FROM GLOBAL TO LOCAL AN ALLIANCE OF FEDERATIONS FOR NCDs 28 April 2010 Structure of presentation • Cary Adams Overview of UICC • Ann Keeling Overview of IDF • Nils Billo Overview of IUATLD • Helen Alderson Overview of WHF Working together as partners • Ann Keeling The NCD Advocacy Agenda UICC: Working to eliminate cancer as a life threatening disease international union against cancer Who we are – an overview The International Union Against Cancer (UICC) is the leading international nongovernmental organization dedicated to the global prevention and control of cancer. Founded in 1933, UICC unites over 360 member organizations, specialized and engaged in cancer control, in more than 100 countries across the world. UICC is non-profit, non-political, and non-sectarian. It’s headquarters are in Geneva, Switzerland. • Current President: Professor David Hill of Cancer Council Australia • Over 1 million individual members working worldwide • 180.000 and growing World Cancer Declaration supporters World Cancer Declaration ‘A global call to action to help substantially reduce the global cancer burden by 2020 and increase cancer's visibility on the international political agenda’ Annual global cancer mortality (millions) Low income countries High-income countries 12 UICC outlines 11 targets and a priority action plan to stop and reverse current trends at local and national level. Aimed towards making significant improvements in the measurement of the global cancer burden, sharing best practice to increase rates of early detection and optimal treatment and thus improvements in cancer survival rates in all countries around the world. 2.44 10 2.38 8 2.1 6 9.49 4 6.87 5.5 2 0 2005 Support the approx. 30 million people living and coping with cancer globally 2015 2030 World Cancer Declaration The Declaration sets 11 targets to stop and reverse current cancer trends And aims to increase cancer’s visibility on the global agenda Targets 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Sustainable delivery systems Improved measurement of the global cancer burden Decreased global tobacco consumption, obesity, and alcohol intake HBV and HPV vaccination programs and screenings Shift in public attitude towards cancer Earlier and accurate diagnosis Appropriate cancer treatments and supportive care Effective pain control measures accessible to all patients Improved professional training opportunities Decrease in emigration of health workers with specialist training in cancer control There will be major improvements in cancer survival rates in all countries Please help us move cancer up on the global agenda by signing online at: www.uicc.org/wcd Promoting diabetes care, prevention and a cure worldwide President Jean Claude Mbanya Cameroon International Diabetes Federation 220+ member associations in 160+ countries, 7 regional offices, 2million+ members US$ 750 million combined income UN Resolution on Diabetes Dec 2006 335 million have diabetes IDF’s role • Global advocacy and campaigning • Evidence: IDF Diabetes Atlas, health economics • Policy Research • Sharing best practice eg diabetes education • Global guidelines and advice to govts • Humanitarian programmes eg Life for a Child • Convening the global diabetes community – World Diabetes Congress Mission The Union brings innovation, expertise, solutions and support to address health challenges in lowand middle- income populations Vision Health solutions for the poor Map of Global Activities Technical Assistance – Education – Research Union Membership Activities Around 3 000 members from 152 countries • 84 Constituent Members • 18 Organisational Members • 2 834 Individual Members www.theunion.org World Heart Federation Helen Alderson, Chief Executive Officer The World Heart Federation Mission The World Heart Federation helps people achieve a longer and better life through prevention and control of heart disease and stroke, with a focus on low- and middle-income countries . The World Heart Federation The World Heart Federation helps people achieve a longer and better life through prevention and control of heart disease and stroke, with a focus on low- and middle-income countries. Leads a united community of over 200 member organizations in the global fight against heart disease and stroke. Brings together the societies of cardiology as well as heart health charities. The World Heart Federation Together with our members we achieve our mission through: Awareness Building Advocacy Demonstration Projects Sharing Science and building capacity Working together as partners on the NCD agenda WEF: Global Risks Landscape 2010 NCDs Non-communicable account for over 60% of global deaths 20000000 C a rdio v a s c ula r dis e a s e s 18000000 16000000 14000000 12000000 10000000 8000000 C a nc e r 6000000 C hro nic re s pira t o ry dis e a s e s 4000000 H IV / A ID S 2000000 T ube rc ulo s is M a la ria 0 Source : WHO 2005: «Preventing Chronic Diseases: A Vital Investment» D ia be t e s 14 million premature deaths in LMCs 60 million 10% 50 million 5.3 M 14.2 M 40 million 30 million 34% 28% 14.0 M 28% 20 million 17.4 M Omitted from the MDGs: 14.0 million premature deaths from non-communicable diseases Total number of deaths in low- and middle-income countries (2004) Group III - Injuries Low-income countries Group II – Other deaths from non-communicable diseases Group II – Premature deaths from non-communicable diseases (below the age of 70), which are preventable Group I – Communicable diseases, maternal, perinatal and nutritional conditions WHO slide Source: 10 million The number of deaths due to NCDs is expected to rise over the next 10 years: the largest increase will be in developing countries 2005 2006-2015 (cumulative) Total deaths (millions) NCD deaths (millions) NCD deaths (millions) Trend: Death from infectious disease Trend: Death from NCD 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% Geographical regions (WHO classification) Africa Source : WHO 2005: «Preventing Chronic Diseases: A Vital Investment» Out of the $21 billion ODA invested in health, where are NCDs? Total ODA for Health in 2006: US$ 21 billion (expressed in 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 Source WHO NCDnet $0,30 $0,20 $0,10 $0,00 Total Percentage of Health Aid spent on NCDs: 0.9 % Source: Nugent & Feigl (2009), Donor Response to Chronic Diseases in Developing Countries, Center for Global Development, Washington, DC. Millennium Development Goals drive the global development agenda 1. Eradicate poverty and hunger 2. Achieve primary universal education 3. Promote gender equality and empower women 4. Reduce child mortality Where are NCDs? 5. Improve maternal health 6. Combat HIV/AIDS, malaria and other diseases 7. Ensure environmental sustainability 8. Develop a global partnership for development The Framework WHO Action Plan: Defines NCDs as 4 diseases: cancers, diabetes, cardiovascular, chronic respiratory Agreed by governments NCDs: a development issue January 2009: The three NCD federation’s formed an alliance and we are pleased to welcome a fourth this year 882 national associations in 170+ countries Call for action at a global level Why will are NCDnet the poorest people in low- and middle-income countries affected the most? What be doing? Objective 5 – Promoting partnerships NCDnet: New network to combat noncommunicable diseases Mission: Help implement the Action Plan by catalyzing a multi-sectoral, multi-level response, with a particular focus on developing countries Goals: ● ● ● WHO slide Increase focus on prevention and control of non-communicable diseases through collective advocacy Increase resource availability (both financial and human capital) Catalyze effective multi-stakeholder action with a focus on country-level implementation IDF – UICC – WHF – IUATLD committed to working towards prevention & control of NCDs International Federations’ key assets: • • • • Members Networks Healthcare Professionals Patient groups Grassroots presence and activities NCDs: the global advocacy agenda 2009 Alliance Advocacy Demands • United Nations special session on NCDs (UNGASS) • NCDs and MDGs: adding NCD indicator(s) at MDG Review Sept 2010. Successors to MDGs post 2015. • International funding for essential NCD medicines/care - Advocating for international and national funding - Global Fund mandate expanded to Global Fund for Health integrating NCDs/Innovative financing for NCDs • Integration of NCDs, especially into primary healthcare Why an UNGASS on NCDs? An UNGASS: what makes it special? • Only 28 Special Sessions in UN history – often mark UN anniversaries eg 2000 Women. Last was 2005. • convened either by Security Council (conflict/peace) or simple majority vote UN states in General Assembly • mega events/mega profile for an issue: 2002 Children: 3500 govt delegates (43 heads of state), 1700 NGOs, 1200 journalists and over 122 supporting events. • can catalyse major change eg HIV/AIDS 2001: Commitment signed by all UN members. National progress reports every 2 years. Led to Global Fund. NCDs UNGASS: building momentum • Jan 2009 IDF started lobbying: no traction • May 2009 Alliance event at WHA built supporters • June 2009 statement CARICOM heads of govt • Alliance followed up with: • publication eg Time to Act • statements/presentations at key events • mobilising our members to lobby govts • behind scenes lobbying July 2009: ECOSOC (58 UN member states) recognize global NCD threat “We also recognize that the emergence of non-communicable diseases is imposing a heavy burden on society, one with serious social and economic consequences, and that there is a need to respond to cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, which represent a leading threat to human health and development.” 9 July 2009 November 2009: UNGASS support by 54 Heads of State "We declare our support for the call to integrate indicators to monitor the magnitude, trend and socio-economic impact of NCDs into the core MDG monitoring and evaluation system during the MDG Review Summit in 2010." "We call for a Summit on NCDs to be held in September 2011 under the auspices of the United Nations General Assembly." 29 November 2009 The Voice of the Alliance at National Level National Associations working together to support global advocacy for NCDs UNGASS: current state of play • Formally adopted by 76 Heads of Govt, other govts supportive eg Russia, Gulf.. • CARICOM countries leading on draft resolution. Optimistic vote in UN May for UNGASS Sept 2011. • Feb 2010 Alliance advocacy supported by powerful NGOs eg GARD, FCA, • Reaching US govt is critical – US alliance • EU important: UK, France, Germany, Portugal, UK, Ireland, Cyprus, Malta committed • NCD panels New York 13 & 20 April, FCA statement UNGASS: current state of play • CARICOM countries leading on draft resolution. Now cosponsored by China, Brazil etc •Optimistic it will go to UN GA in May for a vote for high level Summit on NCDs Sept 2011. • We believe we will get the Summit .....and then the fun begins Current state of support for the UNGASS 75 Heads of State 44 Co-sponsoring 7 ministerial level support Heads of State Antigua and Barbuda Australia The Bahamas Bangladesh Barbados Belize Botswana Brazil Brunei Darussalam Cameroon Canada Chile China Colombia Cyprus Dominica Dominican Republic El Salvador Fiji Islands France Gambia Germany Ghana Grenada Guatemala Guyana Haiti India Ireland Jamaica Kenya Kiribati Lesotho Luxembourg Malawi Malaysia Maldives Malta Mauritius Mozambique Namibia Nauru New Zealand Nigeria Pakistan Papua New Guinea Paraguay Peru Portugal Qatar Rwanda Suriname St Kitts and Nevis St Lucia St Vincent and the Grenadines Samoa Seychelles Sierra Leone Singapore Solomon Islands South Africa Sri Lanka Suriname Swaziland Thailand Tonga Trinidad and Tobago Tuvalu Uganda United Kingdom United Republic of Tanzania Uruguay Vanuatu Zambia Ministerial Support through Gulf Cooperation Council Bahrain Kuwait Oman Qatar Saudi Arabia United Arab Emirates Ministerial Level Russia UNGASS: current strategy • Separate the UNGASS and MDGs: some powerful govts will oppose if the two combined • Secure the UNGASS • Once secured, get renew focus on the MDGs • Focus on ‘feeder meetings’ ie April Commission on Population and Development and July ECOSOC • Secure UNGASS, then launch the consultation (Commonwealth remains keen) NCDs and MDGs: establishing the connections NCDs and the MDGs • 8 MDG goals determine agenda for international funding to LMCs till end date 2015 •MDGs specify particular diseases eg HIV/AIDS, TB – not meant to be taken literally – don’t include NCDs •Adding an indicator would catalyse funding/technical assistance for NCDs • Discussion of an NCD indicator would set scene for inclusion of NCDs in successor goals to MDGs •Sept 2010 MDG review meeting at UN last opportunity before 2015 Jan 2010: WHO Executive Board highlights NCDs in MDG Report “”Recognizing also the growing burden of noncommunicable diseases worldwide, and recalling the importance of preventing infectious diseases that still represent a heavy burden, particularly in developing countries, the adverse impacts of the food, environmental, economic and financial crises on populations, in particular on the poorest and the most vulnerable ones... 21 January 2010 MDG Review September 2010 • Getting into ECOSOC and MDG meetings??? • Discussion of indicators has gone quiet (WHO??) • Many govts determined to raise NCDs at MDG Review • NGO consultations for MDG Review New York 14 and 15 June • Once we secure UNGASS NCDs will be taken more seriously What about the money? Major players in aid to LMCs • Global Fund for AIDS, TB and Malaria: 2008 disbursed US$2.3 billion - almost none on NCDs • Gates Foundation: 2008 disbursed US$3.6 billion (all sectors including health) – almost none on NCDs • UNITAID: 2008 expenditure US$232 million – none on NCDs BUT the global agenda is driven by bilateral aid donors eg Netherlands, DFID, SIDA, NORAD etc (who also fund Global Fund, UNITAID, WHO, World Bank etc) International Funding for NCDs Bilateral donors still sceptical: ‘taxpayers will not support us funding diseases of affluence’ Two common misperceptions: • NCDs are not diseases of the poor • There are no cost effective solutions Meeting with DANIDA 15 and 16 April Paris Declaration Aid Effectiveness is key The Business Case for NCDs: the World Economic Forum • We know costs of diseases but not costs of solutions (including prevention). WHO working on ‘packages’. • WEF important forum for defining business case for NCDs • WEF on NCDNet but WHO weak on NCDs (eg diabetes one staff member in WHO) • Major focus Davos January 2011 ??? Key Events 2010 /11 UN Commission on Population and Development Meeting 63rd World Health Assembly 126th WHO Executive Board OECD Health Ministers Meeting UN General Assembly Special Session on NCDs WDF / DANIDA NCDs Meeting MDG Review Summit at UN General Assembly WEF Davos Meeting ECOSOC Ministerial Meeting WHO NCDNet Meeting Jan Feb Apr May July Sep Oct Jan Late 2010/2011 The Alliance going forward • The alliance: flexible and effective. Hard to coordinate more than 4 organisations. • We will use our 4 logos and not take a name • More NGOs asking to join, work with wider NGO group through NCDnet • US based Lance Armstrong Foundation funding NCD Alliance Campaign Manager, Greg Paton based in IDF • Alliance website as resource and rallying point. Other NGOs free to support our statements/actions. Welcome to the cause! NCDs are at a turning point What can we do together??