who working group on covid-19 and ncds
TRANSCRIPT
Bente Mikkelsen, Director, NCDs, WHO
Jill Farrington, Head of Secretariat, Working Group, WHO
Benn McGrady, Healthier Population Division, WHO
WHO WORKING GROUP ON
COVID-19 and NCDs
UNSG RESPONSE TO COVID-19
Launched on 27 April 2020
Being updatedBeing updated
Launched on 31 March 2020
UN FRAMEWORK
Launched on 27 April 2020
Protecting health services and systems
Social protection and basic services
Protecting jobs, SME and informal sector workers
Macro-economic response and multilateral coordination
Social cohesion and community resilience
COUNTRY-LEVEL UN ARCHITECTURE
COUNTRY-LEVEL UN ARCHITECTURE
Three strategic priorities:1) Rapidly establishing international coordination and
operational support2) Scaling up country readiness and response operations3) Accelerating priority research and innovation.
WHO’s SPRP
BEING UPDATED COVID-19 strategy (14 April 2020) will serve as an input into SPRP/2
❶ COVID-19 response may compromise access to and quality of essential health services for NCDs (already leading cause of death)
❹ People living with NCDs may experience more severe disease and poorer outcomes when infected, and various risk factors exist, such as obesity and smoking
❺ Health workers, food service personnel, and people living in prisons, refugee camps or closed setting are at increased risk of infection
❼ Changing donor commitment may have implications for the continuity of national NCDs responses and WHO’s work on NCDs
❻ Increased prevalence of mental health conditions are being reported
❸ COVID-19 may disrupt whole-of-society approaches for NCDs, disrupt medicine supplies, divert services, complicate health messaging
❷ COVID-19 infection may be associated with cardiac and renal complications, strokes and clotting disorders
New challenges for the NCD agenda
1) Strengthen governance for the preparedness at national, regional and country level by also including NCDs, and building bridges between humanitarian responses and development, emergency and NCDs, using UHC and sustainable funding structures as the foundation.
2) Monitor the access to/continuity of essential health services for NCDs and mental health at country level.
3) Review the evidence emerging related to NCD and risk factors, vulnerable populations, mode of transmission, pathogenesis and disease associations to determine implications for NCDs and mental health services and programmes.
4) Disaggregate data, modelling and integrated surveillance to better understand the numbers of people that are at risk.
5) Elaborate cross-cutting research priorities and agendas – identifying innovative solutions.
6) Use practical guidance for countries on the continuity of essential health and community services, including for NCDs, mental health and substance use disorders, with an emphasis on disease specific guidance
7) Use clearer terminology and communication messages on COVID-19 and NCDs.
What needs to be done?
1) Coordinate approaches in which all guidance is coherent and fully aligned.
2) Build bridges between humanitarian responses and development, emergency and NCDs responses, with UHC as the foundation
3) UNGA, WHA73 and the Regional Committees need to address continuity of health services and activities for healthier populations during the COVID-19 pandemic to achieve UHC
4) Reprogrammed investments and new international funding patterns may require adjustment and “re-setting” of global initiatives and building new partnerships.
5) Implement WHO guidance on resuming health services and activities for health and wellbeing in a post-peak COVID-19 scenario – this should be given the highest priority.
6) Develop systematic approaches to research and innovation, including digital health care solutions
7) Involve Health Ministries in the revision of social, economic, environmental policies and further investments for health in these systems
New opportunities
8 TASK GROUPS FOR WORK STREAMS
Advocacy Governance
PreventionSurveillance
and R&D
Treatment
Communication strategy, advocacy products,
misinformation in the media, and myth busters
Keep NCDs/mental health in national, regional and global response plans during/post-pandemicFunding
Reinforce FCTC, counter industry interference, threats to regulatory
frameworks
Identify key epidemiological & research questions (relevant to all workstreams) and commission
Add NCD/MH specificity to maintaining essential health services, with practical
examplesIdentify & scale-up digital health solutions
Collaboration on maintaining access to medicines and supplies
Respond to disease-specific request
8 TASK GROUPS: TASK-AT-HAND
Tasks:
1) Accelerate the development of COVID-related product types on NCDs between now and 6 May 2020 (i.e. until next WIN/NCD meeting)
2) Agree on a list of product types to be developed between 6-17 May 2020 (i.e. until WHA73)
3) Agree on a list of additional product types to be developed between 17 May 2020 and 1 July 2020
COVID-related product types:• Scientific briefs• Technical guidance• Guidelines• Q & A• Situation reports• Tools• Database• Rapid reviews• Derivative products• Joint position statements• Research papers, commentaries, viewpoints, op-eds• Target product profiles• Campaign materials• Advocacy products• Advice for public: myth busters• News• Donor alerts• SPRP Resource mobilization• Activity report
ASKS FOR THE WORKING GROUP
During the COVID-19 pandemic:1) We should acknowledge “NCDs” and stop relabeling NCDs as
pre-existing conditions. 2) We should acknowledge how many people living with NCDs
are not receiving appropriate treatment during the COVID-19 pandemic.
3) We should emphasize WHO’s relevance as a trusted partner to all countries and all people in supporting countries to strengthen their health response.
Post-COVID-19:4) Acknowledge that prevention, early diagnosis, screening,
and appropriate treatment of NCDs (at PHC for UHC) must be the cornerstone of any global post-COVID response
“NCDs remain the world’s number one killer. People living with an NCD are more vulnerable to becoming severely ill with COVID-19, and die from a co-morbidity. NCDs are hidden, misunderstood and underreported in the COVID-19 response”.
Bente MikkelsenDirector, NCDs, WHO
REPORT BACK (ROUND 1)
❶ A M J J >
1 WHO webpage on COVID19 and NCDs (for all product types) ●
2 Tile for NCDs on WHO’s COVID-19 webpage ●
3 WHO webpage giving a voice to PLWNCDs during COVID19 ●
4 WHO webpage with country stories on COVID-19 and NCDs ●
5 Zoom briefings for the media on the risk of becoming severely ill with the virus for people living with hypertension, persons who have had, or are at risk for, a heart attack or stroke, diabetes, cancer, chronic respiratory disease, obesity, and smoking.
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6 Facebook live sessions for people living with or affected by NCDs on the same topics
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7 Highlight NCD-related products during Tedros’ media briefings ● ● ● ●
REPORT BACK (ROUND 1)
❷ A M J J >
1 Joint statements on NCDs and COVID-19 with UNDP, IAEA (cancer), World Bank
● ●
2 Policy brief for UN Country Teams on COVID and NCDs ●
3 Policy brief for negotiators of resolutions (WHA, ECOSOC, UNGA) and declarations (G20, BRICS, regional IGOs)
●
4 Policy brief on funding streams ●
5 Side-event on NCDs and COVID-19 during ECOSOC/HLPF (July 2020) or UNGA/HLS (Sep 2020)
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6 Include NCDs in updates of (global) SPRP and GHRP ●
7 Include NCDs in 6 national COVID-19 response plans (1/region) ● ● ● ●
REPORT BACK (ROUND 1)
❸ A M J J >
1 Tobacco: • Literature review on increased risk and severity to go to informal peer
review process. Possible position statement• EMRO led position on retention of waterpipe bans
X
X
2 Tax: Possible webinar and/or factsheet on health taxes for revenue generation and prevention of NCDs
3 Alcohol: • Requests to change how information is conveyed on WHO page. (action
underway with DCO) • PAHO webinar • Editorials on further research and future scenarios. • Work underway on relationship between SAFER and alcohol• Monitoring CSR
X
XX
REPORT BACK (ROUND 1)
❸ A M J J >
4 Advocacy needed: • To highlight role of risk factors in causing ‘pre-existing
conditions’ and links to morbidity and mortality• On corporate social responsibility by tobacco, alcohol and food
industries (including BMS) • To encourage governments to enforce existing laws, move
forward with prevention and not let their guard down
X X X
5 Emergency powers: Possible factsheet on use of emergency powers and links to physical activity, availability of tobacco and alcohol
X
REPORT BACK (ROUND 1)
❹ A M J J >
1 Mapping/stock-take of country, regional office and HQ r & s activities
2 Convene expert roundtable to explore and prioritize research on physical activity
3 Changes to lifestyle and impacts on health
4 Changes in non-COVID related mortality
5 Collect / map research of other UN agencies on impacts of COVID and provision of health services
6 Rapid assessment of impact of COVID on NCD essential services
7 Follow up discussion initiated Leanne over email
REPORT BACK (ROUND 1)
❺ A M J J >
1 Conceptualize our thinking on implementing essential health services for NCDs, drawing on existing work in HQ/Regions/other
● ●
2 Contribute NCD/disease-specific modular section(s) to the cross-programmatic ‘Expanded operational guidance’ PRODUCT (JOINT) Technical Guidance
● ●
3 Modeling study (impact of delays & post-pandemic recovery) (link with Surveillance and Governance)
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4 Post-pandemic plan to manage backlog of cases → Governance ● ● ● ●
5 Develop common approach for supporting countries in completing pillar on Essential Health Services in country COVID plans (link with Surveillance)
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REPORT BACK (ROUND 1)
❽ A M J J >
1 Collect disease-specific questions and develop responses → EHS product and/or standalone products PRODUCT: Technical Guidance and/or Webinars with clinicians
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2 Generate stories (success and challenges) in disease management from person/professional perspective PRODUCT: Advocacy stories
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3 Capture, monitor and publicize evidence for interruption of services/delays, linking with disease-specific platforms (link with Surveillance) PRODUCT: Commentary/OpEd, Joint Partnership statement, News Stories
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4 Provide disease-specific examples of services amenable to remote consultations / follow-up →Digital TG and EHS product
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5 Develop Q&As on COVID-19 and NCDs or specific diseases such as cancer PRODUCT: Q&As
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REPORT BACK (ROUND 1)
❻ A M J J >
1 Content for bots and SMS programmes on COVID-19 targetingpreventing NCDs and people living with or affected by NCDs
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2 Smoking cessation AI humanoid counselor ●
3 Call for interest for relevant applications, and establish a clearing house, assessment criteria for NCD digital, innovation challenge
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4 Self-help guide on remote stress via telephone ●
5 Mapping NCD services /workflows/users and bottlenecks ● ● ● ● ●
6 Case studies and stories on using digital to prevent/manage NCDs during COVID
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REPORT BACK (ROUND 1)
❼ A M J J >
1 Conceptualize our thinking on types of challenges faced by countries (supply chain disruption/distribution-access issues/affordability), in coordination with the Access to Medicines and Health Products and procurement teams
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2 Review/compile tools developed at HQ/Regions/other to better evaluate and forecast medicines and supplies needs PRODUCT: Rapid assessment tool
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3 Manage donation of insulin by Novo Nordisk for all regions ● ●
4 Assist countries in applying to NRT Drug facility and develop sustainable model
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5 Mobilize NSAs as part of GCM to better identify country needs, advocate and support countries in ensuring a consistent supply of NCD medicines and products for PLWNCDs
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REPORT BACK (ROUND 1)
❼ A M J J >
6 Contribute NCD/disease-specific modular section(s) to the cross-programmatic ‘Expanded operational guidance’ PRODUCT (JOINT) Technical Guidance
● ●
7 Explore post-pandemic plan to better support countries in the ensuring a consistent supply of NCD medicines and products for PLWNCDs (demand forecasting models, WHO LTAs, pool procurement)
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