6.1 Draft comprehensive global monitoring framework and targets for the prevention and control of noncommunicable diseases

Key documents

• Prevention and control of noncommunicable diseases: Formal meeting of Member States to conclude the work on the comprehensive global monitoring framework, including indicators, and a set of voluntary global targets for the prevention and control of noncommunicable diseases (EB132/6)

Notes by WHO Secretariat

PHM comment pre-EB

Report of discussion

Belgium spoke on behalf of the European Region. Belgium noted that the challenge posed by NCDs requires that both the risk factors as well as the SDH are addressed at all levels with a focus on equity. Lithuania aligned their support with the statement as well as the UK and Russia.

Columbia stated that health promotion activities need to be strengthened, as well as focusing on equality and human rights, structural indicators of poverty and social mobilisation to empower people and communities.

Iran, on behalf of EMRO stated that it is important for the need for all countries to strengthen their health information systems. Members of EMRO reached consensus on 5 targets: tobacco use, salt reduction, blood pressure, diabetes, and physical activity. Some countries from EMRO were reluctant to approve a larger set of targets because of the lack of monitoring systems in those countries. Some MS of EMRO find the current proposal too demanding and may not fulfil the request.

Nigeria on behalf of AFRO asked the WHO to include the targets into the official work of WHO for the period 2014-2020. They called on WHO to provide support to AFRO to establish reliable information systems and stated that equity should be taken into account.

Timor Leste noted that NCDs are not for the health sector alone, but all sectors, including, UN, NGOs, WHO etc. A PHC approach is necessary. They need to strengthen the health info system and capacity for conducting surveys. Country and regional specifics need to be taken into account. Timor-Leste stated that they are struggling with the shortage of the Health Workforce.
Lebanon asserted that implementation needs careful attention to the capacity of the different MS since not all countries have the same information systems. Therefore, indicators and targets should be tested in pilot countries

Brazil  stated that NCDs were responsible for 72% of deaths in 2009 in Brazil. In the last decade Brazil has reduced this by 20% including chronic diseases and respiratory diseases.The incidence of cancer and diabetes has risen though. Brazil has a strategy 2011-2022 for NCDs. They also stated that the global goals must also fit the reality of each country - regional and national realities, ‘we must strengthen our health care systems’. Brazil also noted it had one single strategy on NCDs.

Mexico recommended that regional offices should provide technical support. It also noted dietary factors as important. Barbados recognised challenges for small states in implementing this framework and sought a collaborative effort at regional levels as essential. Maldives emphasised the importance of technical support to member states, especially less endowed developing countries. They argued that border control on harmful goods such as tobacco, food and beverages harmful to health needs to be taken seriously. Mongolia stated that it has recently adopted its law on tobacco control.

The US stated that the targets are ambitious but achievable and supported the proposal without reopening the discussion.Cuba agreed with the report and the various goals and objectives and did not think the discussion should be reopened. Malaysia supported the framework and recommends adoption to WHA without reopening the discussion.

Morocco stated that monitoring tools should be implemented to evaluate the impact of measures on the prevention and control of NCDs. Morocco proposes a fund similar to the Global fund on TB/Malaria for scientific, technical and financial backing for NCDs.

Switzerland stated that the key is not to  measure, but to measure what has to be measured, which must be accessible and understandable. They will facilitate their own solid and coherent national strategy.  

Panama sought to add palliative care, especially for cancer.

Ecuador supported the initiative, stating that the next initiative is the fight against abuse of alcohol.

The UK recognised the need to do more and empower people to help themselves.

Russia stated that the need for a focus on reducing common risk factors such as use of tobacco, excessive alcohol, and physical inactivity’... this requires an intersectoral approach, as many people as possible, including states, civil society and private institutions. The leading role has to be played by the WHO, the lead agency of health in the UN.

The NGO World Health Professions Alliance argued that there was a need to strike a balance between reducing mortality & morbidity, as well as the need for a target on sugars:  Sugar should be no more than 10% dietary intake.

The Assistant DG stated that the unprecedented decision to allow NGOS to participate in the process was ‘one of the key things behind our success’. A data base and information monitoring system is needed – WHO should be well placed to spearhead the global effort “within the limit of available resources”.

DG saw the NCD item as a success.

The EB, having considered the report, decided to endorse the comprehensive monitoring framework for the prevention and control of NCDs. EB request the DG to prepare a draft resolution for the WHA consideration

PHM comment post-EB

Other reports and commentary