AGENDA ITEM GOES HERE IN CAPITALS

Title goes hereAlignment of International Cooperation and National NCD Plans

WHO GCM Working Group, 22 June 2016

Ms Katie DainExecutive Director, The NCD Alliance

Overview

The global agenda – NCDs and development cooperation

The implications – in theory and then reality

Recommendations for action

WEBINAR, 22 JULY 2015

Update from 68th

World Health Assembly

The NCD Alliance…Who We Are

Founded in 2009 - by IDF, UICC and WHF

Now 7 global federations / organisations

With 15 supporters – private sector and NGOs

A network of 2,000+ member associations in 170 countries

45+ national / regional NCD alliances

A Unique Civil Society NetworkLeading the way to a world free of preventable NCDs

About Us

WEBINAR, 22 JULY 2015

Update from 68th

World Health Assembly

The Global AgendaNCDs and Development Cooperation

The Global NCD Agenda

• Global political commitment for NCDs – UN Political Declaration on NCDs, 2011;

• A vision for what we want to achieve – WHO 9 global NCD targets and 25 indicators, 2013;

• A global roadmap to achieve them– WHO Global NCD Action Plan 2013-2020;

• A shift from global to national - National time-bound commitments on NCDs, 2014.

“Progress at the national level on NCDs has been insufficient and highly uneven”

National Commitments – UN Review on NCDs, 2014

By 2015, set national targets for NCDs

By 2015, develop national multisectoral policies and plans

By 2016, implement best buys to reduce risk factors for NCDs

By 2016, implement best buys to enable health systems to respond

4 time-bound commitments:

The Development Cooperation Agenda

• The vision for sustainable development –UN Agenda 2030 for Sustainable Development (SDGs), 2015

• The means to achieve it – Addis Ababa Action Agenda (AAAA), 2015

• The principles for effective aid and good development – Busan Partnership for Development Cooperation, 2011

17 goals

169 targets

15years

NCDs in the SDGs - Agenda 2030

Agenda 2030: 17 Goals

2030 Agenda: Goal 3 on Health and Wellbeing

3.1 Reduce global maternal mortality ratio to less than 70 per 100,000 live births

3.2 End preventable deaths of newborns and children under 5 yrs

3.3 End epidemic of AIDS, TB, malaria, NTDs, hepatitis, water-borne diseases

3.4 Reduce by one third premature NCD mortality, promote mental health & well-being

3.5 Strengthen prevention and treatment of substance abuse

3.6 Halve the number of global deaths and injuries from road traffic accidents

3.7 Ensure universal access to sexual and reproductive health-care services

3.8 Achieve universal health coverage

3.9 Substantially reduce no. of deaths and illnesses from hazardous chemicals and air pollution

3.A Strengthen implementation of WHO FCTC

3.B Support R&D for vaccines and medicines for CDs and NCDs

3.C Substantially increase health financing and health workforce

3.D Strengthen capacity of all countries for global health risks

Addis Ababa Action Agenda (AAAA) for Financing for Development (2015)

FinanceAid

TaxBusiness

Milestones of Aid Effectiveness

• 2002 Monterrey International Conference on FfD - Shift from focusing on volume of aid, to quality.

• OECD HL fora on aid effectiveness = Rome (2003), Paris (2005), Accra (2008), Busan (2011)

• Paris Declaration on Aid Effectiveness = include recipient governments in development cooperation/aid; shift from effective “donorship” to “partnership”; scorecard on aid effectiveness.

• Accra Agenda for Action = refined Paris principles; recognised civil society as key development stakeholders.

• Busan Partnership for Effective Development Cooperation = shift from traditional Western aid model to include south-south, triangular cooperation; from “aid effectiveness” to “development effectiveness” (trade, debt, foreign direct investment); created Busan Partnership; and four principles...

Busan Principles of Aid Effectiveness (2011)

Four Principles

1. Ownership of development priorities – recognizing that developing countries must design and drive their own development;

2. Focus on results – aiming at concrete outcomes that eradicate poverty, reduce inequality and ensure that the necessary resources and capacity are available to take these steps forward;

3. Inclusive partnerships – promoting mutual learning and trust among different development actors;

4. Transparency and accountability to each other – building on transparent ways of working to improve service delivery and clarify mutual responsibilities.

WEBINAR, 22 JULY 2015

Update from 68th

World Health Assembly

The ImplicationsTheory and Reality

In theory, NCDs and Development Cooperation now interlinked…

But in reality, there is still a major disconnect…

Disconnect in global health financing

Source: IHME DAH Database 2016

NCDs

HIV/AIDS

MNCH

Malaria

Other

TB

1

NCDs = 1% total DAH

($480 million)

Source: IHME DAH Database 2016

Funding concentrated on a few NCD areas

NGOs providing more aid for NCDs than bilaterals

DAH Spending on NCDs in LMICS by Funding Source

Disconnect in national development policies2

DAH disaggregated by source

Source: IHME DAH Database 2016

USA

UK

Gates

JapanGermany

France

Persistent myths on NCDs in development community

• Focusing on NCDs will detract from MDGs

• NCDs are diseases of affluence

• There are no cost-effective solutions

• It’s all about personal choice

Source: IHME DAH Database 2016

“NCD blindness” unethical in the context of LICs

Absence of an investment case for NCDs?

• Develop a shared responsibility agenda

• Shift focus from costs and expenditure to investments in NCDs that deliver results

Priorities for

investment

Cost of scaled up

action

Return on investment

Economic burden

22

9

1

6

19

27

0

5

10

15

20

25

30

NCDs Tobacco FCTC

Not mentioned

Mentioned

Lack of demand from LMICs?

Source: UNDP

Inclusion of NCDs in National Development Plans (NDPs)

Or aid effectiveness principles being undermined?

Ethiopia case study

• Developed national strategic action plan on NCDs. Political will and understanding of NCDs a development issue;

• NCDs included in Fourth Health Sector Development Programme 2011-2015. NCDs finally recognized as one of the top three health priorities;

• One of top receivers of DAH – yet donors not responding to prioritisation of NCDs as development priority.

Disconnect in health governance3

2015Countries with national NCD policies/plans

33%Countries with national NCD targets

31%

Insufficient national governance on NCDs

http://www.who.int/nmh/publications/ncd-progress-monitor-2015/en/

Source: OECD, Better Policies for Development, 2014

Importance of policy coherence for NCDs/SDGs

The “Three Ones” Principles of HIV/AIDS

Disconnect in monitoring and reporting4

• Lack of data on NCD resource flows – data helps incentivise investment and improve efficiencies

• Absence of NCDs in OECD Creditor Reporting System (CRS) – for ODA

• NCDs often missing in national health accounts – for domestic resources

The Creditor Reporting System of OECD/DAC tracks international aid flows (including Official Development Assistance), but has no code for NCDs

Examples of existing codes:

12262 – Malaria control

12263 – Tuberculosis control

13020 – Reproductive health care

13040 – HIV/AIDS

See http://stats.oecd.org/Index.aspx?DataSetCode=crs1

Absence of NCDs in OECD CRS

WEBINAR, 22 JULY 2015

Update from 68th

World Health Assembly

Recommendations

Recommendations

• Establish principles for alignment – country-led and ownership; focus on results; transparency and accountability;

• Look beyond aid – international cooperation includes trade, technology, capacity building; and south-south/triangular;

• Strong national governance on NCDs essential – national NCD plans, NCD commissions, and targets/surveillance systems;

• Translate SDGs into national development policies and plans – at both donor and recipient country level;

• Strengthen investment case for NCDs as development priority – how to integrate NCDs into existing programmes/service delivery platforms;

• Promote policy coherence – at national, regional and international levels;

• Improve data on resource flows for NCDs – NCD purpose in OECD CRS.