Reporting back: UN Interactive Hearing on NCDs

Overview 

The Interactive Stakeholder Hearing was convened as part of the preparatory process for the UN HLM and brought together representatives from civil society organisations, philanthropic foundations, academia, medical associations, private sector organisations, and broader communities to discuss priorities for the HLM on NCDs.

Discussions were focused around four panels:

• Scaling up action for the prevention and control of NCDs
• Financing for the prevention and control of NCDs
• Promotion of multisectoral partnerships for the prevention and control of NCDs
• Political leadership and accountability.

The meeting opened with a clear call to action from the President of the General Assembly to scale up what we know is effective to change how NCDs are affecting people globally. Echoing this, James Chau, Goodwill Ambassador for NCDs and Health, argued that NCDs are rooted in inequalities in race, gender, geography and income and we need a response which recognises and responds to this, but that the SDGs give us an opportunity to deliver for patients and their families worldwide.

You can watch the recordings of the discussions here, and a report from the President of the General Assembly is expected shortly. Participants were welcomed to give comments from the floor and you can read statements from the attendees here, if you were unable to deliver your statement please email it through to gcmncd@who.int. 

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Panel summaries 

Scaling up action on NCD prevention and control

Key themes from the discussion included:

• Need to scale-up the implementation of WHO ‘Best Buys’ on prevention – there are opportunities to take these interventions to scale quickly, particularly where they relate to fiscal and regulatory measures by governments
• Recognise the importance of early detection and identifying NCDs early so as to treat or manage them more effectively and with fewer side effects
• Importance of multiple-morbidities and the increased exposure of people living with mental health problems to NCD risk-factors, as well as the need to increase the capacities of health systems to respond to mental health
• Challenge of resourcing national NCD responses and the opportunities to work regionally and with civil society organisations to respond to this

In response, a participant from the Permanent Mission of Egypt raised the importance of improving treatment and care as the missing half of the discussion. He emphasised that access and affordability of NCD treatments meant that many patients struggled and that, while mobilising domestic resources is important, the community also needed to think about the additional funding sources like ODA.

A number of other speakers raised the importance of making sure that NCDs are not forgotten in the development of Universal Health Coverage (UHC) and the need for Head of State/Government support for the HLM. UICC supported this, arguing that countries should utilise the WHO Best Buys, despite political challenges, as the strongest set of evidence-based and cost-effective measures on NCD prevention, early detection, treatment and palliative care.

Financing the prevention and control of NCDs

NCD Alliance CEO, Katie Dain, kicked off discussions by highlighting three important facts

1. Levels of NCD investment have been stagnant for over a decade
2. Less than US$ 1 billion of development assistance for health is invested in NCDs (less than 1/9th of the funding for HIV/AIDS)
3. Economies are losing between 3% and 6% of GDP due to the costs of NCDs, amounting to US$ 7 trillion between 2011 and 2015

Building on this the speakers went on to discuss:

• Importance of the HLM as an opportunity to galvanise NCD funding
• Need for costed national NCD strategies to reach out to funders, including Ministries of Finance, with
• Opportunities for funding including more effective global marketplaces for medicines and technologies to treat NCDs, cost-savings within treatment and care systems, taxation on unhealthy products, insurance and social risk-pooling, and international assistance
• Impacts of taxation on tobacco-users behaviours, as well as the financial impacts – need to share these experiences and monitor the results to help make the case

Questions and comments from the floor raised the importance of finance to enabling countries to meet their commitment to 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major NCDs in both public and private facilities by 2025. Included in this were calls for a new accountability mechanism for the private sector as the current Political Declaration text is copy and pasted from the 2011 declaration and lacks ambition. Moreover there is need to adopt a human-rights based approach as the fundamental driver for action on NCDs.

Focusing on prevention mechanisms, participants emphasised that the financial burdens of prevention mechanisms, particularly around regulation and taxation, were low and so what was needed was a greater focus on implementation.

Promotion of multisectoral partnerships

As a common theme in NCD discussions, this panel looked at the opportunities and challenges of developing partnerships to support action on NCDs, recognising the:

• Need for political leadership in the development to leverage the opportunities in multisectoral partnerships
• Map out the actors we need to engage to improve NCD prevention and control, particularly relevant to discussions around access to affordable medicines and technologies
• Importance of strong civil society actors to facilitate these partnerships and hold actors accountable
• Urgent need for regulation of health-harming industries – whether that be in the development of healthier products, marketing practices, or engagement with the policy-making process. This was of interest given that the participation of the International Food and Beverage Alliance on the panel as particular attention was given to the food and beverage industries, with some participants drawing parallels with the behaviours of the tobacco industry to de-rail policy.

Political leadership and accountability

This session looked particularly at how to create national ownership in order to achieve SDG 3.4.

• Mary Nyamongo raised the importance of recognising that civil society organisations perform different roles nationally, and at different levels, but that these groups need to come together to hold Governments and Heads of State/Government accountable to their commitments.
• Engaging departments beyond head, particularly to support NCD prevention efforts, was highlighted. Particularly as this relies on strong Head of Government leadership as health is a political choice.
• Many Governments are coming into conflict with some of the most powerful industries when they plan and start to implement national NCD prevention and control responses, putting them under significant pressure and which is why measures like the WHO Best Buys are so important.

Governments have different levels and city Mayors have a track record of being able to champion measure for NCDs, particularly around prevention. These actors shouldn’t be forgotten as countries move to implement their national responses.