FROM GLOBAL TO LOCAL

AN ALLIANCE OF FEDERATIONS FOR NCDs

28 April 2010

Structure of presentation

• Cary Adams Overview of UICC

• Ann Keeling Overview of IDF

• Nils Billo Overview of IUATLD

• Helen Alderson Overview of WHF Working together as partners

• Ann Keeling The NCD Advocacy Agenda

international union against cancer

UICC: Working to eliminate cancer as a life threatening disease

Who we are – an overviewThe International Union Against Cancer (UICC) is the leading international non-

governmental organization dedicated to the global prevention and control of cancer.

Founded in 1933, UICC unites over 360 member organizations, specialized and

engaged in cancer control, in more than 100 countries across the world.

UICC is non-profit, non-political, and non-sectarian. It’s headquarters are in

Geneva, Switzerland.

• Current President: Professor David Hill of Cancer Council Australia• Over 1 million individual members working worldwide• 180.000 and growing World Cancer Declaration supporters

World Cancer Declaration‘A global call to action to help substantially reduce

the global cancer burden by 2020 and

increase cancer's visibility on the international

political agenda’

UICC outlines 11 targets and a priority action plan to stop and reverse current trends at local and national level.

Aimed towards making significant improvements in the measurement of the global cancer burden, sharing best practice to increase rates of early detection and optimal treatment and thus improvements in cancer survival rates in all countries around the world.

Annual global cancer mortality (millions)

Support the approx. 30 million people living and coping with cancer globally

World Cancer DeclarationThe Declaration sets 11 targets to stop and reverse current cancer trends

And aims to increase cancer’s visibility on the global agenda

Targets

1. Sustainable delivery systems

2. Improved measurement of the global cancer burden

3. Decreased global tobacco consumption, obesity, and alcohol intake

4. HBV and HPV vaccination programs and screenings

5. Shift in public attitude towards cancer

6. Earlier and accurate diagnosis

7. Appropriate cancer treatments and supportive care

8. Effective pain control measures accessible to all patients

9. Improved professional training opportunities

10. Decrease in emigration of health workers with

specialist training in cancer control

11. There will be major improvements in cancer survival rates in all countries

Please help us move cancer up on the global agenda

by signing online at: www.uicc.org/wcd

Promoting diabetes care, prevention and a cure worldwide

President Jean Claude Mbanya

Cameroon

International Diabetes FederationInternational Diabetes Federation220+ member associations in 160+ countries,

7 regional offices, 2million+ members

US$ 750 million combined income

UN Resolution onDiabetes Dec 2006

335 million havediabetes

• Global advocacy and campaigning

• Evidence: IDF Diabetes Atlas, health economics

• Policy Research

• Sharing best practice eg diabetes education

• Global guidelines and advice to govts

• Humanitarian programmes eg Life for a Child

• Convening the global diabetes community – World Diabetes Congress

IDF’s role

Vision

Health solutions for the poor

MissionThe Union brings innovation, expertise, solutions and support to address health challenges in low- and middle- income populations

Map of Global ActivitiesTechnical Assistance – Education – Research

Union Membership Activities

Around 3 000 members from 152 countries• 84 Constituent Members• 18 Organisational Members• 2 834 Individual Members

www.theunion.org

World Heart Federation

Helen Alderson, Chief Executive Officer

The World Heart Federation helps people achieve a

longer and better life through prevention and control

of heart disease and stroke, with a focus on low- and

middle-income countries .

The World Heart Federation

Mission

The World Heart Federation helps people achieve a

longer and better life through prevention and control

of heart disease and stroke, with a focus on low- and

middle-income countries.

The World Heart Federation

Leads a united community of over 200 member organizations in the global fight against heart disease and stroke. Brings together the societies of cardiology as well as heart health charities.

The World Heart Federation

Together with our members we achieve our mission through:

Awareness Building

Advocacy

Demonstration Projects

Sharing Science and building capacity

Working together as partners on the NCD agenda

WEF: Global Risks Landscape 2010

NCDs

Non-communicable account for over 60% of global deaths

HIV/AIDS

TuberculosisMalaria

Cardiovascular diseases

Cancer

Chronic respiratory diseases

Diabetes

0

2000000

4000000

6000000

8000000

10000000

12000000

14000000

16000000

18000000

20000000

Source : WHO 2005: «Preventing Chronic Diseases: A Vital Investment»

14 million premature deaths in LMCs

Omitted from the MDGs:

14.0 million premature deaths from non-communicable diseases

17.4 M

14.0 M

5.3 M

10 million

20 million

30 million

40 million

50 million

60 million

Total number of deaths in low- and middle-income countries (2004)

14.2 M

Low-income countriesGroup III - InjuriesGroup II – Other deaths from non-communicable diseasesGroup II – Premature deaths from non-communicable diseases (below the age of 70), which are preventableGroup I – Communicable diseases, maternal, perinatal and nutritional conditions

34%

28%

10%

28%

WHO slide

So

urce

:

2005 2006-2015 (cumulative)

Geographical regions (WHO classification)

Total deaths

(millions)

NCD deaths

(millions)

NCD deaths

(millions)

Trend: Death from infectious

disease

Trend: Death from NCD

Africa 10.8 2.5 28 +6% +27%

Americas 6.2 4.8 53 -8% +17%

Eastern Mediterranean 4.3 2.2 25 -10% +25%

Europe 9.8 8.5 88 +7% +4%

South-East Asia 14.7 8.0 89 -16% +21%

Western Pacific 12.4 9.7 105 +1 +20%

Total 58.2 35.7 388 -3% +17%

The number of deaths due to NCDs is expected to rise over the next 10 years: the largest increase will be in developing countries

Source : WHO 2005: «Preventing Chronic Diseases: A Vital Investment»

$0,00

$0,10

$0,20

$0,30

$1,00

$2,00

$2,70

$0,00

$0,08

$0,10

$0,20

$0,20

$0,60

$0,70

$1,30

$1,80

$1,93

$2,10

$4,75

Water Education/ Training

Water resources protection

Waste management/ disposal

River development

Basic drinking water supply & sanitation

Water Policy/ Management

Water supply/ sanitation-large systems

Health Education

Health Training

Basic Nutrition

Family Planning

Medical Services

Medical Research

Basic Health Infrastructure

Reproductive Health Care

Basic Health Care

Health Policy/ Management

Infectious Disease Control

STD & HIV/ AIDS Control

Total ODA for Health in 2006: US$ 21 billion

Source WHO NCDnet

Out of the $21 billion ODA invested in health, where are NCDs?

(expressed in US$ Billions)

0.9 %

Total Percentage of Health Aid spent on NCDs:

Source: Nugent & Feigl (2009), Donor Response to Chronic Diseases in Developing Countries, Center for Global Development, Washington, DC.

Millennium Development Goals drive the global development agenda

1. Eradicate poverty and hunger

2. Achieve primary universal education

3. Promote gender equality and empower women

4. Reduce child mortality

5. Improve maternal health

6. Combat HIV/AIDS, malaria and other diseases

7. Ensure environmental sustainability

8. Develop a global partnership for development

Where are NCDs?

The Framework

WHO Action Plan:

Defines NCDs as 4 diseases: cancers,

diabetes,

cardiovascular,

chronic respiratory

Agreed by governments

NCDs: a development

issue

• -

January 2009: The three NCD federation’s formed an alliance and we are pleased to welcome a fourth this year

882 national associations in 170+ countries

Call for action at a global level

Mission: Help implement the Action Plan by catalyzing a multi-sectoral, multi-level response, with a particular focus on developing countries

Goals: ● Increase focus on prevention and control of non-communicable diseases through collective advocacy

● Increase resource availability (both financial and human capital)● Catalyze effective multi-stakeholder action with a focus on country-level

implementation

NCDnet: New network to combat noncommunicable diseases

What will NCDnet be doing?Why are the poorest people in low- and middle-income countries affected the most?Objective 5 – Promoting partnerships

WHO slide

IDF – UICC – WHF – IUATLD committed to working towards prevention & control of NCDs

• Members• Networks• Healthcare Professionals• Patient groups

Grassroots presenceand activities

International Federations’ key assets:

NCDs: the global advocacy agenda

2009 Alliance Advocacy Demands• United Nations special session on NCDs (UNGASS)

• NCDs and MDGs: adding NCD indicator(s) at MDG Review Sept 2010. Successors to MDGs post 2015.

• International funding for essential NCD medicines/care

- Advocating for international and national funding

- Global Fund mandate expanded to Global Fund for Health integrating NCDs/Innovative financing for NCDs

• Integration of NCDs, especially into primary healthcare

Why an UNGASS on NCDs?

• Only 28 Special Sessions in UN history – often mark UN anniversaries eg 2000 Women. Last was 2005.

• convened either by Security Council (conflict/peace) or simple majority vote UN states in General Assembly • mega events/mega profile for an issue: 2002 Children: 3500 govt delegates (43 heads of state), 1700 NGOs, 1200 journalists and over 122 supporting events.• can catalyse major change eg HIV/AIDS 2001: Commitment signed by all UN members. National progress reports every 2 years. Led to Global Fund.

An UNGASS: what makes it special?

NCDs UNGASS: building momentum • Jan 2009 IDF started lobbying: no traction

• May 2009 Alliance event at WHA built supporters

• June 2009 statement CARICOM heads of govt

• Alliance followed up with: • publication eg Time to Act• statements/presentations at key events• mobilising our members to lobby govts• behind scenes lobbying

July 2009: ECOSOC (58 UN member states) recognize global NCD threat

“We also recognize that the emergence of non-communicable diseases is imposing a heavy burden on society, one with serious social and economic consequences, and that there is a need to respond to cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, which represent a leading threat to human health and development.”

9 July 2009

"We declare our support for the call to integrate indicators to monitor the magnitude, trend and socio-economic impact of NCDs into the core MDG monitoring and evaluation system during the MDG Review Summit in 2010."

"We call for a Summit on NCDs to be held in September 2011 under the auspices of the United Nations General Assembly."

29 November 2009

November 2009: UNGASS support by 54 Heads of State

The Voice of the Alliance at National Level

National Associations working together to support global advocacy for NCDs

UNGASS: current state of play • Formally adopted by 76 Heads of Govt, other govts supportive eg Russia, Gulf..

• CARICOM countries leading on draft resolution. Optimistic vote in UN May for UNGASS Sept 2011.

• Feb 2010 Alliance advocacy supported by powerful NGOs eg GARD, FCA,

• Reaching US govt is critical – US alliance

• EU important: UK, France, Germany, Portugal, UK, Ireland, Cyprus, Malta committed

• NCD panels New York 13 & 20 April, FCA statement

UNGASS: current state of play

• CARICOM countries leading on draft resolution. Now cosponsored by China, Brazil etc

•Optimistic it will go to UN GA in May for a vote for high level Summit on NCDs Sept 2011.

• We believe we will get the Summit .....and then the fun begins

Current state of support for the

UNGASS

75 Heads of State44 Co-sponsoring 7 ministerial level

support

Heads of StateAntigua and BarbudaAustraliaThe BahamasBangladeshBarbadosBelizeBotswanaBrazilBrunei DarussalamCameroonCanadaChileChinaColombiaCyprusDominicaDominican RepublicEl Salvador Fiji IslandsFranceGambiaGermanyGhanaGrenadaGuatemalaGuyanaHaitiIndia

Ireland JamaicaKenyaKiribatiLesothoLuxembourgMalawiMalaysiaMaldivesMaltaMauritiusMozambiqueNamibiaNauruNew ZealandNigeriaPakistanPapua New GuineaParaguayPeruPortugalQatarRwandaSurinameSt Kitts and NevisSt LuciaSt Vincent and the GrenadinesSamoa

SeychellesSierra LeoneSingaporeSolomon IslandsSouth AfricaSri LankaSurinameSwazilandThailandTongaTrinidad and TobagoTuvaluUgandaUnited KingdomUnited Republic of TanzaniaUruguayVanuatuZambia Ministerial Support through Gulf Cooperation CouncilBahrainKuwaitOmanQatarSaudi ArabiaUnited Arab EmiratesMinisterial Level Russia

UNGASS: current strategy • Separate the UNGASS and MDGs: some powerful

govts will oppose if the two combined

• Secure the UNGASS

• Once secured, get renew focus on the MDGs

• Focus on ‘feeder meetings’ ie April Commission on Population and Development and July ECOSOC

• Secure UNGASS, then launch the consultation (Commonwealth remains keen)

NCDs and MDGs: establishing the connections

NCDs and the MDGs • 8 MDG goals determine agenda for international funding to LMCs till end date 2015

•MDGs specify particular diseases eg HIV/AIDS, TB – not meant to be taken literally – don’t include NCDs

•Adding an indicator would catalyse funding/technical assistance for NCDs

• Discussion of an NCD indicator would set scene for inclusion of NCDs in successor goals to MDGs

•Sept 2010 MDG review meeting at UN last opportunity before 2015

Jan 2010: WHO Executive Board highlights NCDs in MDG Report

“”Recognizing also the growing burden of noncommunicable diseases worldwide, andrecalling the importance of preventing infectious diseases that still represent a heavy burden, particularly in developing countries, the adverse impacts of the food, environmental, economic and financial crises on populations, in particular on the poorest and the most vulnerable ones...

21 January 2010

MDG Review September 2010 MDG Review September 2010

• Getting into ECOSOC and MDG meetings???

• Discussion of indicators has gone quiet (WHO??)

• Many govts determined to raise NCDs at MDG Review

• NGO consultations for MDG Review New York 14 and 15 June

• Once we secure UNGASS NCDs will be taken more seriously

What about the money?

Major players in aid to LMCs• Global Fund for AIDS, TB and Malaria: 2008

disbursed US$2.3 billion - almost none on NCDs• Gates Foundation: 2008 disbursed US$3.6 billion (all

sectors including health) – almost none on NCDs• UNITAID: 2008 expenditure US$232 million – none

on NCDs

BUT the global agenda is driven by bilateral aid donors eg Netherlands, DFID, SIDA, NORAD etc (who also fund Global Fund, UNITAID, WHO, World Bank etc)

International Funding for NCDs Bilateral donors still sceptical: ‘taxpayers will not support us funding diseases of affluence’

Two common misperceptions:• NCDs are not diseases of the poor• There are no cost effective solutions

Meeting with DANIDA 15 and 16 April

Paris Declaration Aid Effectiveness is key

The Business Case for NCDs: the The Business Case for NCDs: the World Economic ForumWorld Economic Forum

• We know costs of diseases but not costs of solutions (including prevention). WHO working on ‘packages’.

• WEF important forum for defining business case for NCDs

• WEF on NCDNet but WHO weak on NCDs (eg diabetes one staff member in WHO)

• Major focus Davos January 2011 ???

Jan

WEF Davos Meeting

UN Commission on Population and Development

Meeting

MDG Review Summit at UN General Assembly

OECD Health Ministers Meeting

Sep

Key Events 2010 /11

May

126th WHO Executive Board

WHO NCDNet Meeting

Feb Oct Late 2010/2011

UN General Assembly Special Session on NCDs

Jan

WDF / DANIDA NCDs Meeting

Apr

63rd World Health Assembly

July

ECOSOC Ministerial Meeting

The Alliance going forward• The alliance: flexible and effective. Hard to coordinate

more than 4 organisations.

• We will use our 4 logos and not take a name

• More NGOs asking to join, work with wider NGO group through NCDnet

• US based Lance Armstrong Foundation funding NCD Alliance Campaign Manager, Greg Paton based in IDF

• Alliance website as resource and rallying point. Other NGOs free to support our statements/actions.

Welcome to the cause! NCDs are at a turning point

What can we do together??