NCD and Mental Health

Oleg Chestnov ADG/NMHGauden Galea DNP

Global Process

World Health Assembly resolution WHA64.11

REQUESTS THE DIRECTOR-GENERAL TO:

(4) to report to the Sixty-fifth World Health Assembly, through the Executive Board, on the outcomes of the first Global Ministerial Conference on Healthy Lifestyles and NCD Control and the high-level meeting, and to develop, together with relevant United Nations agencies and entities, an implementation and follow-up plan for the outcomes, including its financial implications, for submission to the Sixty-sixth World Health Assembly, through the Executive Board.

(24 May 2011)

2000

2003

2004

2008

Global Strategy for the Prevention and Control of Noncommunicable Diseases

Global Strategy on Diet, Physical Activity and Health

Action Plan 2008-2013 on the Global Strategy for the Prevention and Control of NCDs

2010

2009

2011

Global Strategy to Reduce the Harmful Use of Alcohol

WHO Global Status Report on NCDs

Political Declaration on NCDs

20132020

The World Health Assembly has requested WHO to develop a'WHO Action Plan for the Prevention and Control of NCDs for 2013-2020'

WHO Action Plan for the Prevention and Control of NCDs for 2013-2020

South-East Asia

24-26 April 2012

Yangon, Myanmar

Americas

7-8 May 2012

Brasilia, Brazil

Eastern Mediterranean

30 June – 2 July 2012

Cairo, Egypt

Western Pacific

11-14 June 2012

Kuala Lumpur, Malaysia

Europe

28-29 June 2012

Astana, Kazakhstan

Africa

September 2012

Nairobi, Kenya

Process: Steps to dateRegional consultations based on a WHO Discussion Paper

2012• 26 July 2012 – 7 September 2012: Web-based consultation for Member States,

UN Agencies, NGOs and private sector entities (WHO Discussion Paper)

2012• 16-17 August 2012: First informal consultation with Member States and UN

Agencies (WHO Discussion Paper)

2012• 1 November 2012: Second informal consultation with Member States and UN

Agencies ('Annotated Zero Draft' Action Plan)

2013• January 2013: Executive Board (Annotated Draft Action Plan)

2013• February 2013: Third informal consultation with Member States and UN

Agencies (Draft Action Plan)

2013• May 2013: World Health Assembly (Final Draft Action Plan)

Process: Next steps

Regional Action

Reduction of Circulatory Mortality

Determinants• “Causes of the causes”:• Income• Education• Early Childhood

• Globalization• Demography

Risk Factors• Modifiable• Behavioral• Biological

• Non-modifiable• Genetics

Diseases / Conditions• CVD• DM• Cancer• CRD

Outcomes• Mortality• Morbidity• Poverty: cause

and consequence of NCDs

NCD Framework for Action

Health Promotion

Prevention Treatment

Whole of Society

Health Services

Workflow: ToolsetBest Buys and instructions for use

Each Tool• Evidence base• Basis for selection• “Instructions for

adaptation and use”

Activation Threshold. Project formally initiated only after national prerequisites fulfilled.

Workflow: Process1

• Integrated Needs Assessment

2• Tool Selection• Prerequisites

3• National

Investment

4• Initiation &

Capacity Building

5• Results

Comprehensive situation analysis. Baselines set. Targets agreed by WHO and country teams

Specific tools selected. Plan for adaptation.Country action PRIOR to initiation agreed

WHO and other partners invest in capacity and support implementation in agreed time.

Results are specific PRODUCTS defined in terms of OUTCOMES and IMPACT

Determinants Risk Factors Diseases Outcomes

Results: Example Product Areas

↑ Legislation↑ Communication↑ Capacity

↑ Service access↑ Service quality↑ Capacity

↑ Measurement

↓ Risky behaviour↓ Biologic risk

↓ Incidence↓ Complications↑ Survival

↓ Mortality↓ Poverty↑ Equity

Outcomes of joint action

Impact of joint action

Capacity [1] National Health Reporting

EUR B+C

NCD mortality 100%

NCD morbidity 100%

NCD risk factors 68%

Capacity to Disaggregate: Medium to Low

Capacity [2] Behavioural Risk factors

EUR B+C

Tobacco 88%

Alcohol 76%

Diet 76%

Physical inactivity 76%

Capacity [3] Biological Risk factors

EUR B+C

Overweight & obesity 76%

Blood pressure 84%

Blood glucose 68%

Blood lipids 44%

For discussion

Participation

How can CIS countries maximize their participation in the global consultation process?

Capacity

How can we build the NCD surveillance capacity of CIS countries?

Mental Health Consultation:Global and Regional Action PlansOslo, Norway, 3-5 September 2012

Global Mental Health Action Plan

Resolution WHA 65.4 in May 2012: global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level.

Challenges:• 13% of global burden of disease.• 40-60% higher risk of premature death.• Estimated lost economic output next 20 years:

$16trillion (World Economic Forum).

Objectives Global Mental Health Action Plan1. Effective leadership and governance.2. Mental health and social care services in community

based settings.3. Mental health promotion and protection that span the

life course.4. Strengthen information systems, evidence and

research.

Each with global targets.

European Mental health Action Plan

Requested by Member States, builds on and customises the Global Action Plan, addressing European needs and priorities:

1. Optimize wellbeing at times of economic distress, particularly those most at risk.

2. Focus on empowerment and social inclusion.3. Provide accessible and affordable services.4. Guarantee respectful and effective treatments.

Targets being developed.

Process

Sep• Joint Political consultation, Oslo, Norway

Nov• Global Consultation

May• WHA: Global Mental Health Action Plan

Sep• RCM: European Mental Health Action Plan

Thank You!