Dismissing the long-held notion that noncommunicable diseases (NCDs) only affect high-income countries, the UN High-Level Meeting on NCDs took place September 19-20th in New York City. The last UN meeting targeting health issues focused on AIDS, Malaria, and Tuberculosis, otherwise referred to as communicable diseases (CDs). While CDs are still a significant issue in global health and development, NCDs are taking center stage. The NCDs selected for the UN meeting include cardiovascular disease, cancer, respiratory diseases/chronic obstructive pulmonary disease, and diabetes. Though experts acknowledge that the list of NCDs featured in the meeting is limited, the chosen NCDs can be attributed to a similar set of underlying factors, including: tobacco use, alcohol consumption, poor diet, and physical inactivity.
With rapidly aging populations, developing countries are experiencing a new wave of economic and social issues. Such a demographic shift requires a country to adapt new health policies that allow its population to lead long and healthy lives. NCDs, which are preventable and treatable in most cases, demonstrate a changing need in developing countries’ health care systems. They also represent a significant change in how to deal with public health issues. While previous programs targeted CDs that signaled immediate danger and could rapidly decrease a country’s population, NCDs reflect an increasingly connected, globalized world, where lifestyle and personal choices may contribute more to one’s health than the circumstances one was born into.
The Center for Strategic and International Studies hosted an event to discuss the outcomes of the UN meeting, where speaker Dr. Nils Daulaire noted that 36 million people died last year from NCDs, and 80 percent of those deaths were in low- and middle-income countries. Ambassador Ebrahim Rasool of South Africa noted that the intersection of CDs and NCDs is of particular interest to South Africa, as people affected by CDs are more at risk of suffering from a NCD. He also discussed the effects of increased access to goods and marketing that have been causal in the increase of NCD cases in developing countries.
Another consequence of the NCD meeting, outlined by Dr. Daulaire, is a dramatic shift from direct foreign assistance to international cooperation (policy setting, sharing of best practices, importance of early prevention, intervention, and treatment) and domestic initiatives. The meeting also encouraged domestic policies for the promotion of tax measures to reduce consumption of tobacco, in addition to vaccinations and screenings for cancer prevention. Similar to how pharmaceutical companies were criticized for the unavailability of AIDS, tuberculosis, and malaria medications, the NCD meeting took direct aim at tobacco companies. The Global Smoke-free Worksite Challenge was highlighted to reduce workplace smoking and create incentives for employees to quit. Uruguay is recognized as the international leader for the fight for increased tobacco control, as its government has already taken action to reduce tobacco consumption in the workplace.
One criticism of the UN meeting is that specific goals and targets for NCD reduction were not made beforehand. Some believe that this will limit the potential effects of the meeting. As a result, some hope that there will be a global fund for NCDs, similar to the Global Fund To Fights AIDs, Tuberculosis and Malaria.
The UN meeting sets a precedent for the World Conference on Social Determinants of Health in Rio de Janeiro later this month. Regardless, the issue of NCDs will be revisited in 2014. It will be interesting to see whether goals and targets can be set, with specific milestones, and achieved in the near future.