Posted by: davidjolson | 05/18/2011

Synergy or fight? Infectious disease, non-communicable disease

This guest blog was written by Dr. Inon Schenker, global health consultant with the Jerusalem AIDS Project in Jerusalem and a member of the Global Health Council delegation to the World Health Assembly.

GENEVA — Side events during the World Health Assembly (WHA) allow you to be exposed to shifts in directions in a most interesting pattern.

Groups with special affiliation to the World Health Organization and those who don’t, yet have such a relationship, offer participants in the WHA opportunities for new insights or other points of view not always discussed in the plenary and sub-committees of the Assembly. These events are also used occasionally to demonstrate support for a particular area in global health or in shifting direction. Networking is an asset in such gatherings, and often around good Swiss or French wine and a rich buffet.

Such was the meeting convened Monday by the World Health Professions (WHPA), representing more than 26 million health professionals in 130 countries. The objective was the launch of a new campaign. The group — uniting nurses, pharmacists, physical therapists, dentists and physicians — warned that the global epidemic of non-communicable diseases (NCDs) had become a significant threat to human health and development and “unless urgently addressed, the burden of NCDs would continue its dramatic increase.”

They argued that what is needed is a single strategy to prevent and manage NCDs including: cardiovascular disease, cancers, respiratory diseases, diabetes, mental disorders and oral disease. They informed us that these diseases combined accounted for more than 60% of global deaths, killing 36 million people in 2008, many prematurely.

People die of NCDs because of four main risk factors: tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. It is crucial to tackle the social determinants of health that contribute to the increase in the NCD burden.

There is a good reason why are NCDs discussed more vigorously now. Under the leadership of Dr. Ala Alwan, assistant director-general for Non-Communicable Diseases and Mental Health of WHO, a U.N. High Level Meeting on NCDs will be held at U.N. headquarters in New York in September. The aim of this meeting, with participation of heads of states and leading global health organizations, is to move towards a consolidated effort in reducing the burden of NCDs globally through added funding, change in policies and a shift in attitudes on developing countries.

The NCD summit makes organizations vested in infectious diseases, and particularly HIV/AIDS, malaria and TB, very anxious. They fear that a successful campaign may shift funds globally and locally to NCDs.

WHPA leaders were quite blunt in supporting the NCD campaign. Here are some of the reactions I heard:

Jean-Luc Eiselé, executive director of the World Dental Federation: “… WHPA NCD advocacy and awareness-raising campaign will address the importance of positive individual behavioral changes and support national interventions targeting social determinants of health.”

Ton Hoek, general secretary and chief executive officer of the International Pharmaceutical Federation: ‘”WHPA is highlighting the importance of a health system built on a primary health care model and including prevention, rehabilitation and specialized health services, as vital if the NCD epidemic is to be tackled.”

Dr. Otmar Kloiber, secretary general of the World Medical Association: “Attention must be paid to the social determinants of health that contribute to the increase in the NCD burden, especially access to health care, changes in lifestyles, housing issues and gender-related inequalities.”

Brenda Myers, secretary general of the World Confederation for Physical Therapy: “Health professionals can support patients and the public to avoid tobacco use and harmful alcohol consumption, improve diet, undertake regular sufficient physical activity, achieve and maintain healthy weight, aim for optimal mental health, manage tension and stress, and access preventive care and screening for preventable illness.”

Switch “NCD” and “HIV/AIDS” in the above statements and you get a great advocacy piece similar to those lobbying for increased funds for the “three big ones: TB, malaria and AIDS”.

Interestingly the WHPA NCD campaign is supported by the International Federation of Pharmaceutical Manufacturers & Associations.

Are we at the beginning of a major global fight between NCD campaigners and infectious diseases campaigners, or is there a way to calm the anxiety and offer a synergistic approach? I doubt it is possible to avoid the conflict.

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