NEW REPORT SHOWS POORER HEALTH OUTCOMES FOR PEOPLE LIVING IN EMERGENCY SETTINGS

According to the first WHO World report on the health of refugees and migrants, millions of refugees and migrants in vulnerable situations around the world, such as low-skilled migrant workers, face poorer health outcomes than their host communities, especially where living and working conditions are sub-standard. This has dire consequences for the probability that the world will not achieve the health-related Sustainable Development Goals for these populations.

Based on an extensive review of literature from around the world, the report demonstrates refugees and migrants are not inherently less healthy than host populations. Instead, the impact of the various suboptimal determinants, such as education, income, housing, access to services, compounded by linguistic, cultural, legal and other barriers, are behind poor health outcomes.

While lack of comparable data on the health of refugees and migrants across countries and over time often impedes good policy development towards health equity, policies and frameworks exist to respond to the health needs of refugees and migrants. However, disparities in health outcomes remain, and the report shows they are mainly due to a lack of meaningful and effective implementation of policies.

Implementing inclusive health systems with the principle of right to health for all and universal health coverage would identify and support individuals in need of health services before many problems become acute. Health systems are only as strong as their weakest link. The inclusion of refugees and migrants is a worthwhile investment for the development and wellbeing of societies around the world.

At this year's World Health Assembly, Member States supported WHO recommendations on how to strengthen policies to prevent, control and treat NCDs for people living in humanitarian emergencies. These recommendations set the principle that people living with NCDs in humanitarian emergencies need special attention and investment through a multi-sectoral all-hazards approach. This includEs ensuring that NCDs are systematically included at every stage of the emergency cycle, across preparedness, response and recovery.

To respond to the continuing need during humanitarian crises to treat people for noncommunicable diseases, WHO has developed dedicated 'NCD kits', containing medicines and equipment for caring for people living with NCDs.

The NCD kit attends to cover gaps in care, by providing essential medicines and medical devices for the management of hypertension and cardiac conditions, diabetes and endocrine conditions, chronic respiratory diseases, and mental health and neurological conditions and neurological conditions for outpatient care in primary health care settings. Each kit covers 10,000 people, for three months.

This video follows the assembly of the kits in the Netherlands and their delivery to southern Turkey, where WHO dispatches the materials to healthcare providers working in Syria to treat people living with NCDs. We continue to deliver the NCDs emergencies kits to other countries affected by conflicts and natural disasters.

SEEKING YOUR FEEDBACK ON THE DRAFT WHO GLOBAL REPORT ON HEALTH EQUITY FOR PERSONS LIVING WITH DISABILITIES

At the 74th World Health Assembly in May 2021, Member States adopted resolution WHA74.8 on The highest attainable standard of health for persons with disabilities. This landmark resolution provides WHO with a mandate to continue its commitment to promote disability inclusion in the health sector.

As part of its guidance to countries, the resolution specifically requests WHO to develop a global report on the highest attainable standard of health for persons with disabilities by the end of 2022.

To ensure the report is practical and relevant, we are seeking inputs from a wide range of partners including Member States, civil society, academia, health professionals and the private sector. The survey includes a link to the full draft version and summary version of the WHO Global Report on health equity for persons with disabilities.

The survey for providing feedback and also the summary version of the Report are available in all official WHO languages, though the full Report version is available only in English. An EasyRead version of the survey and summary of the Report will be available soon on the WHO website.

We kindly ask you to submit your feedback by 5 August 2022.

UPDATING THE WHO NCD BEST BUYS: CHANCE TO CONTRIBUTE TO OUR SECOND INFORMAL CONSULTATION

The WHO 'best buys' are a priority set of effective, feasible and cost-effective interventions that WHO Member States can adopt to improve NCD outcomes for their populations, with a specific focus on accelerating progress in lower- and middle-income countries. As such, they are a crucial technical package for countries around the world to invest in NCDs, unlock sustainable development, and save tens of millions of lives in this decade alone.

In June, we published a first draft WHO discussion paper containing a proposed update to Appendix 3 of the Global Action Plan for the Prevention and Control of NCDs 2013-2030 for public consultation. The Secretariat has also convened a first informal consultation with Member States and UN organizations, and with non-State actors in official relations with WHO (such as NGOs, private sector entities, philanthropic foundations and academic institutions). 

From 1 August, we will be publishing a second draft discussion paper, that takes account of the feedback gathered from these consultations. You will have the opportunity to provide your comments until 28 August. We will share full details of this consultation in next week's NCD Newsflash.

As other notable dates for your diary:

16 September 2022: The Secretariat will convene a second informal consultation with Member States and UN organizations.
19 September 2022: The Secretariat will convene a second informal consultation with non-State actors in official relations with WHO.

WHO RELEASES GLOBAL COVID-19 VACCINATION STRATEGY UPDATE TO REACH UNPROTECTED

The global COVID-19 vaccination rollout is the biggest and fastest in history but many of those at greatest risk remain unprotected. Only 28% of older people and 37% of health care workers in low-income countries have received their primary course of vaccines, while most have not received booster doses.

In response to the spread of Omicron subvariants, advances in vaccine evidence, and lessons from the global vaccination program, WHO has published an update to the Global COVID-19 Vaccination Strategy.

Of special relevance for NCDs, the strategy recommends that for vaccine delivery, “efforts need to continue and increasingly emphasize delivery approaches to implement vaccination for adults, making vaccination for the life course a reality... oppportunities include leveraging services for communicable and noncommunicable diseases”.

It also sets several principles for integrating NCDs within COVID-19 vaccination goals and target setting, including:

• National & global equity: that all individuals, populations and countries should have equitable opportunities to access and distribute vaccines without incurring financial hardship. 
• Quality, safety & efficacy: that vaccines used should meet international standards through WHO authorization. 
• Integration: that vaccines should be deployed without undermining other primary health care priorities but rather leveraging and strengthening primary health care and other relevant communicable and NCD programmes.

NCD HARD TALK: GOING BIG ON NCDs IN TECHNOLOGY, CLINICAL CARE AND THE COMMUNITY

In our latest NCD Hard Talk last week, ‘Going BIG on NCDs: Technology, Clinical Care and the Community’ on 13 July, we explored examples of distinct, cutting-edge visions that can radically impact NCD outcomes and be easily implemented in countries. By addressing health system challenges head-on, countries can move closer to delivering on their promise to people living with NCDs.

Three key areas ripe for innovation and change covered in this session include: 

• Medicines: technology transfer for local production of insulin and NCD medicines to increase access.
• Acute care: strengthening immediate care for saving lives. 
• Community: leveraging community leaders for NCD prevention and control.

We are happy to share the recording of this webinar.

An opportunity has availed itself through the established Global Group of Heads of State and Government on NCD, to engage the highest authorities of nations on these Big NCD Solutions. The first annual gathering of the group will take place during the 77th United Nations General Assembly in New York in September 2022 where such solutions could be shared to enthuse other countries. 

REVIEWING THE EVIDENCE ON TB AND DIABETES: CAN YOU HELP?

The prevalence of diabetes influences both incidence and mortality from tuberculosis (TB), including a twofold risk of death during TB treatment and a fourfold risk of TB relapse after treatment completion. In 2019, just over 15% of people with TB were estimated to have diabetes globally, compared with 9.3% among the general adult population. This equates to about 1.5 million people with TB and diabetes who required coordinated care and follow-up to optimize the management of both conditions.

A decade ago, WHO and the International Union against Tuberculosis and Lung Disease published the 'Collaborative framework for care and control of tuberculosis and diabetes'. This framework contains recommendations on the collaborative management of TB and diabetes. While it has helped to kick-start collaborative action on TB and diabetes, there are still challenges in implementation and scale-up. 

In collaboration with the NCD Department, WHO's Global Tuberculosis Programme has initiated a process to review the evidence on TB and diabetes, and related interventions to address the joint burden of TB and diabetes.

As such, WHO is developing an operational handbook to support countries to implement current WHO recommendations and collaborative activities on TB and diabetes. To inform the handbook, we are seeking expressions of interest from academic institutions or other entities with relevant expertise and experience in systematic reviews, synthesis and quality assessment of available data, summarize the results, and write a descriptive report detailing the methods and findings of the reviews.

We look forward to receiving your expressions of interest by 11 August. The EOIs received will go through a review process, with selected candidates notified on its completion. The selected candidates will be required to develop a proposal for the evidence summary to be conducted, along with details of a budget estimate.

EVIDENCE-BASED INTERVENTIONS FOR PEOPLE LIVING WITH NCDs IN DETENTION

More than 1.5 million people are being held in detention across the WHO European Region. Despite all Member States being mandated to to provide health services in prisons of an equivalent standard to those in the wider community, as part of the principles of the WHO European Programme of Work 2020–2025, people in detention are more likely to suffer from NCDs such as cancer and cardiovascular diseases than the general population.

To mark last month's Nelson Mandela International Day, the WHO Regional Office for Europe (WHO EURO) highlights the major obstacles people face in prisons while trying to stay healthy in a new report “Cancer and health inequities in prison settings”. 

The main findings of the WHO report suggest prison health screening programmes and vaccination can benefit people living in detention and reduce costs for health systems. For instance, breast, cervical and colorectal cancer screenings lead to better health outcomes for women and men in prisons. Yet programmes to screen for cardiovascular diseases have shown poorer outcomes, even though they are much more available for people living in detention today. In addition, it identified major factors that make the health of detained people even more fragile, including: poor record-keeping in prisons; low prioritization of addressing health issues; and inconsistent quality of the health care provided.

Most of the evidence identified focused on cancer, with cervical cancer the most commonly studied disease. Gaps in the evidence, notably related to cardiovascular disease, suggest that additional research is needed on health inequities in prisons.

HOUSEKEEPING AND COUNTRY IMPACT

As part of efforts to improve WHO communications, we always want your feedback of what you like, and what you would like to see more of! Send me your feedback below.

We are also piloting a new On The Pulse feature series, working with WHO Regional and Country Offices to explore our country impact on NCDs! If you would like to be kept in the loop about this, please also let me know by writing.

THE TWEETS WE RETWEET

• A new report from @NCDAlliance on simultaneous action for diabetes and hypertension to build resilient health systems (July 2022)
• The importance of addressing the double-burden of malnutrition among children and adolescents in sub-Saharan Africa from @NCDChild (July 2022)