2018 UN high level meeting on NCDs: Key outcomes and flaws

Since its first ever edition in 2010, the UN High Level Meeting on NCDs has proved to be the high decision-making and most influential platform to discuss how governments can tackle Non Communicable Diseases (NCDs) and shape the future in terms of prevention and control.

The historic event usually takes place on the sidelines of UN General Assembly after every four years.  2018 edition was the third one.

The reason behind hosting this forum during the UN General assembly is to leverage the presence of Heads of State and other global leaders to recognize the socio-economic burden of NCDs, to seek for political support and forge the road-map to beat them.

On September 27, on the margins of the 73rd UN General Assembly in New York, all eyes were on the heads of state to see what would come out from the special political event, this time, not about anything else but rather a global public health subject – the Non Communicable Diseases.

The civil society and other advocates for NCDs were highly expectant of world leaders to deliver on bold commitments about financing and investing in prevention and control of NCDs, and implementing WHO best buys to curb the premature deaths caused by these diseases.

The heads of state committed to a number of actions, including to implement a series of WHO-recommended policies to prevent and control NCDs such as public education and awareness campaigns to promote healthier lifestyles, vaccinating against HPV virus to protect against cervical cancer and treating hypertension and diabetes.

WHO estimates that implementing all these policies could generate US$ 350 billion in economic growth in low and lower-middle-income countries between now and 2030.

Other specific commitments focus on halting the rise of childhood obesity, promoting regular physical activity, reducing air pollution and improving mental health and wellbeing.

But, the civil society and other health advocates – including myself – were far from being impressed and heavily criticized about the outcomes of this gathering. They didn’t shy away from calling it a “squandered opportunity” to beat these preventable diseases. 

Led by the NCD Alliance, a statement dubbed “ENOUGH” was made to respond to what they called “Unambitious and disappointing” political declaration.

Why is the 2018 UN High Level Meeting on NCDs largely considered a missed chance to make significant progress in achieving health related goals by the NCD community?

1. Persistent lack of political will

The World Health Organization and the Civil Society have done their job to lobby for increased presence of heads of state and their active participation in the discussion, but only 23 attended the meeting. This lack of interest reflects how political leaders do not give enough attention to health issues.

It also shows that political leaders still think that health is about expenses, while spending and investing for healthier lives of people actually generates high economic returns on investment.

It is high time for us (public health advocates) to communicate public health issues in an economic and political language that will easily be understood by policy makers and Heads of State. It is definitely a skill that we need to learn.

2. Lack of plans for sustainable financing for NCDs

In the wake of the worst period of the HIV epidemic in 1990’s and early 2000’s, the world responded responsibly to the fight against the disease by establishing the Global Fund for HIV, Malaria and TB to mobilize resources and craft strategies for effective financing. And this changed drastically, the HIV landscape from a death-sentence back then to a now manageable disease.

The global community was expecting a similar model to finance NCD interventions especially in developing countries where the epicenter of NCDs is. I think 2018 is a regret for our leaders to have not bought into this ideal model for NCDs as well.

3. No mention of integration of NCDs management in the primary healthcare

NCDs diagnostics, treatment and medicines remain a challenge to most people especially the poor. Many people struggle with entrenched poverty caused by heavy bills on health expenditures and this contributes to social injustice across the world.

Reluctance or failure to integrate NCDs in primary healthcare not only jeopardizes the achievement of Universal Health Coverage by 2030 but also continues to endanger lives of people who are living with or are at risk to suffer from NCDs.

We need to look beyond the UN High Level meeting and continue advocating, and lobbying for multi-stakeholders and multi-sectorial partnerships to fight NCDs, which are most of the times, preventable and curable diseases.

The 2019 UN High Level Meeting on Universal Health Coverage sets to be a platform to resume unfinished business of the UN HLM on NCDs. It will again be an opportunity to speak out to our leaders to further commit and deliver on bold and evidence-based interventions and actions tailored to end NCDs.

The writer is the CEO of Unitia Pharmaceuticals.