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GHF2008 – PS01 – Management of Chronic Disease I: A Multistakeholder Approach

Session Outline

Parallel session PS01, Monday, May 26 2008, 11:00-12:30, Room 4
Chair(s): Ala Alwan, Assistant Director-General, Non-Communicable Diseases and Mental Health, WHO, Switzerland
Role of an International Federation in Promoting Chronic Disease Prevention
Janet Voûte, Chief Executive Officer, World Heart Federation, Switzerland 
Centres of Excellence in Developing Countries to Counter Chronic Disease
Richard Smith, Director, Ovations / National, Heart, Lung and Blood Institute Chronic Disease Initiative, UK
Reform of Health Systems for Chronic Diseases in Pakistan
Sania Nishtar, Founder and President, Heartfile, Pakistan

Session Documents

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Session Report

Submitted by: Reem Ibrahim (ICVolunteers)

Every year, World Heart Days aims to rise awarness about heart diseases. Image: poster for World Heart Day 2006

With the passing of the World Health Assembly resolution and endorsement, it is the perfect time to address the implementation and strategy objectives for non-communicable disease (NCD) prevention and control. NCDs are responsible for approximately 60 percent of all deaths globally, with figures estimated to increase. A substantial proportion of major chronic diseases (CD), specifically cardiovascular disease (CVD), respiratory diseases, cancer and diabetes can be prevented.

The key objective is to link global socio-economic development and national policies in sectors to raise priority and awareness, increase focus on strengthening national policies, promote interventions, develop research agendas and partnerships, and monitor global NCD. 40 percent of cancer is preventable. 80 percent of heart disease, strokes, and type II diabetes are preventable. 100 percent action is needed: now.

The Chair, Ala Adwan, World Health Organization Assistant Director-General for Non-communicable Diseases and Mental Health Department opened the session by summarizing the key objectives for integrating NCD into the global-health system. Mr. Adwan then introduced the three speakers: Janet Voûte, Chief Executive Officer at the World Heart Federation (WHF), Switzerland; Richard Smith, Director of Ovations/National, Heart, Lung and Blood Institute Chronic Disease Initiative, United Kingdom; and Sania Nishtar, Founder and President of Heartfile, Pakistan.

Janet Voûte highlighted the role a federation can take in working as a complimentary organization towards improving prevention of global heart disease. The WHO Action plan for NCD, Grand Challenges Partnerships is a starting point for change, but more action is needed. NGOs and federations are perfectly positioned to voice concerns regarding health initiatives, such as the need to include NCD prevention and control in the United Nations Millennium Development Goals (MDGs). Key aspects include: raising awareness, modifying risk factors, re-orienting health systems, strengthening national policies and monitoring progress.

Ms. Voûte emphasized the pertinence of mobilized member networks consisting of continental members and members in national societies to complement WHO efforts on prevention and control. "By mobilizing member networks, a federation can be a strong partner in the control of chronic disease". She explicitly addressed the essential factors for progress: awareness, advocacy, sharing of scientific knowledge and demonstration projects. For example, the World Heart Day is one aspect for mobilizing networks to increase awareness: each year, a chosen theme focuses on risk factors of NCDs, in order to induce change in our daily lives. Efficient use of all available resources and tools is vital to spreading key health messages.

The WHF leadership can be a model for other federations to improve existing tools and strategies, to help mobilize members, to work in partnerships and monitor and evaluate progress.

Richard Smith expanded on the call for immediate action for the prevention and control of LCDs, stating that in 2005, thirty-five million people died from chronic disease. Yet, he noted, only minimum available health-funding is used to treat them. A higher burden is evident in low-middle income countries, and a rising prevalence of death in younger generations has also been registered. Nonetheless, a number of cost-effective intervention strategies have been established that can help pave the way to prevention.

Mr. Smith continued on the topic of commitment. Partnerships must be created with the developing countries to build capacity and raise international consciousness. The partnership of Ovations and the National Heart, Lung and Blood Institute (NHLBI) deploys a proactive approach to work effectively towards meeting current objectives. Each of these organizations contributes fifteen million dollars as funding to eight "Centers of Excellence" in the chronic disease initiative. These centers, created to promote change in an entire community, are responsible for research, advocacy, policy development, community intervention, providing guidelines for non-doctors, disease management, as well as fostering primary and secondary prevention strategies. They have also developed tools for estimating chronic disease risk in low income countries.

To correlate the vital topics concerning NCD prevention and control, Sania Nishtar wrapped up the session with three main ideas:

  • Multi-stakeholder response to management
  • Pakistan's response
  • The health system

Ms. Nishtar stated that a comprehensive consolidated global response is needed. We know that 80 percent of NCD cases occur in low-middle income countries.

She drew attention to the significant development of the World Bank on committing resources to NCDs and focusing on country assistance, and she applauded the initiatives by academia and industry. Global partnership for chronic disease control will bring the needed change into practice by, for example, setting standards; synchronizing multi-stakeholders; and assisting the developmental agreement of the WHO. Partnerships certainly can derive donor assistance and provide financial instruments that catalyze the reallocation of resources towards the social sectors.

Ms. Nishtar also highlighted Pakistan's response to NCD:

  • 0.6 percent of GDP is spent on health
  • The government agreement in 2003 to allocate resources to an action plan on NCD prevention and control
  • The establishment by the government of an action plan on disease surveillance with appropriate legislation

Various challenges do exist, however, and there is a fundamental need to strengthen the country's health system. Certain flaws in management have raised issues, such as data statistics gathering, connectivity, central reporting, the lack of adequate research mechanisms and the delivery of service. To promote a mainstream program of health within a country, it is vital to first strengthen the health system.

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