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WHO discussing the NCD agenda - the important of action against non-communicable diseases

On 30 November and 1 December WHO hosted a consultation on Prevention and control of NCD’s. The Danish ambassador, Carsten Staur, participated in a panel discussion on 1 December. His opening remarks are here:

H.E. Ambassador Carsten Staur,
Permanent Representative of Denmark to the UN in Geneva

Panel on NCD’s – WHO Board Room, 1 December 2015

The SDG health target on NCDs is a newcomer on the international development agenda. Is it welcome? To us – certainly! It’s difficult being a newcomer when you enter into a field where you figure as one target among 13 targets under the health goal of “ensuring healthy lives and promoting well-being for all at all ages”. At the same time NCDs cut across sectors, which offer a number of opportunities to link firmly up to the broader health systems agenda as well as the wider development agenda.

It’s not easy to create space for NCD’s – the sheer scale of the challenges is fairly frightening. It has to be done, of course – the global health agenda has to deal with NCD’s if it is to make any sense. But the NCD agenda in itself is most probably not going to generate more ODA funding for health. By broadening the international targeted development agenda, the SDG’s have most probably made international resource mobilization for health an even greater challenge.

Additional costs thus have to be found be domestic resource mobilization, innovative funding and public-private partnerships, incl. with pharmaceutical companies – and not least through utilization of potential synergies and efficiencies within the health sector and within efforts to increase public awareness of health risks. The 30-40 % waste in the health sector, which the DG referred to, is a case in point.

If implemented wisely, the NCD agenda can contribute to the much needed strengthening of health systems and to the creation of more sustainable systems for health. The other side of that coin is that health systems should also be designed to effectively combat NCDs.

But we, of course, have to look beyond the health goal and targets. Energy, agriculture, education, gender equality and human rights are some of the sectors where synergy can and must be found and where cooperation can be of great benefit to the NCD agenda.

An excellent example to learn from for the NCDs could be UNAIDS and the AIDS response in general. Both politically and programmatically, the AIDS response has been successful in entering into other agendas, sectors and spheres as well as partnering with multiple partners, including CSOs, NGOs and the private sector. The Security policy agenda (UNSC1308), in education (sexuality education), in the humanitarian field and Product RED - to mention a few examples. To tackle the ever-rising scale of the NCD problems, we need to learn from this multi-sectorial and crosscutting approach.

Three specific points:

1).   At national level, state regulation can be a relevant response. These can either be regulations that encourage healthy behaviour, for example better infrastructure for pedestrians or bicyclists, or discourage unhealthy behaviour such as taxation on tobacco or alcohol, as we also discussed yesterday. Prohibiting smoking in public places is another well-known regulatory intervention in many countries. But it’s, of course, also an agenda, which has international ramifications – through trade policies. To allow or not allow genetically modified food? In our view, food security and health concerns must prevail also in this context.

2).  On taxation, let me expand a bit on yesterday’s discussion. Our policy choices here are fairly clear. Sin taxes are fine. But we think that a direct link between public revenue generation and public spending lead to suboptimal decisions in both arenas. Revenue generation is a science in itself – how to tax in a way that sends the right signals in term of behavioural change, and do not hamper economic growth. Linking it to certain public expenditures – and thus safeguarding or protection certain public expenditures from normal prioritization, is not in our view the right thing to do. But I acknowledge that others may differ.

3).  Final Point: Denmark is a country, where the population has a relatively high level of health literacy in general and also a high level of NCD awareness.

A lesson we have learned is, however, that higher levels of health literacy do not automatically guarantee better health outcomes. To work efficiently, this literacy continuously needs to be complemented by strong awareness and advocacy. And it is a long term and continuous investment, especially when it comes to prevention and changing people’s attitude and behaviour. We know that from ourselves. And from the lessons we have learnt from the AIDS-response.

On an individual level, we actively try to empower individuals to manage their own health. This effort is also supported through public awareness campaigns and through a public web portal, where each citizen, can have their own, secured, health journal with the latest information on treatments, medications, allergies, etc.
Goal 3: Ensure healthy lives and promote well-being for all at all ages .
Target 3.4: By 2030 reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well being