2022 was a year of global commitments and progress to improve NCD outcomes for all. These commitments reflect ever clearer that NCDs are critical to future global health sustainability, development efforts and strong economies, and our collective preparedness against pandemics and humanitarian crises. We have effective, cost-effective and equitable tools that can save lives and improve livelihoods all over the world.

This year's World Health Assembly agreed a record number of decisions to speed up the world's response to NCDs. These included an NCD implementation roadmap to achieve SDG 3.4, accelerating action on diabetes and oral health, and improving NCD outcomes in humanitarian settings - among others below - to save lives and improve livelihoods.

Work is tirelessly going on around the world to prevent and see more people avoiding, or receiving better care, for their NCD. Though I cannot share every interesting innovation that has emerged this year, here are four places that gave me hope for a better NCD future.

First, in Accra, Ghana, we saw Member States, civil society and partners around the world come together in a landmark International Strategic Dialogue on NCDs and the SDGs, recognizing that SDG 3.4 is perilously at risk, and that urgent action on NCDs is necessary for health systems, economies and equity.

This was followed by a first-ever Global Group of Heads and State and Government for the Prevention and Control of NCDs in New York, alongside this year's UN General Assembly (UNGA). This meeting saw leaders from Small Island Developing States (SIDS), the European Commission and Ghana championing the political prioritization of NCDs at the highest level.

Just last month, I have spent time with colleagues across the Eastern Mediterranean in Cairo, discussing the importance of tools and priority for NCDs in humanitarian emergencies and learning from this region’s longstanding expediencies in humanitarian settings. As my team has been supporting the humanitarian response in Ukraine, we have seen first hand how NCDs need attention during war and humanitarian crises. We also see their human toll: complicating a heartbreaking decision of whether to stay or leave, while demonstrating the depths of multilateralism to receive people seeking care.

And fourth, for this year's World Heart Day, WHO colleagues and I saw work on the WHO HEARTS technical package in Iloilo province, Philippines. Through the Healthy Heart Project, WHO is supporting a package of interventions and technical assistance to local government units, including health promotion, evidence-based treatment protocols, access to essential NCD medicines, and the implementation of monitoring systems. This was just one example of country impacts the WHO NCD Department is having, working with Country and Regional Offices on areas of NCD management, integrated service delivery, disability, rehabilitation and sensory functions, and in NCD surveillance, monitoring and reporting. Across these functions, we help to develop and deliver technical packages, respond to country support plans and monitor and scale country impacts.

In my annual year in review, I'm sharing a few highlights of the work of the NCD Department, and my superb colleagues working on NCDs in WHO at national, regional and global level. It cannot do justice to all of the vital and urgent work you do across the NCD space. None of this would be possible without your support: in national Ministries of Health, across civil society, in conversations with people living with NCDs challenging us to improve meaningful engagement, in clinics, communities, health centres, and with academia and all our partners supporting around the world. Thank you.

Beginning in just a few short weeks, I am particularly looking forward to our first High-level technical meeting on NCDs and mental health in SIDS and subsequent Ministerial Conference, our global meeting on NCDs and emergencies, the second High-level Meeting of the United Nations General Assembly on universal health coverage, and the third WHO global meeting of national NCD directors and programme managers.

I wish you a happy, healthy and safe time in 2023.

Bente

JANUARY: NCDs A MAJOR INFLUENCE ON ACHIEVING UNIVERSAL HEALTH COVERAGE

Universal health coverage (UHC) is a priority goal for many countries, and one of WHO’s Triple Billion targets to improve the health of billions of people for 2023.

UHC means that everyone receives quality health services, when and where they need them, without incurring financial hardship. Before COVID-19 struck, the world was far short of reaching SDG target 3.8 and the goal of one billion more people benefiting from UHC by 2023.

We begin 2022 with WHO publishing its global monitoring report on tracking UHC for 2021. The report used 14 indicators of service coverage from reproductive, maternal, newborn and child health (RMNCH); infectious diseases; NCDs; and service capacity and access. These indicators are indicative of service coverage, rather than a complete or exhaustive list of the services or interventions required to achieve UHC.

The report showed us that:

• Progress on integrating NCDs in universal health coverage is happening more slowly than for infectious diseases or RMNCH;
• While service coverage has improved in the last 20 years, the proportion of people facing financial hardship from out-of-pocket health spending has increased;
• Primary data were only available for 42% of NCD indicators at the global level - worse than any other indicator - with data collection poorer in lower-income countries;
• The COVID-19 pandemic is likely to halt progress made towards universal health coverage, particularly among disadvantaged populations;
• Even before the pandemic, the world was still 730 million people short of WHO's goal of one billion more people benefiting from UHC by 2023 - we now estimate that shortfall to be between 800 and 840 million.

In short: we cannot make progress on UHC without accelerated action on NCDs.

FEBRUARY: ACCELERATING ACTION AT THE GLOBAL DISABILITY SUMMIT

"More than one billion people around the world experience some form of disability. The right to health belongs to everybody, which is why we must work together to recognize the barriers that prevent people with disabilities from accessing the services they need to commit to creating a disability-inclusive health sector; and to act to make it a reality."

 - Dr Tedros, 2022 Thematic Pre-Summit on Disability Inclusion in the Health Sector 

In February, the Government of Norway, the Government of Ghana and the International Disability Alliance co-hosted the second Global Disability Summit. The Summit mobilized efforts to implement the UN Convention on the Rights of Persons with Disabilities (UNCRPD), champion the principle of leaving no-one behind, and encouraging building back better with more disability-inclusive responses to the COVID-19 pandemic. More than 100 global leaders attended the summit, with more than 1500 commitments made by participants.

The Global Disability Summit offered a concrete mechanism for collecting new, ambitious, and widespread commitments critical to achieving real change for persons with disabilities. It followed a successful 'Thematic Pre-Summit on Disability Inclusion in the Health Sector', covering topics such as the need for the health sector to listen to the voices of people who live with disabilities, how inclusion of people with disabilities could help achieve national health objectives, and opportunities for international collaborations. 

The Global Disability Summit has four stated objectives, to:

• Raise global attention and focus on neglected areas and inclusive sustainable development;
• Strengthen the capacity of organisations of persons with disabilities in the Global South and their engagement with governments;
• Mobilise targeted and concrete commitments on disability inclusion and inclusive development;
• Showcase best practice and evidence from across the world on disability inclusive development, and progress made from the GDS in 2018.

MARCH: CONSULTING PEOPLE LIVING WITH NCDs AND MENTAL HEALTH CONDITIONS ON A WHO FRAMEWORK FOR MEANINGFUL ENGAGEMENT

Throughout the WHO Global Coordination Mechanism for Noncommunicable Disease (GCM/NCD), WHO has been in the process of developing a Framework for Meaningful Engagement of People Living with NCDs, and Mental Health Conditions. This framework will guide WHO and Member States in how to meaningfully engage people living with, or affected by these conditions, including to co-design policies, programmes, and principles. It will contribute to the advancement of understanding, knowledge and action on meaningful engagement and other related participatory approaches through an evolving evidence base.

The consultations sought participatory development for the framework, explored why meaningful engagement is important, and how it could be implemented at a regional and national level. Discussions during the Regional Consultations built on recent WHO Informal Consultations, for people living with NCDs, and with diabetes, in 2020 and 2021 respectively.

Thanks to insights gathered from the consultations, WHO was able to publish its WHO Framework for Meaningful Engagement of People Living with Noncommunicable diseases (NCDs) and Mental Health conditions for a web-based consultation, with relevant contributions to be shared through a webinar in early 2023.

Anu found out she had Rheumatic Heart Disease at 11. She has undergone two open heart surgeries including a mechanical heart valve operation. This is her story.

Ali was diagnosed with Type 2 diabetes in 2017. He helps motivate others in his community to adopt healthier lifestyles through diet and physical activity. This is his story.

In 2013, Hauwa was sexually assaulted. Two years later, she was diagnosed with bipolar disorder. A few months following, she nearly took her own life. Hauwa went on to create a platform where she could share her experiences as a Nigerian living with a mental health condition. This is her story.

LaVerne was diagnosed with breast cancer in 2018. She is a breast cancer survivor, a mother and a leader in her community. This is her story.

Mark was diagnosed with Type 1 diabetes as a child. He is now a global advocate for improving diabetes care and prevention. This is his story.

Helena was diagnosed with an Auto inflammatory disease in 1997. She had to give up her work in 2007 due to multiple and worsening disabilities. In 2009, she was diagnosed with cancer. This is her story.

APRIL: THE INTERNATIONAL STRATEGIC DIALOGUE ON NCDs AND THE SDGs

Insufficient global action on NCDs, combined with the COVID-19 pandemic, are creating the very real possibility that Sustainable Development Goal (SDG) targets 3.4 and 3.8 will not be met. Just 14 countries are on track to achieve SDG target 3.4, to reduce by one-third the premature mortality of NCDs through prevention and treatment and promote mental health and well-being by 2030. 

In April, the Government of Ghana, Government of Norway and the World Health Organization co-hosted the International Strategic Dialogue on NCDs and the SDGs in Accra, Ghana. The International Strategic Dialogue will take the next decisive step towards comprehensive action on NCDs and achieving SDG 3.4, specifically seeking to:

• Raise the priority accorded to the prevention and control of NCDs within the national SDG response in low- and middle-income countries;
• Bring together national and international actors and partners to share knowledge and ideas with key stakeholders on what would it take globally for low- and middle-income countries to achieve SDG 3 on health, with a particular focus on SDG 3.4 (NCDs) and SDG 3.8 (UHC) targets; and
• Raise the political visibility of Heads of State and Government who are providing a strategic leadership role in the prevention and control of NCDs to a global level.

The Dialogue saw the launch of:

• An International NCD Compact 2022-2030 to accelerate the progress towards the NCD and SDG targets; and
• A Global Group of Heads of State and Government on the Prevention and Control of NCDs that will meet annually during the High-level general debate of the United Nations General Assembly (UNGA) in September 2022 towards 2025.

MAY: RECORD NUMBER OF NCD RESOLUTIONS AT WORLD HEALTH ASSEMBLY 75

The World Health Assembly (WHA) is the supreme decision-making body for WHO. It meets in Geneva each year, and is virtually attended by delegations from all 194 Member States. Its main function is to determine the policies of WHO. WHA appoints the Director-General, supervises financial policies, and reviews and approves the Proposed programme budget.

NCDs were a core priority of this years' WHA. Alongside other key agreements on the longer-term sustainable financing of WHO, the re-election of Director-General Dr Tedros Adhanom Ghebreyesus, and discussions on strengthening WHO's preparedness for and response to health emergencies, delegates approved a record number of recommendations related to NCDs.

In addition to an agreed preparatory process in the lead-up to the next UN High-level meeting on NCDs, measures to reduce deaths from NCDs include a new implementation roadmap that sets out the pathways needed from Member States to achieve the NCD-related Sustainable Development Goals.

For the first time, delegates at the World Health Assembly have supported the creation of global targets for addressing diabetes. The targets are part of a new comprehensive set of recommendations to strengthen and monitor national diabetes responses.

As made clear by recent health emergencies in Ukraine and from COVID-19, people living with NCDs require special attention in emergency planning, preparedness and response. Delegates have now also agreed on recommendations to better support people living with NCDs in humanitarian emergencies, including developing an essential NCD health package to be guaranteed in an emergency.

Despite affecting almost half the world’s population, to date there has been no global strategy on oral health. Delegates agreed that such a global strategy is now necessary. 

Strengthening multi-sector and multi-stakeholder action and collaboration to address NCDs and mental health, delegates  agreed to a new work plan for the Global Coordination Mechanism on the Prevention and Control of NCDs (GCM/NCD). Overseen by Dr Dévora Kestel, Director, Mental Health and Substance Use, we also saw an action plan to reduce the harmful use of alcohol, and to improve the lives of people living with epilepsy and neurological disorders. And with Dr Ruediger Krech, Director, Health Promotion, we saw recommendations for the prevention and management of obesity across the life course.

JUNE: SECOND MEETING OF OUR STRATEGIC AND TECHNICAL ADVISORY GROUP ON NCDs

The Strategic and Technical Advisory Group on the Prevention and Control of Noncommunicable Diseases (STAG-NCD) acts as an advisory body to WHO to further our work in addressing the prevention and control of NCDs.

In its capacity as an advisory body to WHO, the STAG-NCD serves to:

• Identify and describe current and future challenges, particularly related to premature mortality from NCDs, progressively covering more people with essential NCD needs, and strengthening NCDs within universal health coverage;
• Advise WHO on priority strategic directions;
• Advise WHO on developing global strategic documents; and
• Propose other strategic interventions and activities for implementation by WHO.

In June 2022, we held our second STAG-NCD, chaired by Dr Jennifer Cohn, Clinical Assistant Professor of Infectious Diseases and Scholar, Center for Global Health, University of Pennsylvania School of Medicine, USA.

Over two days, the 24 Members and WHO staff working on NCDs, including Dr Ren Minghui, Assistant Director-General on UHC/Communicable and Noncommunicable Diseases, Dr Naoko Yamamoto, Assistant Director-General for UHC/Healthier Populations, and Dr Nono Simelela, Assistant Director-General for Strategic Priorities: Cervical Cancer Elimination discussed a number of priority issues. These included:

• Ensuring WHO’s work on NCDs best aligns with Dr Tedros’s five priorities for his second term; 
• Making our update to ‘Appendix 3’ (our NCD best buys) to ensure we create a priority set of NCD interventions;
• Building strong political NCD responses, including accelerating the adoption of essential NCD interventions by WHO Member States around the world, and safeguarding policies from undue commercial influence.

This year saw the launch of our NCD Stories from the Field repository, explaining how WHO is working to improve NCD outcomes in primary health care and universal health coverage, by providing better health care for people living with diabetes, to diagnose, treat and manage hypertension, improve cancer outcomes, support people living with NCDs in health emergencies, integrate disability and rehabilitation in health systems, and more! 

JULY: SUPPORTING MEMBER STATES TO DEVELOP MULTISECTORAL NCD ACTION PLANS AND UNDERSTAND SDG 3.4 PROGRESS

A multisectoral action plan is one of the best ways a government can plan strategic policy-making to prevent and control NCDs, bringing sectors and ministries together to foster policy coherence in national NCD responses.

As the development of a comprehensive multisectoral action plan for NCDs diseases is an ambitious task, WHO developed an online toolkit to assist with this process. This toolkit serves as a “how to” guide for developing, implementing and evaluating a multisectoral action plan for the prevention and control of NCDs. It is intended to help countries, provinces and cities to achieve global and national NCD targets, and the SDGs. 

The tool has five stages, focused on establishing health needs and engaging relevant stakeholders, before determining the actions to take, identifying and prioritizing interventions, deciding on ways to address NCDs while establishing support and resources for prevention and control, and evaluating progress in implementing the plan.

Also released at a similar time in 2022 was a new web tool allowing users to visualize the impact of a select package of NCD clinical interventions and intersectoral policies could have on WHO Member States achieving SDG target 3.4 by 2030.  

AUGUST: PREPARING FOR THE WHO WORLD REHABILITATION ALLIANCE

In many countries around the world there is an urgent need to strengthen rehabilitation.

Globally, an estimated 2.4 billion people are living with a health condition that could benefit from rehabilitation. This number is expected to grow due to people living longer and with more chronic disease and disability. It is estimated, however, that in low- and middle-income countries, more than 50% of people do not receive the rehabilitation they require, while the full impact of the COVID-19 pandemic on future rehabilitation needs is also yet to be seen.

In August, we were preparing to launch the World Rehabilitation Alliance. The Alliance is a WHO global network of stakeholders whose mission is to support the implementation of the Rehabilitation 2030 Initiative through advocacy activities. It focuses on promoting rehabilitation as an essential health service that is integral to Universal Health Coverage and to the realization of Sustainable Development Goal 3, ensuring healthy lives and promote well-being for all at all ages. 

The World Rehabilitation Alliance has five workstreams, advancing action on the themes of workforce, primary care, research, emergencies and external relations.

Persons with disabilities have been disproportionately impacted by COVID-19, both directly because of infection, and indirectly because of restrictions to reduce the spread of the virus. This video, developed by WHO and UNICEF, provides a summary of the considerations for governments, health care providers and persons with disabilities when accessing COVID-19 vaccination.

SEPTEMBER: LANDMARK FIRST GATHERING OF THE GLOBAL HEADS OF STATE AND GOVERNMENT FOR THE PREVENTION AND CONTROL OF NCDs

On Wednesday 21 September, we saw a landmark First Annual Gathering of a Heads of State and Government Group for the Prevention and Control of NCDs, convened by the President of Ghana and the Prime Minister of Norway, WHO Director-General Dr Tedros Adhanom Ghebreyesus, chaired by President of Ghana and hosted by Michael R. Bloomberg, WHO Global Ambassador for NCDs and Injuries. The event was held during the 77th Session of the United Nations General Assembly (UNGA77). This follows the launch of a Global NCD Compact earlier this year by Ghana and Norway. 

The First Gathering of the Heads of State and Government Group included participation from the Prime Minister of Barbados, Prime Minister of Mauritius, Prime Minister of Samoa, Prime Minister of Tonga and State Secretary, Germany on behalf of the G7, WHO Director-General Dr Tedros Adhanom Ghebreyesus, and WHO Global Ambassador for NCDs and Injuries Mr Michael R. Bloomberg. We witnessed a high-level strategic discussion on the importance of delivering the Global NCD Compact to advance NCD outcomes for all. The Global NCD Compact focuses on five areas of commitment:

• saving, by 2030, the lives of 50 million people from dying prematurely of NCDs by implementing the most cost-effective measures to prevent and control NCDs;
• protecting 1.7 billion people living with NCDs by ensuring that they have access to the medicines and care they need during humanitarian emergencies;
• integrating NCDs within primary health care and universal health coverage;
• comprehensive NCD surveillance and monitoring; and
• meaningfully engaging 1.7 billion people living with NCDs and mental health conditions in policy-making and programming.

To mark the occasion, WHO has released a new report, Invisible Numbers: The true scale of noncommunicable diseases and what to do about them. We also publish a new data portal that for the first time, brings together all WHO data related to NCDs for 194 countries.

Further accelerating action, Dr Tedros renewed the two-year appointment of Michael R. Bloomberg as WHO Global Ambassador for Noncommunicable Diseases and Injuries. This is Bloomberg’s third reappointment as Ambassador, having first been appointed to the role in 2016.

For the first time, a new NCD Portal has brought together all WHO data related to NCDs for 194 countries. The portal highlights the extent of global NCD burden, risk factors, and the progress each country is making in their efforts to combat these diseases and conditions.

You can find data on several indicators, including the: probability of premature mortality (before age 70) from NCDs; percentage of total deaths due to NCDs; percentage of premature NCD deaths; and the age-standardized NCD death rate, and view data at country, regional and global level.

How is your country performing? Check out the NCD Data Portal!

OCTOBER: REPORTING ON THE STATUS OF THE WORLD'S ORAL HEALTH

“Our biggest challenge now is ensuring that all people, wherever they live and whatever their income, have the knowledge and tools needed to look after their teeth and mouths, and access to prevention and care when they need it.”

- Dr Tedros, launch of the WHO Global Oral Health Report 

Oral health is integral to general health and supports individuals participating in society to achieve their potential. Yet oral diseases are the most widespread noncommunicable diseases affecting almost half of the world’s population (45% or 3.5 billion people worldwide) over the life course from early life to old age.

In October, we published a new WHO Global Oral Health Status Report reviewing the most recent data on major oral diseases, risk factors, health system challenges and opportunities for reform. The report’s clear conclusion is that the status of global oral health is alarming and requires urgent action. In addition, for the first-time ever,  the report provides country oral health profiles for all 194 WHO Member States, giving unique insights into key areas and markers of oral health that are relevant for decision-makers.

Nearly 20 years after the publication of The World Oral Health Report 2003 and in alignment with the landmark WHA 74.5 Resolution on oral health (2021), the GOHSR will serve as a reference for policy-makers and provide orientation for a wide range of stakeholders across different sectors; and guide the advocacy process towards better prioritization of oral health in global, regional and national contexts.

Hear from Dr Tedros about the importance of integrating oral health within universal health coverage, with remarks released in support of the Global Oral Health Status Report!

NOVEMBER: FIRST-EVER WHO LANGUAGE SURVEY TO MARK WORLD DIABETES DAY

In 2019, diabetes was the direct cause of 1.5 million deaths, with around half of all deaths (48%) due to diabetes occurring ‘prematurely’ (before age 70). Diabetes is also a major challenge for countries to achieve Sustainable Development Goal 3.4 to reduce premature mortality from NCDs by one-third by 2030. 

This year’s theme, ‘access to diabetes education’, underpinned the larger multi-year theme of 'access to care'. The language WHO uses to communicate about diabetes in health information and technical assistance matters. 

Learning from lived experience to research what information needs to be provided to key political and public audiences, can improve efforts to explain diabetes, complications, policies and programmes in an accurate, impactful, and non-stigmatizing way. 

Reflecting the importance of diabetes education, on this year's World Diabetes Day, WHO published it's first-ever key informant survey for people with lived experiences of diabetes on the importance of effective language and communication about the different types of diabetes that exist.

More than 950 participants from 58 WHO Member States took part in the survey, exploring accurate and inaccurate presentations of diabetes in the media, common myths and misconceptions, and novel values-based messaging methodology, to understand how framing can help make the case for accelerated action on diabetes among WHO Member States, funding partners and the general public.

Results showed the following themes require more appropriate consideration in media: 

• Accurately explaining diabetes types;
• An over-emphasis on sugar and lifestyle;
• The impacts of diabetes stigma;
• Costs (financial, personal and interpersonal); and 
• Mental health and related burdens. 

Irrespective of audience, values-based messages important for WHO to convey are ‘urgency’, ‘preventing suffering’, ‘improving wellbeing’ and ‘meaningful engagement’ of lived experience.

You can read some of the quotes from respondents in our graphics below. WHO is also scoping conducting similar work of this nature for cancer and other NCDs.

People with lived experiences of diabetes from all over the world tell us why accurate language and communication about diabetes is so important: here are some of their own words (names have been changed to protect anonymity).

DECEMBER: EXPERT MEETING ON NCD CARE AS NECESSARY TO EMERGENCY PREPAREDNESS AND RESPONSE

From 13 to 15 December 2022, key global and regional stakeholders and experts from across WHO, UN agencies, NGOs and other entities convened in Cairo, Egypt to address strengthening integration of NCD care in emergency preparedness and response. 

Drawing on the recommendations on how to strengthen the design and implementation of policies to treat people living with noncommunicable diseases and to prevent and control their risk factors in humanitarian emergencies adopted during the 75th session of the World Health Assembly (WHA/A75/10/ Annex 4 Add.2), and contributing to the NCD implementation road map 2023–2030, this meeting aimed to build political momentum to NCD and emergencies discussions. The meeting also discussed the development of a comprehensive approach to better include NCDs into emergency preparedness and response plans.

It sought to develop tailored recommendations to Member States, WHO, and international partners for better inclusion and strengthening policies, programmes, and services to treat people living with NCDs and prevent and control their risk factors into country COVID-19 response other humanitarian responses (HRPs) and recovery plans. Specific recommendations were also made for WHO EMRO to strengthen collaboration, communication, and joint work across technical departments.

In support of the WHO Global and regional technical meeting on addressing NCDs in emergencies, watch a series of videos from NCD experts, including our Unit Head Dr Slim Slama, discussing how WHO and partners can:

• Scale up efforts to manage noncommunicable diseases in emergency settings
• Make treatment of noncommunicable diseases efficient in emergency settings
• Promote access to the WHO noncommunicable diseases emergency kits
• Improve integration of noncommunicable diseases in humanitarian emergencies
• Reorient health systems to address noncommunicable diseases in emergencies
• Support health information and data systems for the continuity of care in emergencies
• Improve the management of noncommunicable diseases to ensure resilient health systems
• Maintain health services for noncommunicable diseases during emergencies
• Invest in research on noncommunicable diseases in emergencies is needed
• Provide treatment for noncommunicable diseases in emergency settings, with an example from Gaza.

HOUSEKEEPING

We are aware that the NCD Newsflash is not currently being produced on a weekly basis. The team member who has been responsible for preparing the NCD Newsflash has recently begun a new position within WHO HQ.

Please be assured that we eagerly look forward to returning to our weekly schedule as soon as we can, with recruitment ongoing for their replacement.