Dear NCD Newsflash readers and friends,

Over the past few days, delegates from around the world have come together to discuss the most pressing global health challenges at the 75th World Health Assembly (WHA).

This has been a landmark year for NCDs.

NCDs have been 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. This year, delegates have approved a record number of recommendations related to NCDs.

In addition to an agreed preparatory process in the lead-up to the meeting, 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.

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.

For the first time ever, we saw delegates support global targets for the coverage and treatment of people living with diabetes, as well as a global strategy on oral health - whose diseases affect almost half of the world's population - laying the groundwork for a global action plan coming next year.

Strengthening multi-sector and multi-stakeholder action and collaboration to address NCDs and mental health, delegates have agreed to a new work plan for the Global Coordination Mechanism on the Prevention and Control of NCDs (GCM/NCD), housed in the Office of Dr Zsuzsanna Jakab, Deputy Director-General. Overseen by Dr Dévora Kestel, Director, Mental Health and Substance Use, we also saw an action plan to reduce the harmful use of alcohol, 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.

These decisions come ahead of the fourth United Nations General Assembly High-level meeting on the prevention and control NCDs to be held in 2025. You can learn more about our work between now and the High-level meeting in the newsletter below.

Together alongside our existing work, these new decisions create the potential to save hundreds of millions of lives. By prioritizing and integrating NCDs - the world's single biggest killers - into strong health systems, including in primary health care and to advance universal health coverage, and learning from the perspectives of people living with NCDs, the world has the tools to immediately take steps that are effective, cost-effective and equitable.

Thank you to all of you, for your dedication and commitment to improving outcomes for people living with NCDs, including the contributions and support to many of the decisions that have been made this week.

Across my Department of Noncommunicable Diseases, we are excited and inspired to deliver on the requests of the WHO Secretariat. With almost three in four of the world's deaths coming from NCDs, we do not have a moment to lose.

DELEGATES AGREE TO AN IMPLEMENTATION ROAD MAP (2023-2030) FOR THE NCD GLOBAL ACTION PLAN (2013-2030)

The global implementation of actions to prevent and control NCDs over the past two decades has been insufficient to reduce their impact as the world’s biggest killers. The world is off track to achieve SDG target 3.4, to reduce premature deaths from NCDs, and no country is achieving all nine voluntary targets set out in the Global Action Plan for the Prevention and Control of NCDs 2013-2030.

In response, delegates have decided that WHO should adopt an implementation roadmap to accelerate the speed at which the world is responding to the urgent and growing burden of noncommunicable diseases (NCDs), such as cancers, diabetes, heart and lung diseases.

The roadmap identifies several barriers to achieving global outcomes and preventing the adoption of cost-effective interventions to prevent and control NCDs. It sets three strategic directions, focusing on the need to:

• Accelerate national responses based on the understanding of NCDs epidemiology and risk factors and the identified barriers and enablers in countries;
• Prioritize and scale up the implementation of most impactful and feasible interventions in the national context; and to
• Ensure timely, reliable and sustained national data on NCD risk factors, diseases and mortality for data driven actions and to strengthen accountability.

Member States are recommended to identify the barriers and opportunities for scaling up the national NCD response, including to strengthen national monitoring and surveillance, research and multi-stakeholder responses. International partners are recommended to assist and support in the development of the implementation road map at all levels. 

The WHO Secretariat will now take forward several actions, including updating very cost-effective and affordable interventions (previously known as the ‘best buys’), developing a data and web-based simulation tool, and developing guidance on pursuing meaningful multi-stakeholder collaboration, including meaningful engagement of people living with NCDs and mental health conditions, to advance national NCD responses.

APPROVING RECOMMENDATIONS TO SUPPORT PEOPLE LIVING WITH NCDs IN HUMANITARIAN EMERGENCIES

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.

The number of people living with NCDs in natural and human-caused disasters is growing. This is particularly pertinent for people living with NCDs in Ukraine: in 2019, 92% of all deaths in Ukraine – more than half a million people – were the result of an NCD, with many more people still needing services for their NCD treatment and care.

NCDs have common characteristics that make affected people more vulnerable during an emergency. Emergencies appear to increase the risk of NCD-related complications, such as heart attacks and strokes, relative to normal pre-emergency circumstances. Often a consequence of health emergencies, the disruptions of essential NCD health services has been clearly seen during the COVID-19 pandemic.

The recommendations are both for strengthening NCD-related responses to COVID-19, and for acting on all hazards beyond the pandemic. Actions for the WHO Secretariat include to:

• review current WHO NCD-related responses in countries in emergencies to strategically improve technical assistance;
• develop a prioritized essential NCD health package to be guaranteed in health emergencies; and
• Strengthen WHO’s normative role and technical capacity.

In his opening address, Dr Tedros gave a rallying call about the scale of impact that WHO, Member States and collaborating partners can have when we prioritise action on NCDs - watch it here!

FIRST-EVER GLOBAL COVERAGE TARGETS FOR DIABETES ADOPTED

For the first time ever, WHO Member States have supported the creation of global targets for diabetes, as part of recommendations to strengthen and monitor diabetes responses within national NCD programmes. The five new targets set the standard that, by 2030:  

• 80% of people living with diabetes are diagnosed;
• 80% have good control of glycaemia;
• 80% of people with diagnosed diabetes have good control of blood pressure;
• 60% of people with diabetes of 40 years or older receive statins; and
• 100% of people with type 1 diabetes have access to affordable insulin and blood glucose self-monitoring.  

The targets mark a landmark 12 months for diabetes, beginning in the creation of the WHO Global Diabetes Compact, aiming is to reduce the risk of diabetes, and move towards a world where all people who are diagnosed with diabetes have access to equitable, comprehensive, affordable and quality treatment and care.

The recommendations and targets are a core part of work requested by Member States in a resolution at last year’s World Health Assembly (A74/A/CONF./5). This resolution also requested the WHO Secretariat to: 

• Strengthen and monitor diabetes responses within national NCD programmes, and recommendations for the prevention and management of obesity over the life course, including considering the potential development of targets;
• develop pathways of how to achieve the targets;
• provide concrete guidance to Member States on strengthening policies for diabetes prevention and control across all relevant sectors;
• provide concrete guidance for the uninterrupted treatment of people living with diabetes in humanitarian emergencies;
• promote convergence and harmonization of regulatory requirements for diabetes medicines;
• continue to analyse data, with a view to assessing the feasibility of a web-based tool to share information relevant to market transparency for diabetes medicines and related health products;
• develop recommendations for adequate, predictable and sustainable financing for diabetes;
• report on progress made in the implementation of the present resolution to the Health Assembly.

At World Health Assembly 75, we were delighted to launch our 'Eye Care in Health Systems: Guide for Action', an important set of tools to support countries to include eye health in their national health programs. 

A billion people live with vision impairment that could be prevented or treated. Eye care has an enormous unmet need, a universal benefit to all populations, and benefits from simple, cost-effective and equitable interventions mandated by Member States. We hope the Guide for Action will empower and accelerate action on eye care in health.

You can read the Guide for Action by clicking on the image above!

A LANDMARK GLOBAL STRATEGY ON ORAL HEALTH

Oral diseases are among the most common NCDs worldwide. While largely preventable, there were estimated to be more than 3.5 billion cases of oral diseases and other oral conditions globally in 2019. Oral health varies over the life course from early life to old age, is integral to general health and supports individuals in participating in society and achieving their potential.

Also for the first time ever, Member States agreed to adopt a global strategy on oral health, which will inform the development of a new global action plan, including a framework for tracking progress with targets to be achieved by 2030. The strategy sets the bold vision of universal health coverage (UHC) for oral health, reaching all individuals and communities by 2030. This enables people to enjoy the highest attainable state of oral health and live healthy and productive lives, including by tackling social and commercial determinants and risk factors of oral diseases and conditions.

The strategy is the first concrete step towards the full implementation of last year’s  WHA74.5 resolution on oral health. With actions for WHO Member States, international partners, civil society and the private sector, the strategy sets four overarching goals to guide Member States, to:

• develop ambitious national responses to promote oral health;
• reduce oral diseases, other oral conditions and oral health inequalities;
• strengthen efforts to address oral diseases and conditions as part of UHC; and
• consider the development of targets and indicators, based on national and subnational contexts, building on WHO guidance, to prioritize efforts and assess the progress made by 2030.

Milestones for the WHO Secretariat are also established. By 2023, WHO will translate the strategy into an action plan for public oral health. This will include a monitoring framework for tracking progress, with measurable targets to be achieved by 2030. By 2024, WHO will recommend cost-effective, evidence-based oral health interventions as part of the updated Appendix 3 (also known as the ‘best buys’) to the NCD Global Action Plan for the Prevention and Control of NCDs, and the WHO UHC Compendium.

Noma, a necrotizing NCD starting in the mouth, is estimated to be fatal for 90% of affected children in poor communities, mostly in Africa, and leads to lifelong disability and often social exclusion. 

Through the World Health Assembly Resolution on oral health (WHA74.5) in 2021, Member States asked WHO to explore including “noma in the planned WHO 2023 review process to consider the classification of additional diseases within the road map for neglected tropical diseases 2021–2030".

Following WHO's recent stakeholder meeting to facilitate a coordinated effort among key stakeholders for inclusion of noma in the planned review process, we were glad to participate in a WHA75 event discussing the importance of acting on Noma. The event featured Noma survivors, Dr Bente Mikkelsen and Honorable Dr. Osagie Emmanuel Ehanire, Minister of Health, Nigeria. 

You can watch the event at the link above!

A NEW WORKPLAN FOR MULTISECTORAL AND MULTISTAKEHOLDER ACTION: WHO’S GLOBAL COORDINATION MECHANISM ON THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES

The WHO Global Coordination Mechanism on the Prevention and Control of Noncommunicable Diseases (GCM/NCD) is a Member State-led platform facilitating multi-stakeholder engagement and cross-sectoral collaboration to prevent and control NCDs and mental health conditions. Founded in 2014, the WHO GCM/NCD’s mandate was last year extended until 2030.

Exchanging knowledge, evidence-based information, research, best practices, tools, and guidance is crucial to inform effective multi-stakeholder and multi-sectoral NCD responses and strengthen capacity at country level. This forms a core element of the new workplan.

Since 2018, the WHO GCM/NCD has hosted the Knowledge Action Portal, a dedicated online knowledge repository and community platform. In line with the new workplan, the Knowledge Action Portal is currently being developed further and will receive a new look and improved functionality to share knowledge and connect partners.

Through a recent Call for Submissions, Member States and other national and sub-national governments are invited to share their experiences in collaborating across government sectors for improved NCD prevention and control. The most innovative and promising of the submitted experiences will then be mapped, and selected case studies commissioned to showcase successful approaches in implementing multi-sectoral action for further knowledge collaboration and capacity development.

Beating NCDs and mental health conditions strongly relies on people living with respective health conditions having a say in the design and implementation of related policies and programmes. Recognizing this linchpin to an effective NCD-response, the WHO GCM/NCD is currently co-developing a novel WHO Framework for the meaningful engagement of people living NCDs and mental health conditions. 

Expected to be finalized in late 2022, the Framework will be supported by tailored policy briefs and advocacy materials, and the WHO GCM/NCD is planning to support framework implementation in Member States through tailored capacity building.

On the morning of the opening of WHA75, NCD Department staff took part in Walk the Talk, both in Geneva and remotely! 

In preparation for World Health Assembly, we thanked Bloomberg Philanthropies for convening an important side-event on why people living with NCDs are critical to health emergency preparedness, planning and response, and for a set of technical dialogues on pressing NCD matters with Dr Kelly Henning, Public Health Programme Lead, Bloomberg Philanthropies.

With Michael R. Bloomberg as WHO's Special Ambassador for NCDs and Injuries, Bloomberg Philanthropies support several vital NCD products, including the Partnership for Healthy Cities.

SETTING OUT THE PREPARATORY PROCESS FOR THE 4th UN HIGH-LEVEL MEETING ON NCDs

Also at WHA75, delegates have set out the preparatory process leading to the fourth high-level meeting of the United Nations General Assembly on the prevention and control of noncommunicable diseases (NCDs).

Many countries are still lacking the capacity to fulfil the commitment, as set out in paragraph 17 of United Nations General Assembly resolution 73/2, to provide strategic leadership for the prevention and control of NCDs. This can be achieved by promoting greater policy coherence and coordination through whole-of-government and Health in All Policies approaches. 

The fourth high-level meeting will be convened under the auspices of the President of the United Nations General Assembly. It will produce a resolution and outcome document, to be negotiated by Member States under the auspices of two co-facilitators that will be appointed by the President of the United Nations General Assembly closer to the meeting, and an outcome document.

The high-level meeting will also provide an opportunity for Member States to deliver statements and for Member States, nongovernmental organizations and private sector entities to engage in roundtable discussions.

The preparatory process leading to the fourth high-level meeting includes meetings and consultations co-sponsored by WHO and relevant partners, which may serve as input into the negotiations among Member States on the “modalities” resolution and the outcome document. A full list of these meetings can be found on our ‘Road to 2025’ page available below.

As the global cancer burden continues to rise, low- and middle- income countries (LMICs) are disproportionately affected in terms of cancer cases and deaths. 

The IAEA and WHO have a long-standing collaboration to support Member States to address their cancer burdens. A new IAEA initiative, Rays of Hope, is being launched to support Member States to provide access to diagnosis and treatment of cancer using radiation medicine, beginning with African countries most in need. Nearly 70% of countries in Africa report that radiotherapy is generally not available to their populations.

You can read a joint statement from Dr Tedros Adhanom Ghebreyesus, Director-General, WHO and Mr Rafael Mariano Grossi, Director General, International Atomic Energy Agency, by clicking the image above.

ACCELERATING ACTION TO REDUCE ALCOHOL-RELATED HARM

Delegates also agreed an action plan (2022-2030) to effectively implement the Global strategy to reduce the harmful use of alcohol as a public health priority.

The pace of development and implementation of alcohol policies has been uneven in WHO regions and countries. Since its endorsement 10 years ago, the resources and capacities for implementation of the WHO Global strategy to reduce the harmful use of alcohol have been inadequate to address the magnitude of the problem. As a result every 10 seconds a person dies from alcohol related harm.

The alcohol action plan proposes operational objectives and principles, key action areas for Member States, WHO Secretariat, international partners, civil society and academia, as well as proposed measures for economic operators in alcohol production and trade. It contains a set of global targets, indicators and milestones for monitoring progress.

 RECOMMENDATIONS FOR THE PREVENTION AND MANAGEMENT OF OBESITY OVER THE LIFE COURSE

WHA delegates agreed new recommendations for the prevention and management of obesity over the life course, including a set of related targets. They outlined specific actions to be taken by governments, society as a whole, and the WHO Secretariat. The goals of the targets are to halt the rise of obesity in children under 5, adolescents and adults by 2025, and end all forms of malnutrition by 2030.

WHA has also considered an Acceleration Plan clarifying how WHO will support Member States in implementing the recommendations based on individual country needs and priorities. This acceleration plan sets five workstreams, to:

• Identify priority actions for greater impact on the prevention and
  management of obesity throughout the life course;
• Support implementation of country actions;
• Communicate rationale for action, advocate for the adoption of WHO
  recommendations and targets and acknowledge progress;
• Promote the engagement of multiple stakeholders in support of country action; and
• Monitor progress towards global obesity targets.

Expanding access to safe and affordable surgery is a critical component of advancing universal health coverage. On Monday 23 May, multiple Member States co-sponsored a side-event entitled ‘Strengthening Health Systems through upscaling Surgical Care: Overcoming the Final Hurdle: Sustainable Financing’, covering why basic and effective interventions for NCDs in low-resource clinical settings can improve global outcomes.

IMPROVING THE LIVES OF PEOPLE WITH NEUROLOGICAL DISORDERS

Delegates agreed a new intersectoral global action plan on epilepsy and other neurological disorders (including stroke, migraine, dementia and meningitis) that aims to improve access to care and treatment for people living with these conditions, while preventing new cases and promoting brain health and development across the life course.

Neurological disorders are the leading cause of disability-adjusted life years and the second leading cause of death globally. Despite the high global burden of neurological conditions, access to both services and support for these conditions is insufficient, especially in low- and middle-income countries.

The action plan will address the challenges and gaps in providing care and services for people with neurological disorders that exist worldwide and ensure a comprehensive, coordinated response across sectors.

Dr Bente Mikkelsen meets with H.E. Prof Dr Sanja Musić Milanović, to discuss the NCD agenda, and in a roundtable event co-hosted by the First Lady, with Ministers from Seychelles, Brazil, Chile, Mexico and the Philippines to discuss the WHO STOP Obesity Acceleration Plan. For more information about the plan, you can contact Francesco below.

Youth advocates bring perspectives of NCDs across the life course, and hold organizations to account to adopt evidence-based NCD policies and programmes that benefit people of all ages. Dr Bente Mikkelsen meets with members of the Young Leaders Program at NCD Child.

HOUSEKEEPING

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.

THE TWEETS WE RETWEET

• Many more meetings between WHO staff and global NCD champions and advocates! Including: 
  • Tackling the challenge of translating global policies and evidence based interventions for Cardiovascular Disease to practice at national level, with @WorldHeartFed at the World Heart Summit (May 2022)
  • A thorough and thought-provoking leadership series on social impact for sustainability from @NCDAlliance, on what @WHO, Member States, UN Agencies, civil society and the private sector can do to bridge the NCD financing gap (May 2022)
  • Speaking at a new chapter with @uicc and partners on visions and commitments of the ATOM Coalition: improving access to essential cancer medicines in LMICs, prioritizing those on @WHO's Essential Medicines List! (May 2022)
  • The importance of engaging family doctors in NCDs to advance primary health care and universal health coverage with @WoncaWorld (May 2022)
• Follow our coverage of the World Health Assembly using the hashtag #WHA75 (May 2022)