Dr Ala Alwan
Assistant Director-General
Noncommunicable Diseases and Mental Health
World Health Organization
Scope, Objectives and Agenda
Noncommunicable Diseases and Injuries
Magnitude
•
•
•
•
•
Four major noncommunicable diseases (NCDs):
– Cardiovascular diseases
– Diabetes
– Cancers
– Chronic respiratory diseases
Four shared modifiable risk factors:
– Tobacco use
– Unhealthy diet
– Physical inactivity
– Harmful use of alcohol
60% of deaths globally – 70% if injuries are included -80% in developing countries
40-50% are premature
Magnitude has a major socio-economic impact on developing countries
 NCDs and injuries are still excluded from global discussions on development
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
Injuries
• Cause 10% of all deaths and 16% of all
disability
• Road traffic crashes alone are the leading
cause of death for young people aged 1024 years
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
Oil and gas price spike
Retrenchment from globalization
Asset price collapse
NCDs
Fiscal crisis
Flu pandemic
Food crisis
Infectious disease
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
http://www.weforum.org/pdf/globalrisk/globalrisks09/global_risks_2009.pdf
Global Risk Assessment 2009
World Economic Forum
Deaths (millions)
Projected global deaths (2030)
12
Cancers
10
Ischaemic
heart disease
Stroke
8
Acute
respiratory
infections
6
4
2
Road traffic
accidents
Perinatal
HIV/AIDS
TB
0
Malaria
2000
2005
2010
2015
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
2020
2025
2030
www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html
Noncommunicable Diseases & Injuries
Noncommunicable Diseases
Death trends (2015)
Geographical
regions (WHO
classification)
2006-2015 (cumulative)
Total
deaths
(millions)
NCD
deaths
(millions)
NCD
deaths
(millions)
Trend: Death
from infectious
disease
Trend: Death
from NCD
Africa
10.8
2.5
28
+6%
+27%
Americas
6.2
4.8
53
-8%
+17%
Eastern
Mediterranean
4.3
2.2
25
-10%
+25%
Europe
9.8
8.5
88
+7%
+4%
South-East Asia
14.7
8.0
89
-16%
+21%
Western Pacific
12.4
9.7
105
+1
+20%
Total
58.2
35.7
388
-3%
+17%
WHO projects that over the next 10 years, the largest increase in
deaths from cardiovascular disease, cancer, respiratory disease and
diabetes will occur in low- and middle-income countries.
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
www.who.int/chp/chronic_disease_report/media/impact/en/index.html
2005
Noncommunicable Diseases
The poorest people in developing countries are the ones who smoke the most
%
All smoking prevalence
45
40
35
30
25
20
15
10
5
0
Low income
Low er-middle
income
Q1
Q2
Upper-middle income
Q3
Q4
Q5
Source: World Health Survey 2006
Range: from Q1 = poorest quintile to Q5 = Highest income quintile
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
High income
Noncommunicable Diseases
Macro-economic impact
2005
2006-2015 (cumulative)
Lost national income (billions)
Lost national income
(billions)
Brazil
3
49
China
18
558
India
9
237
0.4
8
Pakistan
1
31
Russian Federation
11
303
Tanzania
0.1
3
Countries
Nigeria
WHO: "Heart disease, stroke and diabetes alone are estimated to
reduce GDP between 1 to 5% per year in developing countries
experiencing rapid economic growth"
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
(WHO Chronic Disease Report, 2005)
Lost national income from
premature deaths due to heart
disease, stroke and diabetes
Noncommunicable Diseases
The vicious cycle of poverty and NCDs
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
NCDs are emerging as a serious
threat to Arab countries
and are undermining development
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
Noncommunicable Diseases
www.who.int/healthinfo/global_burden_disease/estimates_regional/en/index.html
Magnitude in the Middle East
Diabetes (2%)
Neuropsychiatric disorders (2%)
Digestive diseases (4%)
Total deaths: 4.3 million
• Noncommunicable conditions: 50%
• Communicable diseases*: 39%
• Injuries: 11%
Cardiovascular
diseases (27%)
Intentional injuries (4%)
Respiratory
diseases (4%)
Malignant
neoplasms (7%)
Unintentional injuries (7%)
Perinatal conditions (10%)
Infectious and parasitic
diseases (17%)
Respiratory infections (10%)
* Including maternal and perinatal conditions and nutritional deficiencies
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
Top-10 countries in diabetes prevalence in the world
(2007)
Rank and country
Age- adjusted prevalence of diabetes in
20-79 yr age group (%)
1. Nauru
30.7
2. United Arab Emirates
19.5
3. Saudi Arabia
16.7
4. Bahrain
15.2
5. Kuwait
14.4
6. Oman
13.1
7. Tonga
12.9
8. Mauritius
11.1
9. Egypt
11.0
10. Mexico
10.6
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
NCDs and injuries are preventable
We know what works
We have cost-effective interventions:
•Tobacco control interventions
•Measures to improve healthy dietary and physical activity patterns
•Early detection and effective treatment of cancer
•Treatment of hypertension, diabetes
•Treatment of heart disease and stroke
•Intersectoral injury prevention measures
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
The global response to address
noncommunicable diseases
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
2008-2013 Action Plan for the Global Strategy
Six Objectives of the Action Plan
1. Integrating NCD prevention into the
development agenda, and into policies
across all government departments
2. Establishing/strengthening national policies
and programmes
3. Reducing/preventing risk factors
4. Prioritizing research on prevention and
health care
5. Strengthening partnerships
6. Monitoring NCD trends and assessing
progress made at country level
Under each of the 6 objectives, there are sets of
actions for member states, WHO Secretariat and
international partners.
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
The NCD gap in the development agenda
(Health ODA* Commitments 2006 by major subsector)
US$ Billions
$4.75
STD & HIV/AIDS Control
$2.10
Infectious Disease Control
$1.93
Health Policy/Management
$1.80
Basic Health Care
$1.30
Reproductive Health Care
$0.70
Basic Health Infrastructure
$0.60
Medical Research
Medical Services
$0.20
Family Planning
$0.20
Basic Nutrition
$0.10
Health Training
$0.08
Health Education
$0.00
$2.70
Water supply/sanitation-large systems
$2.00
Water Policy/Management
$1.00
Basic drinking water supply & sanitation
River development
Waste management/disposal
Water resources protection
Water Education/Training
$0.30
$0.20
$0.10
$0.00
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
Total = $20.9 billion
* ODA = Official Development Assistance provided by 24 OECD/DAC donor countries, as well as the EC
Noncommunicable Diseases
President of the 61st World Health Assembly
… … MDGs … failed to identify noncommunicable conditions, in spite of the
fact that these diseases account for fully 70% of the global mortality… most
of the morbidity and mortality caused are preventable … a serious omission
… I propose we seriously consider an MDG+, which would set goals for the
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
NCCs, as
we have
done diseases
for other
… challenges.
Addressing
noncommunicable
and injuries
(Doha, Qatar, 10-11 May 2009)
Global NCD Action Plan 2008-2013
Milestones
Objective 1: To raise the priority accorded to noncommunicable
diseases in development work at global and national level
• Regional Ministerial Meeting on Health Literacy (Beijing, 2930 April 2009)
• Regional Ministerial Meeting on NCDs, Poverty and
Development (Qatar, 10-11 May 2009)
• ECOSOC High Level Segment on Global Health (Geneva, 68 July 2009)
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
What do we want to achieve from this meeting?
• Review the magnitude and trends of NCDs and
injuries with special emphasis on socio-economic
impact
• Discuss successful approaches and interventions
to address NCDs and injuries and identify costeffective measures to improve access of the poor
and vulnerable populations to proper health care
• Discuss ways and means of integrating the
prevention of NCDs and injuries into national,
regional and global development initiatives
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)
What do we want to achieve from this meeting?...
• Recommend key actions for countries to incorporate
NCD prevention into poverty reduction strategies
and relevant social and economic policies
• Recommend mechanisms to involve all government
departments to ensure that NCD and injury
prevention receives a cross-sectoral response
A Call for action by the international community and
development agencies to respond to the needs of
countries in scaling up action against NCDs and
injuries
ECOSOC/UNESCWA/WHO Western Asia Ministerial Meeting
Addressing noncommunicable diseases and injuries
(Doha, Qatar, 10-11 May 2009)