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??