WHO Western Pacific regional action plan for the prevention and control of NCDs (2014-2020)
Article information
This is an excerpt of the “Western Pacific Regional Action Plan for the Prevention and Control of Noncommunicable Diseases (2014-2020)” (RAP NCD) which has been endorsed by the Member States of the Western Pacific Region of World Health Organization (WHO) in October 2013. The Regional plan is fully harmonized with the Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013-2020). The regional plan calls for a systematic approach to NCD prevention and control. The plan provides a road map and a menu of very cost-effective interventions for all Member States and other stakeholders, to take coordinated and coherent action at all levels to attain the nine voluntary global target by 2025. The original version of RAP NCD is downloadable from the website (http://www.wpro.who.int/noncommunicable_diseases/WHO_NCD_RAP.pdf?ua=1).
In addition, there are NCD tools in the WHO homepage (http://www.who.int/nmh/ncd-tools/en/).
INTRODUCTION
The noncommunicable disease (NCD) epidemic is a serious threat to life, health and development in the Western Pacific Region. The major NCDs — cardiovascular diseases, diabetes, cancers and chronic respiratory diseases — account for more than 80% of all deaths in the Region. NCDs account for 50% of all premature mortality (under 70 years of age) in low- and middle-income countries in the Region.
In the Region, the burden of morbidity and mortality from NCDs occurs against a complex backdrop of globalization, rapid economic growth, unplanned urbanization, environmental degradation, climate change and growing inequities within countries. Changing lifestyles and increased purchasing power in some populations have led to a reduction in breastfeeding, fewer meals prepared at home, and increasing consumption of fast food, tobacco and alcohol. The marketing and promotion of unhealthy foods are changing the diets of children. In addition, greater use of motorized transport and the lack of space for walking and biking have reduced physical activity for many people and worsened air quality. All of these factors point towards a dramatic increase in an already high NCD burden.
The Western Pacific Regional Action Plan for the Prevention and Control of Noncommunicable Diseases (2014-2020) was developed in response to a resolution adopted at the sixty-second session of the World Health Organization (WHO), Regional Committee for the Western Pacific. The regional plan is fully harmonized with the Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013-2020) while adding the value of actions that build on regional achievements, contexts, opportunities and perspective.
RESPONDING TO THE CHALLENGE OF NONCOMMUNICABLE DISEASES
Effective governance is needed to address social, political and economic pathways that lead to reduction of NCD risk factors and chronic NCD conditions. But political leaders will need information, data and evidence that show how policies impact health and how cost-effective interventions can deliver a higher and more valuable yield in terms of public health vis-à-vis short-sighted economic gains.
It is recognized that countries vary in their infrastructure and in their capacity to implement all policy options and interventions. A set of very cost-effective interventions is summarized in Table 1.
The need for action to combat NCDs has been well articulated. Cost-effective interventions are available. A call for political action at the global level has triggered unprecedented awareness of the urgency of the NCD epidemic. Strategic and specific action that will result in effective policies, programmes and supportive environments is now of critical importance.
DEVELOPMENT OF THE REGIONAL ACTION PLAN
The Regional Committee for the Western Pacific, in resolution WPR/RC62.R2, requested the Regional Director to develop a regional action plan to address NCDs, in consultation with Member States and in collaboration with partners and stakeholders. The Western Pacific Regional Action Plan for the Prevention and Control of Noncommunicable Diseases (2014-2020) fulfils that mandate and is intended to guide the Region’s governments in strengthening their response to the NCD epidemic. The regional action plan draws upon global commitments contained in the Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Noncommunicable Diseases. The political declaration urges countries to integrate NCD prevention and control into their national health planning process and their development agenda by promoting, establishing or strengthening multisectoral national policies and plans for the prevention and control of NCDs.
COMPREHENSIVE GLOBAL MONITORING FRAMEWORK FOR THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES
The comprehensive global monitoring framework, including 25 indicators and a set of nine voluntary global targets for the prevention and control of NCDs, was adopted by the World Health Assembly (WHA66.10) in May 2013 and is presented in Table 2. Countries can develop their national targets in alignment with the global targets. Reports on progress achieved in attaining the nine voluntary global targets will be made in 2016, 2021 and 2026.
WESTERN PACIFIC REGIONAL ACTION PLAN FOR THE PREVENTION AND CONTROL OF NONCOMMUNICABLE DISEASES (2014-2020)
Overview
VISION: Governments and societies sustain their political and financial commitments to prevent and control NCDs so that these diseases are no longer a barrier to socioeconomic development.
MISSION: To scale up effective interventions to prevent and control NCDs through health-promoting environments.
GOAL: To reduce the burden of preventable morbidity and disability and avoidable mortality due to NCDs in the Western Pacific Region.
Overarching principles and approaches
Leadership and coordination
Prevention and control of NCDs need a “whole-of-government” and a “whole-of-society” approach. The health sector has to take the lead in evidence-based advocacy and monitoring. Beyond inclusion in national health plans, NCD prevention and control should be included in national development plans.
Human rights
NCD prevention and control strategies must be formulated and implemented in accordance with international human rights conventions and agreements.
Empowerment of people
Individuals, families, communities and societies should be empowered and involved in activities for the prevention and care of NCDs.
Evidence-based practice
Strategies for the prevention and control of NCDs need to be based on scientific evidence and public health principles.
Life-course approach
A life-course approach is key to the prevention and control of NCDs. The process starts with maternal health, including preconception, antenatal and postnatal care and maternal nutrition. In addition, proper infant feeding practices, including promotion of breastfeeding and health promotion of children, adolescents and youth, followed by promotion of a healthy working life, healthy ageing and care of NCDs for people in later life, are integral components of a life-course approach.
Multisectoral action
Effective NCD interventions require a number of combined elements including, as appropriate, meaningful community participation and engagement, supportive policy prioritization and settings, multisectoral collaboration, a health-in-all-policies approach and active partnerships among national authorities, nongovernmental organizations, academia and private sector.
Universal health coverage and equity
Good health is essential to sustained economic and social development and poverty reduction.
Access to needed health services is crucial for maintaining and improving health. At the same time, people need protection from being pushed into poverty because of the cost of health care.
Universal health coverage is defined as ensuring that all people have access to needed promotive, preventive, curative and rehabilitative health services of sufficient quality to be effective, while also ensuring that people do not suffer financial hardship when paying for these services. Universal health coverage has therefore become a major goal for health reform in many countries and a priority objective of WHO.
All people should have full access to health care and opportunities for the prevention and control of NCDs based on need regardless of age, sex, social status, presence of disabilities and the ability to pay.
Objectives and actions for Member States and WHO
The objectives of the Western Pacific Regional Action Plan for the Prevention and Control of Noncommunicable Diseases (2014-2020) are aligned with Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013-2020) for consistency and to help Member States adapt them to their national context.
In summary, the objectives are as follows:
To raise the priority accorded to the prevention and control of noncommunicable diseases in global, regional and national agendas and internationally agreed development goals, through strengthened international cooperation and advocacy.
To strengthen national capacity, leadership, governance, multisectoral action and partnerships to accelerate country response for the prevention and control of noncom-municable diseases.
To reduce modifiable risk factors for noncommunicable diseases and underlying social determinants through creation of health-promoting environments.
To strengthen and orient health systems to address the prevention and control of noncommunicable diseases and the underlying social determinants through people-centred primary health care and universal health coverage.
To promote and support national capacity for high-quality research and development for the prevention and control of noncommunicable diseases.
To monitor the trends and determinants of noncommunicable diseases and evaluate progress in their prevention and control.
Proposed actions for international partners
International cooperation and capacity strengthening:
Resource mobilization for the prevention and control of NCDs:
Monitoring and reporting progress
Monitoring and reporting of the Western Pacific Regional Action Plan for the Prevention and Control of Noncommunicable Diseases (2014-2020) will be fully aligned with the proposed monitoring of the Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013-2020) to harmonize the efforts. WHO is in the process of developing appropriate action plan indicators to monitor progress of implementation of the Global Action Plan for the Prevention and Control of Noncommunicable Diseases (2013-2020). These indicators, based on feasibility, current availability of data and capability of application across the six objectives of the global action plan, will be used to assess the progress made in 2016, 2018, and 2021.
Reports on progress achieved in attaining the nine global voluntary targets will be submitted in 2016, 2021, and 2026.
WHO will also update Annex 3 (menu of policy options) of the global action plan, which appears as Annex 1 of the regional action plan, as appropriate, to be considered through the Executive Board, by the World Health Assembly, in the light of new scientific evidence.
SYNERGIES BETWEEN NONCOMMUNICABLE DISEASES AND OTHER PROGRAMMES
There are many other conditions of public health importance that are associated with the four main NCDs — cardiovascular diseases, cancers, diabetes and chronic respiratory diseases. The other conditions include:
Other NCDs — renal, endocrinal, neurological, haematological, hepatic, gastroenterological, musculoskeletal, skin and oral diseases;
Mental disorders;
Disabilities, including blindness and deafness;
Violence and injuries
Some of these conditions are the subject of other WHO strategies and World Health Assembly resolutions. NCDs and their risk factors are also linked to communicable diseases, maternal and child health, reproductive health, ageing, and social, environmental and occupational determinants of health. The Western Pacific Regional Action Plan for the Prevention and Control of Noncommunicable Diseases (2014-2020) will explore potential synergies between NCDs and interrelated conditions to maximize opportunities and efficiencies for mutual benefit.
Notes
The authors have no conflicts of interest to declare for this study.