UN: Collective global effort key to combating non-communicable diseases

Non-communicable diseases, particularly diabetes, cancer, cardiovascular disease and chronic respiratory disease, not only impose an enormous human health burden, but present a significant threat to social and economic development as well, according to representatives at the U.N. High-level Meeting on Non-communicable Diseases. International cooperation, they said, is essential to addressing this global problem.

"Let there be no doubt that non-communicable diseases have reached epidemic proportions," Nassir Abdulaziz al-Nasser, president of the U.N. General Assembly, said during the meeting's opening plenary session on Monday, noting that they account for 63% of deaths worldwide, or approximately 36 million of 57 million deaths annually.

At the conclusion of the opening address, the General Assembly accepted without vote the U.N.'s political declaration to adopt a coordinated effort to tackle the issue of non-communicable diseases.

This landmark, 2-day meeting marked only the second time in history that the U.N. has convened to discuss a health-related issue. The HIV/AIDS Summit in 2001 was the first, and speakers expressed hope that world leaders learn from the multifaceted approach that has been so successful in combating infectious diseases worldwide.

"Since [our first meeting regarding the health issue of AIDS], we have made enormous progress," said Ban-Ki Moon, secretary-general of the U.N. "We still have a long way to go, but no one can doubt that government officials saved lives, and no one can minimize the contributions of industry leaders who made medicines affordable."

Prevention as a priority

Many non-communicable diseases such as diabetes and CVD are preventable, health officials at the meeting said, and the most cost-effective option for treatment is actually prevention. Although encouraging, this option also represents a significant challenge, especially for lower- and middle-income countries that have been hit hardest by these health problems.

Encouraging physical activity, reducing salt, sugar and fat content of people's diets, and curbing tobacco and alcohol use form the basis of preventive strategies, but poorer countries often lack access to nutritious food, which may actually cost more than cigarettes in some areas. Other regions may not have safe spaces in which children can play and exercise, speakers said. For example, as a representative from the World Bank said, simply addressing the problem of obesity could stretch beyond Mexico's federal budget.

These nations, however, are trying. The president of Mexico reported a partnership with FIFA to expand the areas in which children can participate in sports such as soccer. Similarly, Mwai Kibaki, president of Kenya, outlined legislative efforts to regulate smoking in public places and enforce restrictions on alcohol consumption.

Even so, in the future, many of the poorer regions still require more funding to mount effective prevention campaigns, increase access to healthy foods, bolster primary care and specialty clinics, and improve access to affordable medication.

"We need to ensure equitable access to care as a human right," Wonchat Subhachaturas, MD, of the World Medical Association, said during a round table discussion.

Coordinated action can work

Although the meeting called attention to the growing problem of non-communicable diseases, many representatives said the next steps will be most important. During a round table discussion, speakers highlighted crucial areas that must be addressed moving forward.

Strengthening national surveillance and regional and international sharing of information will provide concrete data about the severity of non-communicable diseases in various areas. Moreover, heads of state, health ministries and researchers will learn about which interventions have proved most effective and which areas require more attention.

In addition, international cooperation will aid lower- and middle-income countries in their regulatory battles regarding advertising and marketing of alcohol and tobacco, as well as marketing of unhealthy foods to children. This coordination may also strengthen their ability to negotiate with the pharmaceutical industry for more affordable medications.

Finally, international organizations such as the U.N. and WHO will be essential in helping nations secure the necessary financial and social support that has so far impeded certain countries from obtaining the help that they need.

"There is no time to lose. Act now. More than ever before, we need honest and responsible international cooperation and coordination," Margaret Chan, MD, MPH, director-general of WHO, said. "We need to hold each other to account - account to transparency and account to what is promised. I look to you all for working closely with us as required by the U.N.'s political declaration."

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