Progress on a set of global targets to tackle non-communicable diseases (NCDs) is likely to be inadequate during next week’s 65th World Health Assembly in Geneva.

The NCD Alliance, a global advocacy organisation representing hundreds of global and national groups, believes this could cripple the momentum that has been built, following last September’s historic UN Summit on NCDs in New York in which UN member states committed to a range of actions to tackle the NCD epidemic.

NCDs are responsible for 60% of all global deaths.

They are the leading cause of death in most high-income countries (80%-90%), and also in most low-income and middle-income countries. In all settings, the burden of these conditions is growing.

Ann Keeling, Chair of the NCD Alliance and CEO of the International Diabetes Federation, comments, “In the run-up to the UN Summit on NCDs, we urged Member States to include meaningful targets to prevent and control NCDs. We particularly called for the adoption of an overarching goal to reduce preventable deaths from NCDs by 25% by 2025. Member States deferred decisions about targets to 2012. Eight months on from the UN Summit, there can be no excuse for the world’s Health Ministers not to adopt at least this global goal, and supporting targets.”

In accordance with the Political Declaration agreed at the UN Summit, the World Health Organization (WHO) released a discussion paper in December 2011, in which 10 targets were presented.

As well as an overarching target of reducing preventable NCD deaths by 25% by 2025, there were nine other targets covering tobacco, salt, alcohol, and a range of other contributors to the NCD epidemic.

But following input from just 21 Member States (when the UN has 194), the second discussion paper, released in March, had reduced the proposed targets to just five.

Mortality and blood pressure targets remained – both 25% relative reductions by 2025. The tobacco and salt targets had been watered down. The other targets had been dropped, including the target on alcohol (a relative reduction of 10% adult per capita consumption)—after intense lobbying from the alcohol industry, which objected strongly to any attempt to reduce overall consumption worldwide, since this clearly directly affects profits.

One piece of good news in the second discussion paper was a new target to reduce levels of physical inactivity by 10% by 2025. Only 25 countries commented on this new, smaller set of targets, although 59 attended a Member State consultation on 26-27 April.

“If countries are serious about tackling the NCD crisis afflicting them all, they must be bold and commit to 10 targets, not 5 or fewer. We need to recapture the passion demonstrated at the UN Summit and commit to realising in full the ambitions articulated in the Political Declaration,” says Keeling. She points out that the UN recently adopted 10 new targets for 2015 on HIV/AIDS when this is one condition. Yet the international community appears to be resisting the same number of targets for NCDs, including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, that have at least four common risk factors (tobacco use, harmful alcohol use, unhealthy diets and physical inactivity).

Measurable targets are essential since, as WHO Director General Dr Margaret Chan says, ‘What gets measured, gets done.’ The NCD Alliance believes that, at the very least, UN Member States should commit to the overarching target on mortality at next week's World Health Assembly, in order to unequivocally demonstrate their commitment to the process agreed at the UN High-Level Meeting.

The NCD Alliance is also calling for an emphasis on treatment as well as prevention in whatever targets are adopted. “Prevention efforts are absolutely essential to reducing future cases of NCDs. And in addition there is an urgent need to provide care for people living with NCDs today to prevent premature death and crippling complications,” says Keeling. The Alliance proposes 10 targets be kept, with one dedicated to “Equitable and increased availability of affordable, quality essential medicines and technologies for communicable and non-communicable diseases in all healthcare sectors”.

Source: The NCD Alliance