It is hard to overstate the impact that NCDs, such as cancer, diabetes and heart diseases, have had in 2021. NCDs continue to kill more people than any other group of diseases - and are responsible for seven of the top ten most common causes of death. This is despite us having a suite of effective, cost-effective and equitable tools that can save lives and improve livelihoods all over the world. It is becoming ever clearer that NCDs are critical to the future sustainability of global health, development efforts and strong economies.

This year saw NCD services all over the world continue to be widely disrupted by the COVID-19 pandemic. More than half of countries have endured part or complete disruptions to health services for many NCDs and their complications, to be able to act on the pandemic. COVID-19 has been like an X-ray that shows us one simple thing: persons living with NCDs must be front and centre of country response plans, in everything from access to vaccines, to bringing dignity and quality care. Prevention, early diagnosis, treatment and rehabilitation will be critical to building efficient and sustainable health systems around the world.

Responding to calls to action from Member States, the NCD Department and other dedicated WHO colleagues have worked to prepare 10 activities for next month's WHO Executive Board (EB150). Including a roadmap to achieve SDG 3.4, accelerating action on diabetes, and improving NCD outcomes in humanitarian settings - among many more - these activities will save lives and improve livelihoods. We have also seen flagship investments from Member States and partners alike, including work with: the Government of Norway supported by their development strategy on NCDs to increase the coverage of NCDs in primary health care; with St. Jude Children's Research Hospital to increase the affordability of childhood cancer medicines; and with Resolve to Save Lives to control hypertension and the World Diabetes Foundation for diabetes.

I cannot adequately cover all of the superb work being done by my colleagues in WHO at national, regional and global level, and our NCD champions in Member States, civil society and people living with NCDs, in this short message. I do try, but there is always so much to say! So I want you to know this: I am always in awe of the dedication and commitment of our global community to prevent and control more NCDs, and better learn from the perspectives of those who live with one or more of these diseases. 

Ever since I become WHO's Director for Noncommunicable Diseases in 2020, I have been humbled and fascinated to learn from your enthusiasm and expertise. Thank you.

In this message, I share some of my highlights for 2021. If you have any questions about these highlights, or our plans for 2022, you can reach out to me below.

I wish you a happy, healthy and safe time in 2022. And finally, I am excited for us to build together on the road to the fourth UN High-Level Meeting on NCDs in 2025!

Bente

JANUARY: NCDs MAKE UP SEVEN OF WORLD’S TEN LEADING CAUSES OF DEATHS

We began the year with news that NCDs now make up seven of the world’s top 10 causes of death, according to WHO’s 2019 Global Health Estimates. This is an increase from four of ten 10 leading causes in 2000. The new data, covering the period from 2000 to 2019 inclusive, saw heart disease remain the leading cause of death globally, with diabetes entering the list.

The findings also show that people are living longer – but with more disability. Collectively, heart disease, diabetes, stroke, lung cancer and chronic obstructive pulmonary disease were responsible for nearly 100 million additional healthy life-years lost in 2019 compared to 2000.

FEBRUARY: LAUNCHING A NEW FRAMEWORK TO BUILD STRONG REHABILITATION SERVICES

In many countries, the rehabilitation workforce is under-equipped to meet population needs due to workforce shortages. As the demand for rehabilitation escalates, the need to expand the workforce, strengthens regulation, and build quality assurance mechanisms becomes increasingly critical.

In February, we launched our Rehabilitation Competency Framework. The Framework defines the core values and beliefs shared by the rehabilitation workforce, and encompasses the competencies, behaviours, knowledge and skills required to perform the range of activities and tasks involved in rehabilitation practice and service delivery. This framework was supported by bespoke training for the rehabilitation and clinical management of patients with COVID-19.

In February, we also confirmed that Michael R. Bloomberg will continue for a third term as WHO’s Global Ambassador for Noncommunicable Diseases and Injuries. After more than 15 years of collaboration, WHO and Bloomberg Philanthropies have shared major achievements across public health, including:


• 5 billion people covered by at least one strong tobacco control measure;
• 3.3 billion people have benefitted from stronger road safety laws;
• 70 cities covering almost 300 million people, committed to preventing NCDs and injuries;
• Countries around the world have been supported to strengthen their health data systems through the Data for Health Program.

Persons with disabilities are 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.

MARCH: LAUNCHING THE GLOBAL BREAST CANCER INITIATIVE

In March, we introduced the Global Breast Cancer Initiative with the objective of reducing global breast cancer mortality by 2.5% per year until 2040.

Achieving this objective would avert an estimated 2.5 million deaths globally. A major new collaborative effort, WHO is working in unison with other UN agencies and partner organizations, to provide guidance to governments on how to strengthen systems for diagnosing and treating breast cancer. In turn, this is expected to improve capacities to manage other types of cancer.

How is WHO working to prevent and control NCDs for people living in humanitarian settings? Read here about WHO's work in Cox's Bazar to deliver services for Rohingya refugees who live with NCDs.

APRIL: LAUNCHING OUR GLOBAL DIABETES COMPACT TO MARK 100 YEARS SINCE THE DISCOVERY OF INSULIN

In 1921, insulin was co-discovered by Canadian researchers at the University of Toronto. This marked a revolutionary and life-saving step in transforming diabetes from a death sentence for people living with type 1 diabetes to a manageable disease, thereby saving millions of lives worldwide. 

During 2021, the world celebrated the 100th anniversary of the discovery of insulin, a discovery that has changed the lives of millions of people. To mark the centenary of the discovery of insulin, and with the support of the University of Toronto, WHO and the Government of Canada co-hosted a Global Diabetes Summit on 14 April 2021.  The Summit aimed to raise awareness of diabetes as a global challenge, and to highlight what is being done — and what more needs to be done — to scale-up prevention and treatment efforts within primary health care systems, and across diabetes care services, in a way that is affordable to all. 

Participating in the Summit were four Heads of State, seven Ministers of Health, as well as United Nations organizations, 21 people with lived experience of diabetes, civil society advocates and representatives of the private sector.

Also in April, WHO launched its updated technical manual for tobacco tax policy and administration, to guide policy-makers through the necessary steps to create and implement the strongest tobacco taxation policies.

In April, Dr Tedros opened the Global Diabetes Summit co-hosted with the Government of Canada, to raise awareness of diabetes as a global challenge and address the need to scale-up prevention and treatment as part of primary health care and universal health coverage. 

MAY: NCDs AT THE WORLD HEALTH ASSEMBLY

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 featured prominently at WHA74, with discussions including how to achieve the highest attainable standard of health for persons living with disabilities; the future of the Global Coordination Mechanism on NCDs; diabetes; WHO’s work on integrated people-centred eye care, including preventable vision impairment and blindness; and a mid-point evaluation of the implementation of the WHO global action plan for the prevention and control of noncommunicable diseases 2013–2020.

In May, WHO also launched its ‘Commit to Quit’ campaign to support those millions of tobacco users who are actively taking steps to save their lives, but still need help to succeed.

Recap on some key NCD activities at this year's World Health Assembly (WHA74) here!

JUNE: CALL FOR INNOVATION IN WOMEN'S CANCERS

Each year, nearly 3 million women are diagnosed with breast or cervical cancer globally. While high-income countries have made significant progress to effectively prevent cervical cancer and control breast cancer, nearly 80% of deaths from these two cancers are in low- and middle-income countries (LMICs). This profound inequality in a woman’s likelihood of surviving breast or cervical cancer is a threat to sustainable development and to the health and well-being of women, their families and their communities.

Innovation provides a unique opportunity to respond to unmet public health needs in cancer, by creating new ways of thinking and working, focusing on the needs of vulnerable populations. In June, we announced a joint call for innovation in women’s cancer, with the Islamic Development Bank (IsDB) and the International Atomic Energy Agency (IAEA), continuing an existing partnership to improve cancer control, diagnostic and prevention in IsDB Member Countries. The focus of this project is on the development of health promotion programmes, and timely cancer diagnosis respectively.

NCDs are the leading cause of death in Solomon Islands. In order to combat this growing issue, WHO supported the country in establishing the SolPEN (Solomon Islands Package of Essential NCDs) programme.

This video explores how patients with NCDs are now seen at specialized clinics led by NCD coordinators who work with patients to improve their health from a holistic perspective. In Tulagi, an island in Central Province, Virginia Legaile is an NCD coordinator whose involvement in her community extends outside the clinic office.

JULY: BUILDING KNOWLEDGE THROUGH OUR NCD HARD TALKS

We engage with both public and private sectors to reduce NCDs, including regular dialogues with representatives from international business associations, and the pharmaceutical, health technology and other industries whose products and services impact on human health. From the local to the global level, the private sector can help support disease control efforts.

In July, we held an NCD Hard Talk on working with the private sector to encourage the procurement of medicines. Procurement is an important component of an effective medicines supply system. Key elements such as quantity, cost and quality are influenced by the procurement process. Innovative approaches for ensuring a consistent and sustainable supply of essential medicines are therefore needed at country, regional and global levels. Pooled procurement is an example of one such initiative. 

During this month, we also issued new recommendations for screening and treatment to prevent cervical cancer. This included some important shifts in WHO’s recommended approaches to cervical screening, including recommending an HPV DNA based test as the preferred method.

AUGUST: NEW HYPERTENSION GUIDELINES AND GLOBAL ESTIMATES

Hypertension – or high blood pressure – is a serious medical condition that significantly increases the risk of heart, brain, kidney and other diseases. More people die each year from cardiovascular diseases than from any other cause. An estimated 1.4 billion people worldwide have high blood pressure, but just 14% have it under control, despite several cost-effective interventions existing.

In August, we published the most current and relevant evidence-based global public health guidance on the initiation of treatment with pharmacological agents for hypertension in adults. The recommendations target adult, non-pregnant patients who were appropriately diagnosed with hypertension and counselled about life-style modifications. 

The guidelines were released alongside new data showing that more than 700 million people with untreated hypertension.

SEPTEMBER: IMPROVING ORAL HEALTH THROUGH USING DIGITAL TECHNOLOGY

In September, we released 'Mobile technologies for oral health: an implementation guide' to guide Member States to complement existing oral health initiatives and oral health system responses through mobile technologies. As well as promoting oral health through text messages sent to the general public, it provides guidance on training for health workers, early detection of oral health conditions, the collection of epidemiological data, and the monitoring of the quality of patient care, all through mobile technologies.

The product is one of a set developed through the 'Be He@lthy, Be Mobile' initiative, run by WHO and the International Telecommunication Union. Since being established in 2012, handbooks have been released on topics including diabetes, cervical cancer, hypertension and dementia.


In September, both the NCD Department and the UN Interagency Task Force on NCDs held official side-events at the UN General Assembly, including to commemorate and reflect on the 10-year anniversary of the first political declaration for the prevention and control of NCDs.

In September, we worked with the Governments of Norway and Jamaica to bring together Member States, civil society and persons living with NCDs, to reflect on ten years of progress since the first UN Political Declaration on the Prevention and Control of NCDs.

OCTOBER: HONOURING HENRIETTA LACKS

In October, Dr Tedros honoured the late Henrietta Lacks with a WHO Director-General’s award at a special ceremony at the WHO office in Geneva, recognizing her world-changing contribution to medical science. 

Henrietta Lacks, a Black American woman and a young mother, died from cervical cancer, 70 years ago. She was 31 years old. Although her life was cut short, her legacy lives on through an “immortal” line of cells, known as HeLa cells. These samples of Mrs. Lacks’ tumour were taken without her knowledge or consent. For two decades, her cells were commercialized and distributed across the globe unknown to her family.


Contributing to nearly 75 000 studies, Henrietta Lacks' cells have paved the way for advancements from HPV and polio vaccines to medications for HIV/AIDs and breakthroughs including in vitro fertilization. In addition, HeLa cells are currently used in vital research for COVID-19 response efforts.


Last year as the Lacks family marked the 100th anniversary of Henrietta Lacks' birth, WHO launched a historic campaign to eliminate the very disease which claimed her life, under the guidance of WHO’s Global strategy to accelerate the elimination of cervical cancer. Joining this global movement, the Lacks Family continues to advocate for equitable access to the HPV vaccine, a life-saving tool that protects against cervical cancer but remains inaccessible to too many girls around the world.


The award was received at the WHO office in Geneva by Lawrence Lacks, Henrietta Lacks’s 87-year-old son.

This year, our Surveillance, Monitoring and Reporting team has also updated our cervical cancer profiles, explaining the current status of cervical cancer for every WHO Member States. These profiles include the disease burden, prevention efforts, treatment and supportive care.

NOVEMBER: WHA SPECIAL SESSION AND ONGOING DISRUPTIONS TO NCD SERVICES

In a consensus decision aimed at protecting the world from future infectious diseases crises, the World Health Assembly agreed to kickstart a global process to draft and negotiate a convention, agreement or other international instrument to strengthen pandemic prevention, preparedness and response.

NCDs are critical to future global efforts for preparing against the COVID-19 pandemic, and future pandemics. Persons living with NCDs are disproportionately vulnerable to infectious disease, with NCD health services disrupted and deprioritized around the world. As well as accelerating progress of SDG target 3.4, and the WHO Triple Billion targets, improving outcomes for people living with NCDs will lead to stronger global pandemic preparedness.

Our Surveillance, Monitoring and Reporting team shared the second round of our survey assessing NCD service delivery during the COVID-19 pandemic, finding that 136 countries reported that NCD services reported disruptions in 2021. Other findings included that:

• The majority of services for diabetes and related complications (61%), cancer screening (59%) and treatment (52%), hypertension (58%) and asthma services (53%) continue to be either partially or completely disrupted;
• The most reported reasons for service disruption are community fear/mistrust in seeking health care, clinical staff redeployed to provide COVID-19 relief, and a decrease in outpatient volume due to patients not presenting;
• Just 20% of countries have allocated additional funding from government budgets for NCDs for the COVID-19 response;
• Despite their importance to health system sustainability, just 55% of countries have included the continuity of NCD services in their national COVID-19 plans. Of counties that have included NCD services in their national COVID-19 plans, most have prioritized services for the four major NCDs.

Finally, a report was also released for World Diabetes Day explaining the current situation regarding access to insulin and associated devices, understanding barriers to access, and proposing actions to address them.

DECEMBER: THE LARGEST-EVER FINANCIAL COMMITMENT TO CHILDHOOD CANCER MEDICINES

In December, we were delighted to launch the Global Platform for Access to Childhood Cancer Medicines, thanks to the largest ever financial commitment for a global effort in childhood cancer medicines from St Jude Children’s Research Hospital.

The first of its kind, the platform will provide an uninterrupted supply of quality-assured childhood cancer medicines, initially to 12 low- and middle-income countries. St. Jude’s commitment will provide medicines at no cost to countries participating in the pilot phase, with an ambition to reach 50 countries by 2027. It will dramatically increase access to childhood cancer medicines around the world.

In December, we also launched an update to Saving Lives Spending Less, modelling the economic benefits of adopting the ‘WHO Best Buys’ for the prevention and control of NCDs across lower- and middle-income countries would bring. Supported by Bloomberg Philanthropies, our report has modelled the economic benefits of applying the 16 NCD Best Buys to 76 LMICs.

As well as showing that USD$1 invested in NCDs returns USD$7 in net economic benefit, if all Best Buys were adopted, by 2030 they would save:

• 7 million lives
• 230 billion dollars in economic gains
• 10 million avoided heart attacks and strokes

Investing in NCDs continues to pay for itself: again and again and again. The sooner investments are made, the quicker we save lives, and the quicker governments begin saving money. We hope this report explains the need for investment as a clear and sensible win-win.

OUR NEW LOOK

As part of efforts to improve WHO communications, this edition of the NCD Newsflash comes from our new platform, Campaign Monitor! We appreciate your patience as we refine this new template, and you can share your feedback at the link below.