WHO launches Action Plan for NCDs 

While infectious diseases such as HIV/AIDS, malaria and tuberculosis have had the attention of the global health agenda, non-communicable diseases have received little attention.

By establishing and adopting a Global Action Plan to address the prevention and care of chronic non-communicable diseases, the World Health Organization (WHO) calls upon countries, member states and international development partners to support and work jointly in the implementation of the Global Action Plan. The World Diabetes Foundation welcomes and fully subscribes to the Global Action Plan and the pressing need to invest in non-communicable diseases.

A call for commitment

In 2008, the World Health Assembly passed Resolution WHA61.14 endorsing the Action Plan for the Global Strategy for the Prevention and Control of Non-communicable diseases. The Action Plan sets out objectives, actions to be implemented between 2008 and 2013, and performance indicators to guide the work of WHO at national, regional and global levels, with a particular focus on low and middle-income countries and vulnerable populations. Some of the most critical objectives are to raise priority accorded to non-communicable diseases in development work and to integrate prevention of such diseases into polices across all government departments. Another critical element of the Global Action Plan is to strengthen national policies, promote and evaluate prevention interventions and create global partnerships for the prevention and control of non-communicable diseases.

According to WHO, the global burden of non-communicable diseases continues to grow. Tackling this burden constitutes one of the major challenges for development in the 21st century. “We have the right vision and knowledge to address these problems. Proven cost effective strategies exist to prevent and control this growing burden. However, high-level commitment and concrete action are often missing at the national level. Prevention of non-communicable diseases and control programmes remain dramatically under-funded at the national and global levels and have been neglected from the global health agenda,” says Dr. Ala Alwan, Assistant Director-General in charge of non-communicable diseases and mental health at the WHO headquarters. He further adds: “Despite impacting the poorest people in low-income countries and imposing a heavy burden on socio-economic development, prevention of non-communicable diseases is currently absent from the Millennium Development Goals.”

Closing the gap of imbalanced aid

While infectious diseases such as HIV/AIDS, malaria and tuberculosis have had the attention of the global health agenda, non-communicable diseases have received little attention. According to WHO, in 2002 infectious diseases caused 40% of deaths worldwide, while non-communicable diseases accounted for 60%.  In the same year, USD 2.9 billion were allocated by international donors to infectious diseases, while only USD 0.1 billion were allocated to non-communicable diseases. 

This imbalance emphasises the urgent need for increased focus on non-communicable diseases and their impact on the global health and development agenda. As one of the leading international funding agencies devoted solely to funding projects within diabetes care and prevention in the developing world, the World Diabetes Foundation possesses important resources to bridge the gap. Since 2002, the World Diabetes Foundation has funded 182 projects in 83 countries, focusing on awareness, education and capacity building at local, regional and global levels. The total project portfolio has reached USD 191.4 million of which USD 62.2 million were donated by the World Diabetes Foundation.

In response to the WHO Global Action Plan, Dr. Anil Kapur, Managing Director of the World Diabetes Foundation elaborates on the importance of the strategy: “The role of international partners is of paramount importance in the global struggle against non-communicable diseases and diabetes in particular in order to leverage the goals and provide synergies to meet the challenges. At the World Diabetes Foundation, we see the Global Action Plan adopted by WHO as an extremely important political framework for the prevention and care of non-communicable diseases. Partnerships are vital because resources for the prevention and control of non-communicable diseases are limited in most national and institutional budgets.”
 
He further stresses: “Although chronic non-communicable diseases are the leading cause of death and disability, they are surprisingly neglected issues on the global health agenda. They are widely neglected as development issues and underestimated as diseases with profound economic consequences. It is, however, possible to significantly reduce the rates of death by applying a sustainable and tangible set of interventions directed towards whole populations, community settings, and high-risk individuals.

The global burden of non-communicable diseases continues to grow. Tackling this burden constitutes one of the major challenges for development in the 21st century.

Supporting the WHO Global Action Plan

One of the greatest barriers to controlling diabetes is ignorance and apathy, not only among lay people, but even among caregivers and policymakers. Placing diabetes on the agenda and making it everyone’s business is an important step in addressing the issue. Involving the policymakers, bilateral and multilateral donors, non-governmental organisations, health care providers and the media and making them partners in the efforts to raise awareness about diabetes is, therefore, another important part of the World Diabetes Foundation’s strategy.

The World Diabetes Foundation has already initiated funding of several primary prevention interventions involving lay people, school children, parents, work places, health care professionals, primary health care centres, policymakers, non-governmental organisations and development groups, as well as the media in a joint effort to promote healthy living. Within the next few years, school-based projects supported by the World Diabetes Foundation for diabetes awareness, prevention and education are estimated to reach more than 1.3 million school children in China, India, South Africa and the Caribbean. These are interventions that have not only proven realistic to implement, but also highly cost-effective in the long term.

Since 2006, the World Diabetes Foundation has actively organised regional summits and round tables for advocacy and awareness in collaboration with the WHO regional offices and other multilateral donors. “By organising regional summits and field visits, we provide policymakers, important stakeholders and the media an opportunity for firsthand experience of the pain and suffering diabetes and its complications cause and demonstrate how the right interventions can effectively contribute to alleviate the suffering,” explains Dr. Anil Kapur.

According to WHO, concerted action against non-communicable diseases on a global scale requires governments and partners in development assistance to play a stronger role and implement policies and plans for the prevention and control of non-communicable diseases in collaboration with major international agencies, non-governmental organisations, research institutions, industry partners and the private sector in specific target areas such as advocacy, resource mobilisation, capacity building and strengthening the existing health infrastructure.
 
“Supporting a broad range of health promotion and prevention interventions will be imperative and play a major part of the implementation of the global strategy adopted by the WHO. The “Diabetes Action Now” programme and the recently adopted UN Resolution on Diabetes are excellent examples of how the World Diabetes Foundation has joined hands with WHO and the International Diabetes Federation in order to improve delivery of diabetes care in the world’s poorest countries and raise awareness of diabetes globally through increased advocacy and action,” explains Mrs. Sanne Frost Helt, Programme Manager at the World Diabetes Foundation.

Non-communicable diseases across the agenda

In recognition of the interconnection between a broad range of diseases and the inherent potential for achieving obvious synergies in terms of utilising the same human resources, skills and health infrastructure, the World Diabetes Foundation – in addition to the existing projects – is actively starting to fund broad non-communicable disease programmes and health promotion in the developing countries.

“Working with national ministries of health, local non-governmental organisations, diabetes associations, health industry, health care providers and bilateral donors, we use our expertise in diabetes as an entry point to assist in the formulation of long term, comprehensive and holistic interventions that can be fully incorporated in national policies and action plans,” explains Dr. Anil Kapur. “Diabetes is associated with many more co-morbidities and complications than any other non-communicable disease, which makes it an obvious entry point for targeting the whole range of non–communicable diseases,“ he argues.

Risk factors and co-morbid conditions associated with diabetes.

Building health promotion programmes and targeting diabetes prevention has not only a salutary effect on diabetes but also on the risk of hypertension, cancer, stroke, and heart diseases. In facilitating an outpatient clinic that provides diabetes screening and care services, that clinic can also be used to provide services for hypertension, obesity and heart disease. In addressing nutrition and healthy living with school children, the preventive effect is seen across the range of most non-communicable diseases.

National programmes

Another key focus area for the Foundation is to address the apparent lack of formulated health policies, strategies and action plans to address the emerging pandemic of diabetes and other non-communicable diseases. Isolated interventions do take place, but in the absence of an overall framework guiding the process and ensuring sustainability, planning, coherence and impact may suffer. The World Diabetes Foundation has therefore found it a logical next step to facilitate sustainability of the individual projects in a country by ensuring – where possible – that the interventions are elevated to a national strategy in a national non-communicable disease programme. A national health programme combines the efforts towards improving access to health care with primary and secondary prevention, under the umbrella of a government endorsed network of stakeholders, joined in the fight against diabetes and other non-communicable diseases.

“By taking an integrated and comprehensive approach, we seek to ensure that diabetes and non-communicable diseases in general are included in national health strategies and are approached with the necessary commitment and resources required to fight the imminent socio-economic burden of non-communicable diseases in the developing countries”, explains Mrs. Sanne Frost Helt.

Presently, the Foundation supports major national programmes and interventions in Kenya, Tanzania, Uganda, Cameroon, China, India and Ghana.