 508 0997








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