UN General Assembly Addresses Issue of Noncommunicable Diseases in the Developing World

The United Nations (UN) held a High-Level General Assembly meeting in New York last month on Sept. 19 and 20 to address the problem of the rising prevalence of noncommunicable diseases (NCDs) in the developing world. The meeting was attended by more than 30 heads of state and government and by at least 100 other senior ministers and experts. The delegates adopted a declaration that calls for a multipronged approach by governments, industry, and civil society to set up by 2013 the plans needed to curb the risk factors behind four of the leading NCDs: cardiovascular disease, chronic respiratory disease, diabetes, and cancer.

“This will be a massive effort, but I am convinced we can succeed,” said UN Secretary-General Ban Ki-moon, in the opening session of the meeting held Sept. 19. The General Assembly meeting was only the second meeting by the General Assembly to deal with a health-related issue; the first and only other time was on HIV/AIDS. The overall annual death toll from NCDs is estimated at 36 million worldwide, accounting for more than 60% of annual global deaths of 57 million, according to a Sept. 20, 2011, UN press release. By 2030, the number of deaths attributable to NCDs is expected to reach 52 million. Approximately 9 million of the deaths attributable to NCDs occur before the age of 60, with nearly 80% of those deaths occurring in the developing world.

“Our collaboration is more than a public health necessity,” said Secretary-General Ban. “Noncommunicable diseases are a threat to development. NCDs hit the poor and vulnerable particularly hard and drive them deeper into poverty,” he said, pointing to the problem of families being pushed into poverty when a member becomes too weak to work or when the cost of medical care and treatments overburden the family. “The prognosis is grim,” he said. According to the World Health Organization (WHO), deaths from NCDs will increase by 17% in the next decade. In Africa, that number will jump to 24%.

The High-Level meeting, which heard from nearly 90 speakers, also featured two roundtable discussions. The first discussion was on the rising incidence of NCDs, developmental challenges and the social and economic impact of NCDs and their risk factors. The second discussion was on strengthening national capacities, including appropriate policies, for prevention and control of NCDs.

Secretary-General Ban outlined five recommendations to further progress in tackling the problem of NCDS. First, implement a complete government approach to adopting population-wide interventions that address risk factors. Second, undertake sustained primary health-care measures, including prioritized packages of essential interventions, along with palliative and long-term care, for those who already have NCDs or who are at high risk of contracting them. Third, strengthen the capacity of member states to monitor such diseases and their risk factors and determinants, especially in lower-income countries; social data disaggregated by, for example, by gender, was also encouraged. Fourth, harness lessons learned from national HIV/AIDS, tuberculosis, and malaria programs in low- and middle-income countries for effective integration of communicable diseases and NCD initiatives. Finally, prioritize the prevention and control of NCDs through commitments governments, the private sector, civil society, the UN, and other international organizations.

The declaration adopted by the delegates calls for greater measures at global, regional, and national levels to prevent and control NCDs. Steps range from price and tax measures to reduce tobacco consumption to curbing extensive marketing to children, particularly on television, of foods and beverages that are high in saturated fats, trans-fatty acids, sugars, or salt. Other measures seek to cut the harmful consumption of alcohol, promote overall healthy diets, and increase physical activity. The UN has directed WHO to set up a comprehensive global monitoring framework and prepare recommendations for voluntary global targets before the end of 2012. The member states also requested Secretary-General Ban to prepare two reports, in collaboration with the Director-General of WHO and other stakeholders; one to be presented to the General Assembly’s sixty-seventh session on strengthening multisectoral preventive actions, and the other, to be presented at the assembly’s sixty-eighth session, on progress to that end and towards achievement of the UN Millennium Development Goals. That report would set the stage for a comprehensive 2014 review of the status of the declaration’s implementation.

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