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La Directora de la OPS llama a la Unidad para detener la epidemia de las ECNT, una epidemia mundial que exige una respuesta global

Nos acercamos a un momento histórico en la lucha contra las enfermedades crónicas no transmisibles (ECNT): cardiovasculares, cáncer, diabetes y obesidad, enfermedades respiratorias crónicas y factores de riesgo asociados como régimen alimentario no saludable, inactividad física, consumo de tabaco y uso perjudicial del alcohol,  que están causando millones de defunciones prematuras por año y se han convertido en el principal costo-conductor de la salud para la mayoría de los países. [en inglés]

" The World Health Organization is the ideal convener to build the world wide coalition that is required to achieve success, protect the people and bring health and prosperity  for the current and future generations "

Dr Mirta Roses Periago
Director of the Pan American Health Organization

Speech at the opening ceremony of the
WHO-Wide Planning Meeting for the United Nations General Assembly High-level Meeting on the Prevention and Control of Non-communicable Diseases
Washington DC. PAHO HQ.
3 February 2011.


Dr. Ala Alwan, ADG, Noncommunicable Diseases and Mental Health (MNH);

Dr. Werner Obermeyer, and Dr Karen Sealey, WHO UN NY

Colleagues from AFRO, EMRO, EURO, SEARO and WPRO

Members of our staff:

It gives me great pleasure to welcome you to PAHO, the house of  health in the Americas, as we gather for this important WHO-wide planning meeting for the UN High Level Meeting on NCDs, which as you know will take place in New York on 19-20 September 2010.

In welcoming you, I would like to reflect on the opportunity of the historic importance of this High Level Meeting (HLM), the second one to be devoted to a health issue, the role of the Organization, share with you also some insights from my recent participation in the Executive Board  discussion on NCDs, and in the World Economic Forum annual meeting in Davos, Switzerland, and look at our expectations from this meeting.

I would also like to specially recognize and thank Dr. Ala Alwan for his leadership role of the Noncommunicable Diseases and Mental Health (NMH) cluster in Geneva, and his commitment to the cause of NCD prevention and control.  With him and the GPG Global Policy Council chaired by the DG with the 6 RDs, the need for a WHO wide planning meeting was identified and we offered AMRO to be the venue for it.

The initiative to move to a high level meeting at the UN was generated from this Region, with the Caribbean countries holding their historic Summit of CARICOM Heads of State in September 2007 in Trinidad and Tobago, this summit led to the “Declaration of Port of Spain”, a call to Unite to stop the epidemic of NCDs, and a 15-point, multi-sectoral action agenda.  Early evaluations have shown that that high level political commitment was essential, but not sufficient, as ongoing work needs to be done to build capacity in countries to implement. There was also recognition that NCDs are a global epidemic, demanding a global response.

Since that beginning, the momentum has grown - through the Commonwealth Heads of Government meeting later in 2007, the Summit of the Americas, the ECOSOC, the WHA- to the decision of the UN in May of 2010 to have a High Level Meeting on 19-20 September.

The UN HLM in September represents a unique policy window opening to:

1. Put NCD prevention and control on the global development and economic agenda

2. Stimulate a multi-sectoral response which saves lives and suffering

3. Decrease the upward spiral of health costs, and

4. Increase growth and productivity prospects.

We have to think big, and grasp this opportunity to shake the whole of the health sector and the whole of society to confront this massive growth of NCDs.

We know that NCDs like cardio vascular disease (CVD), cancer, diabetes and obesity, and chronic respiratory disease, and associated risk factors like unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol are causing millions of premature deaths per year and have become the major cost-driver in health for most countries.  This, however, is still not sufficiently well appreciated by policy makers and the public.

At one level, NCDs may be seen simply as a major new challenge in health resulting from the so called demographic transitions (urbanization, lifespan extension, ageing). At another level, NCDs may be seen as symptoms of the failures of our development paradigm in the world today. That is because NCDs are linked to deeper social and environmental determinants such as access to services, agri-food policies, transport and urban planning; education and social protection policies; poverty and economic development, behavioral changes and incorporation of global trends of choices and adoption of foreign cultural models.

And that is why we need a UN HLM, to raise awareness at the highest level, and stimulate an “all of society” response to address this most important public health challenge in global health, to generate multi sector action to implement the proven cost-effective measures like tobacco control, dietary salt reduction, scale up access to preventive care for CVD, transform diets and levels of physical activity to combat obesity, which has emerged in the last 2 decades as a major problem. The need for the all of society response is the reason that we are committed to build a multi-partner Partners Forum to take joint action between sectors and we offer to share the experiences, in what is not an easy task - innovation.

I would like to refer to some of the important messages we need to hear so that we plan to address them during the regional consultations and global meetings like Moscow.

1) These are not the priorities of the poor countries or the poor people in every country. When we have the evidence that the burden is accumulating and raising faster among them.

2) The nutrition priority is still under nutrition. When we know the metabolic relation and the continuum  between hunger and obesity and the importance of moving from food quantity to the concept of healthy weight and nutritious food.

3) The need to concentrate in achieving the MDGs when we are already 2/3 down the road and should start thinking beyond 2015 and also we can show the intimate relationship of the health of mothers and children to the risk factor and burden of NCDs.

4) The complexity in addressing the multifactorial and multilevel interventions, when we know that the whole of society took us to where we are (marketing and agri policies, industrialized food chain, sedentary life, tobacco and alcohol complacency) and therefore we can use of that knowledge that moved us into the wrong direction and apply them to the right direction.

5) The challenges in changing human and social behaviors when we know that the public is moving fast to a culture of wellness and celebration of life and health and also appreciating and increasingly worrying about the intimate linkage between human and the planet’s healthy survival.

6) The challenge of 80% people living in our Region live in urban settings, so municipal level is so important for action.

7) The challenge of huge number of people already have an NCD.  250 million ppl in our region have some NCD already; need to engage and empower them in a new way. Information technology will play key role, eg, mobile health /cellphones will have to be part of the solution.

We also need the Summit to raise significant new resources. One estimate by Rachel Nugent at the Center for Global Development puts current levels of international funding for NCDs at some $600M annually, while the Lancet series on NCDs suggest that something like $6billion per year is needed. We can debate the accuracy of these figures, but there is no debating that we need significant new resources.

Within AMRO/PAHO, recognizing the importance of the UN HLM, and given the issue of chronic disease prevention and control involves work from across the Organization from many areas, I have established a Task Force chaired by me and including Deputy Director (DD) and Assistant Director (AD). Its inter-programmatic nature responds to the fact that chronic diseases cannot be addressed solely by one Area/project and a complex process is involved in the chronic disease strategy which spans promotion, prevention of risks, and management of diseases, grounded in good science.  These require coordinated efforts from many sectors which include health and other public sectors, the private sector and civil society. 

The purpose of this Task Force is to provide guidance and oversight across AMRO/PAHO Areas and coordinate an Organization wide effort to prepare for the 2011 UN Summit on NCDs and beyond.  We hope this will contribute to the WHO-wide effort.  The Task Force will meet monthly, leading up the September UN meeting.  It will function for a period of 2 years to leverage the UN Summit on NCDs and other major events in 2012 that include the G-8/G-20, the Summit of the Americas, and the Summit of the Social Determinants of Health. You will receive more details today on our preparatory steps, and we are happy to share all our plans and materials, and to learn from the other Regions what you are doing and cross-fertilize for a richer overall effort. Many streams are connecting into a big river leading to the UN Summit and beyond.

Within the wider WHO, in countries, and among partners, we are aware that intensive preparatory activities have commenced with a number of global, regional and national activities completed, and many more planned.  It is critical at this time that we come together as an Organization and that we update our plans for the coming months leading to the HLM. We need to exchange and plan together to guide the participation of high level VIP figures in the different events, and also take this debate to the diverse forums, Ministers of Finance and Planning, Urbanism, Food and agri policies, water use and climate change, recreation and safe spaces for people to move, Youth movements, faith based institutions, mass media briefings to get the adherence of journalists.

We also need to identify multilevel interventions engaging from the top policy level to the local governments and community leaders. And as DG has said we need to learn from HIV AIDS regarding the importance of creating a social movement which in our case is about health and well being and also to focus on prevention and not only into care and cure.

That is why we are moving ahead with 2 major initiatives: one called the Be well week in collaboration with Mayor Bloomberg and WEF to start with NYC and other cities that may sign up, we have the mayor of Mexico already interested. And the other is the Workplace wellness coalition that is sponsored by the WEF and is being applied already in major corporations but will spread also worldwide. The most critical and fundamental instrument is our Global Strategy because we have the information on the problem and the interventions to address it. But as the DG says the health sector is at the receiving end and we have called the attention to the whole of society regarding the responsibility to change now in order to prevent a major crash and confront the sad prospect of watching the first generation that may shorten its life expectancy below their parents achievement.

I hope you can exchange on your creativity and expectations towards the role of WHO in making the UN HLM on NCD a crucial turning point in the world awareness and commitment to the collective’s responsibility and optimism in confronting and averting this tremendous storm.

We can take our part of the responsibility from the health sector but it will not be enough and tomorrow we will listen to other partners that are already on board to act from their own constituencies. WHO is the ideal convener to build the world wide coalition that is required to achieve success, protect the people and bring health and prosperity  for the current and future generations.

I wish you well and look forward with keen interest to the outcomes.

Thank you.

- See: PAHO Director's Public Gallery »

For more information, contact Office of the Director, Pan American Health Organization (PAHO/WHO)




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