Non-Communicable Diseases: Beyond International Health (II)
The first United Nations High-level Meeting on Non-Communicable Diseases recently took place in New York and culminated with government leaders pledging to make greater efforts to address the NCD challenge, enshrined in the official declaration of the summit. Among the commitments were implementing tax measures to reduce tobacco and alcohol consumption, improving access to vital medicines, and pushing for universal health coverage.
While the unanimously-approved declaration has been lauded as an important step forward by some, criticism has been equally pronounced. Among them was the assessment that a major barrier to overcoming the NCD challenge is a lack of enthusiasm from the developed world. It was simultaneously noted that this also opens a unique window of opportunity to emerging economies to lead the effort. Brazil, Russia, India, China and South Africa have high NCD burdens and it was argued that although these countries could use this as a springboard for greater advocacy, there remains no strong indication that they are ready to undertake this endeavour.
Others have claimed that the declaration was watered-down from the originally proposed call to action and that the document did not specify targets, unlike the declaration that resulted from the 2001 HIV/AIDS summit. Doubts were expressed about the possibility of generating political will, financial investment and social momentum towards access to affordable medications to treat NCDs; contrasting the Global Fund to Fight AIDS, Tuberculosis and Malaria’s USD 22.4bil funding to a lack of financial commitments towards addressing NCD challenges.
Some critics have been particularly skeptical, calling the summit “a whimper rather than a bang”. This “whimper” was attributed to various factors including the effects of the global financial crisis on public health expenditure, links between technological and economic progress and the rise of NCD risk factors, and world leaders’ readiness to pay lip service to the cause but unwillingness to make accompanying political commitments. This is particularly distressing in light of the World Health Organization (WHO) saying that USD 1.20 per person per year in cheap interventions could dramatically reduce the occurrence of NCDs worldwide.
There is no doubt that the implications of the rise of NCDs will continue to extend beyond the purview of health, posing greater challenges to human security worldwide. The socio-economic opportunity costs of the globe’s 36 million NCD deaths (of which nine million occur among those under the age of 60, and 90 per cent occur in developing countries) has severe and far-reaching ramifications for international development, growth and prosperity.
It can also be argued that difficulties in mobilising support to fight NCDs can be linked to the nature of NCDs themselves. Many NCDs are associated with lifestyle and consumption factors, and cannot simply be cured by developing a vaccine or drug. Political, let alone financial support is difficult to generate given this lack of a clearly defined or certain pathway to cure. It remains to be seen whether the current wave of political momentum on the NCD issue will be sustainable over the coming years given the unique set of challenges it faces.
