Initially slow to react to this growing public health challenge, countries finally adopted a Political Declaration on NCDs at the United Nations in 2011. In 2013, the World Health Assembly endorsed the WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020. The nine voluntary targets for 2025 against a baseline from 2010 is the centrepiece:
Target 1: A 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases.
Target 2: At least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context.
Target 3: A 10% relative reduction in prevalence of insufficient physical activity.
Target 4: A 30% relative reduction in mean population intake of salt/sodium.
Target 5: A 30% relative reduction in prevalence of current tobacco use in persons aged 15+ years.
Target 6: A 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national circumstances.
Target 7: Halt the rise in diabetes and obesity.
Target 8: At least 50% of eligible people receive drug therapy and counselling (including glycaemic control) to prevent heart attacks and strokes.
Target 9: An 80% availability of the affordable basic technologies and essential medicines, including generics, required to treat major noncommunicable diseases in both public and private facilities.
Subsequently, the control and management of NCDs was brought into the centre of the 2030 Agenda for Sustainable Development. SDG 3 seeks to “ensure healthy lives and promote well-being for all at all ages”. Specifically, target 3.4 commits to reduce by one-third premature mortality from non-communicable diseases through prevention and treatment. Target 3.8 aims for “universal health coverage, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all”. This has immense implications for NCD related promotion, prevention and treatment interventions.
The 2030 Agenda asks for “no one to be left behind” and calls for “those furthest behind now”, i.e., the poorer and more vulnerable populations, to be given priority attention. This is both a moral issue and a necessary response to the mood of the turbulent age we live in, where we have growing discontent over widening inequalities at a time of unprecedented accumulation of wealth, knowledge, and capabilities that should benefit everyone.
The WHO’s 2014 Global Status Report on NCDs describes the constraints and challenges for lesser developed countries including the lack of national policies, health system capacities, availability and affordability of medicines, and financing. The WHO Director General, Dr Tedros Adhanom Ghebreyesus has called for “changing the NCD paradigm” through choosing healthy policies right across the national policy spectrum, recognising that “all roads lead to Universal Health Coverage”.
Accordingly, the Partnership strives to advance UHC in resource-poor countries by tackling NCDs in a systematic and sustained manner through nationally led health policies, and systems, and driven by their own National NCD Action Plans. The WHO-recommended “best-buys” for NCD management are being pursued.