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Posted April 4, 2012

World Health Day

NCD Alliance says dropping key targets on non-communicable diseases places future health of the world’s ageing population at risk

New York - The theme of this year’s World Health Day is healthy ageing. With data showing that the major causes of premature death and years lost to disability in people aged 60 years and over are non-communicable diseases (NCDs), the NCD Alliance* says that dropping key targets on NCDs will put the health of the world’s ageing population at risk.

Data released by the World Health Organization (WHO) shows that the major causes of premature death and years lost to disability in older people in both high-income countries (HIC) and low- and middle-income countries (LMIC) are NCDs such as heart disease, cancers, diabetes, stroke, dementia, visual disorders and chronic respiratory disease. Furthermore, NCDs are the leading cause of death in the world, causing 60% of all deaths. In HIC, up to 90% of deaths are caused by NCDs, while in most LMICs, NCDs are also the leading cause of death.

In September, 2011, world leaders gathered at the first ever United Nations High Level Meeting on NCDs in New York. The Political Declaration adopted at the meeting set out a road map for development of targets and a monitoring framework, with a requirement to make significant progress by the end of 2012. The first discussion paper released by WHO, in late in 2011, featured 10 targets including an overarching goal to reduce NCD mortality by 25% by 2025 and to improve access to multidrug therapy for those at risk of heart attack and stroke. However, alarmingly, the second WHO discussion paper released on March 22 has cut the proposed targets to just five. This lack of commitment to action on NCDs will place the health of the world’s ageing population at risk.

Two of the original proposed targets are still in: on mortality and blood pressure, both 25% relative reductions between 2010 and 2025. Two of the original targets have been changed, with the goal on tobacco down from a 40% to 30% relative reduction, and the target on salt changed from a goal of 5 grams per person per day to a 30% relative reduction. While a physical activity target (reducing prevalence of physical inactivity by 10%) has been added, a total of six targets have been dropped from the original discussion paper, including those on alcohol, transfats, obesity and multi-drug therapy, which have reduced to simply ‘indicators’. The NCD Alliance believes these removed targets should be reinstated. The Alliance also raises major concerns that the reduction in proposed targets has come about from feedback from just 21 of WHO’s Member States. The Alliance believes all 194 Member States should be shaping the NCD Agenda.

“It is vital that people aged over 60 years, and in fact people of all ages, have access to essential medicines in order to prevent the onset of NCDs, and to treat and control existing conditions,” says Johanna Ralston, NCD Alliance Steering Group member and Chief Executive Officer of the World Heart Federation. “If we don’t address NCDs in older people, health systems in even the most developed countries will be completely overwhelmed as populations age. We also need to address these common risk factors across people of all ages, since today’s younger people will be the older population in generations to come.”

Interim data released from WHO’s Stage study to mark World Health Day shows that across six LMICs (China, Ghana, India, Mexico, South Africa, Russian Federation) 32-80% of people aged over 50 years have high blood pressure, while only 4-14% of them receive appropriate blood pressure-lowering medications. Even in developed countries such as the UK and USA, there are many older people in whom these risk factors are undiagnosed or untreated. This is despite a wealth of evidence showing that treatment for the majority of these conditions is cheap and cost-effective. The NCD Alliance advocates for appropriate treatment and prevention efforts across the lifecourse to both prevent and control NCDs.

Ralston concludes: “We believe the dramatically reduced set of proposed targets fails to match the ambitions and the scope of the Political Declaration. We strongly urge Member States to adopt targets that will drive progress in the prevention and control of NCDs for the next 15 years.”

Another aim of the NCD Alliance, to ensure NCDs are included in the post-Millennium Development Goals global health agenda, looks set to become reality after the UN Development Programme announced that NCDs would be included in their thematic discussions with academia, media, the private sector, employers and trade unions, civil society and decision makers in 50 countries. These discussions begin next month.

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