Update on WHO Global Monitoring Framework consultations on NCDs

Find out the latest on the formal Member State consultations to agree on the Global Monitoring Framework (GMF), including indicators and targets on NCDs. The three-day meeting is taking place at the World Health Organization (WHO) in Geneva, Switzerland from 5-7 November 2012.

Day 3 Summary - Wednesday 7 November 2012

With the formal Member State consultations at WHO on the Global Monitoring Framework for NCDs now complete, we are very happy to report that Member States have agreed to nine global targets and 25 indicators on the prevention, control, and treatment of NCDs.

This consultation went down to the wire, wrapping up at 10:30 pm last night. This framework is a milestone achievement for all of us, and another step toward fulfilling the commitments made at the UN High-level Meeting on NCDs and in the Political Declaration.

The Chair of the NCD Alliance, Cary Adams, made this statement at the close of the proceedings. As you will see, rather than focus on targets and indicators that were not agreed, or wording that could have been better, we are now focussing on the draft Global Action Plan. The framework is a very good basis for moving forward, but getting it fully integrated into a comprehensive plan is essential.

Our notes of the decisions on targets and indicators are set out in this table. However, it is always possible that wording can be tightened up for the official report of the meeting. This is being finalised today and tomorrow so please wait to receive that before circulating this table to your networks.

The Chair of the meeting, Dr Bjørn-Inge Larsen, did a truly amazing job and deserves our sincere thanks. Government representatives and WHO staff worked very hard over the last three days to achieve agreement and they deserve our congratulations.

Please take the time to thank your government for approving this important framework for NCD prevention and control. Here is a template letter for you to adapt.

Day 2 Summary - Tuesday 6 November 2012

The formal Member State consultation on the Global Monitoring Framework has made very good progress and has agreed a set of indicators and some targets. The meeting continues as we write.

Indicators agreed with no change from WHO proposed wording
Unconditional probability of death, cancer incidence, fruit and vegetable intake, blood glucose, salt intake, saturated fats, palliative care, drug therapy to prevent heart attack/stroke.

Indicators agreed with changes to WHO proposed wording

  • Overweight and obesity: 2 agreed, 1 for adults, 1 for adolescents
  • Physical inactivity:  2 agreed, 1 for adults, 1 for adolescents
  • Cholesterol: agreed with both ‘mean cholesterol’ and prevalence
  • Blood pressure: agreed with both 'mean blood pressure’ and prevalence
  • Tobacco: 2 agreed, 1 for adults, 1 for adolescents, ‘tobacco use’ not ‘smoking’
  • Alcohol: 3 agreed, heavy episodic drinking, APC, and mortality/morbidity
  • Cervical cancer screening: added wording on national programs/policies
  • HBV vaccines: added wording to ensure 3 doses in infants
  • Marketing of food to children: added non-alcoholic beverages
  • Transfats: wording on policies to reduce saturated fats
  • Essential medicines and technologies: wording on affordability, quality, safety, efficacy.

Indicators that were not agreed

  • Polyunsaturated fats
  • HPV vaccines (but might still be agreed later tonight)

Targets agreed so far today
Tobacco, salt, alcohol, physical inactivity, essential medicines and technologies, and drug therapy to prevent heart attack/stroke. The targets currently under negotiation are on: raised blood pressure, fat intake, obesity, cholesterol and blood glucose (a late addition).

Some Member States want to stop now, with the targets agreed; others are arguing strongly for just raised blood pressure and raised blood glucose; a small number are arguing for fat intake, obesity and raised cholesterol. 

We will send another update tomorrow with the final conclusions of the meeting – hopefully with specific details of the indicators and targets agreed.

Day 1 Summary - Monday 5 November 2012

The Chair of the NCD Alliance – Cary Adams, CEO of UICC – delivered a very short statement to Member States this afternoon. This is drawn from a 2-page summary that we sent to all Missions last week and have been disseminating here at WHO this morning.

Report from the WHO gallery
Following regional statements in the morning, Member States started to work through the 19 indicators proposed by WHO. By the end of the evening session, they had agreed on some and deferred others to Tuesday: 

Indicators agreed with no change

  • Unconditional probability of death
  • Cancer incidence
  • Salt intake
  • Fruit and vegetable intake
  • Blood glucose

Indicators agreed with changes

  • Overweight and obesity – agreed, and another one on obesity for adolescents
  • Physical inactivity – agreed, and another one for adolescents
  • Cholesterol – agreed with ‘mean cholesterol’ and prevalence
  • Blood pressure – agrees with 'mean blood pressure’ and prevalence

Indicators discussed but deferred to Tuesday

  • Tobacco – change ‘smoking’ to ‘tobacco use’ and discussion around age range
  • Fats – lengthy discussion about different types of fat
  • Alcohol – debate on heavy episodic drinking vs annual per capita consumption.
  • Cervical cancer – different views on age range and frequency of screening                                                                             

Add your voice

E-consultation on NCDs in the post-2015 development agenda
Last Friday, we launched an online consultation as a way to further establish a common position on our asks for NCD prevention, treatment, and care, in the post-2015 development framework.
 
We would greatly appreciate your participation in this consultation, as responses will play a critical role in our campaign on the global development framework. The Survey Monkey questionnaire takes approximately 15 minutes to complete and can be accessed here. Background materials, with information regarding the post-2015 process, health, and NCDs, are available here.

It is with thanks to the United States delegation and the Norwegian Chair that NGOs are able to observe the proceedings, who proposed to include NGOs after we noted civil society’s exclusion from the meeting last week.

The papers for the meeting, including presentations from yesterday’s Member State briefing are available here. The agenda and background papers for the briefing are available here.

The report on the Global Monitoring Framework, dated 31 October, is virtually the same as the 3rd Discussion Paper, issued in late July. The only differences are noted here.

The summary of feedback on the GMF from regional WHO meetings includes an incredibly short summary of feedback from UNAIDS (one sentence); nine private sector agencies (three sentences); and from 32 NGOs, these three sentences:

Input from a number of relevant nongovernmental organizations indicated broad support for the draft global monitoring framework, including indicators, and a set of voluntary global targets for the prevention and control of noncommunicable diseases. Comments were generally supportive of the number and type of indicator and target, with some concerns regarding the exclusion of younger age groups for some indicators. The need for balance was highlighted, in particular among targets on prevention, treatment and care, as was the importance of considering the global monitoring framework in relation to other WHO commitments.

All of the detailed work put in by NGOs to comment on targets and indicators has NOT been conveyed to Member States by WHO.  This makes it all the more important that we try to influence the next draft of the Global Action Plan so that anything left out of the GMF stands a chance of being included in the Plan.