What causes 63% of all deaths in the world? If you guessed AIDS, tuberculosis or malaria, you'd be wrong. It's actually non-communicable diseases, with the top four being cancer, diabetes, heart disease and lung disease. It costs governments billions of dollars in both healthcare costs and loss in worker productivity, and that's just one of the many reasons why a delegation of heads of state, ministers of Foreign Affairs and Health, and representatives from NGOs (non-governmental organizations) met at the UN in New York City last week.
It may sound like just another day at the office for politicians, but a UN Summit is actually a pretty big deal! The first (and last) time the UN's General Assembly met to discuss a health issue was in 2001, when a special session of high-level delegates discussed how to proactively fight the alarming epidemic of AIDS. And yet despite the overwhelmingly dangerous impact that non-communicable diseases have on society, the UN Summit on Non-communicable Diseases (NCDs) ended with more of a whimper than a bang.
NCDs are expected to cost the world $47 trillion by 2030! — yet it ended up being a huge struggle to get governments on board with targets for action.
Although a declaration adopted at the UN Summit laid out the economic and social importance of eradicating chronic disease, it didn't actually provide concrete targets. Instead, this political declaration included suggestions, such as promoting healthier diets, tobacco-free workplaces, access to cancer screening programs, and breast-feeding for about six months from birth. But the declaration did not set any actual metrics to show progress, such as reduction in mortality by a certain deadline. It's one thing to say you're going to do something, but quite another to actually implement a method to measure the promised outcomes!
"This was always going to be complex," says Ann Keeling, CEO of the International Diabetes Federation and Chair of the Non-communicable Disease Alliance. "The Summit was about four diseases and four common risk factors. Governments were slow to establish their political positions. Many governments were not up to speed on these issues. The Summit has brought them up to speed. This was one reason why governments ran out of time when agreeing on targets. They have now deferred this to 2012." One example of a measurement is in reducing deaths by 25% by 2025, as promoted by the advocacy hashtag #NCDs25by2025 that went viral on Twitter in the weeks before the Summit.
Ann says that although the UN Summit might look unproductive, it was actually a very impressive show of commitment.
"Although we didn't get everything we wanted, governments made the first-ever political declaration and committed to action," she says. Originally the UN hesitated to give Summit organizers more than one day to meet, because they thought no one would be interested (!) Turns out, lots of people are interested in having healthy, productive countries! (Ya think?
) Twice as many governments asked to speak at the Summit as originally expected. "The UN reckoned that only 60 would want to make statements, but in the end over 130 opted to speak, which was very significant in itself," Ann says.But with the current economic problems in the U.S., Europe and China, it may have just been poor timing for governments and NGOs to commit to specific actions."The kinds of programs needed to enforce behavior change, such as implementing reforms in the food and tobacco industries, will require a great deal of legislation and manpower," Ann says. "The global financial crisis made some governments resistant to any measures that might involve new expenditure. By the end of the Summit, I think most had got to the point where prevention and early detection/treatment of NCDs represent the best possible investment — and this is the morally right thing to do."Ann believes that in the short term, more countries and official agencies will need to focus on providing medicine and technology to the 100 million people who don't have regular or reliable access to things like insulin or glucose meters, the kinds of things that the IDF's Life for a Child
program provides."They need to do some hard thinking about how you do that when the health systems are very weak," Ann says.As for the O for Outrage campaign
that we PWDs were all clamoring to support this summer, that appears to have fallen on deaf ears. When we inquired as to whether the White House responded, IDF PR director Sarah Webber said, "We have not yet received any feedback."What's the deal, Obama Administration?!
Isn't there somebody in the oval office (or mail room over there) who could at least acknowledge the 2,000+ postcards received from the diabetes community? OK, on a global scale, that's not so many people, I guess, but we're giving it our all.
So did the Summit actually accomplish anything? Yes and no. (We don't happen to agree with some critics that the Summit was a sham
.) As Ann Keeling has pointed out, we called attention to NCDs and "got them on the agenda
."But it's clear that these problems are decades
in the making, and it's likely going to take just as long before we finally see real results of any kind. So here's our rallying cry: We as the PWDs of the world need to continue to advocate for changes in public policy and let our respective governments know that this is a critical issue. The best way to do that is probably to support the efforts of the International Diabetes Federation and its partners at the Non-communicable Disease Alliance
. Who's with us? (You too, ADA?!)