This post was co-authored by Nalini Saligram and Sandeep P. Kishore
We were deeply perturbed to learn that the negotiations for the Outcomes Document of the UN High Level Meeting on Non-Communicable Diseases (NCDs), a mere month or so away, had stalled because member states failed to reach consensus.
To us, members of civil society, concerned world citizens, students, young professionals, watchers of the global NCD policy-level dialogue, and women worried about the future of our children, this does not bode well. At all.
We celebrated in May 2010 when the UN announced the high-level meeting on NCDs to be held in September 2011 at the General Assembly, and in December 2010 when member states collectively committed to a Modalities resolution and to an action-oriented Outcomes Document.
We participated with passionate interest in the Moscow deliberations in April and in every meeting in the lead-up to this UN summit. We cheered every publication, circulated every op-ed and heard every webcast. We read every word of the Zero Draft of the Outcomes Document when it became available June 23rd. We organized and mobilized and agitated. We have seeded a new global community of advocates. We’re proud of our united and mutually supportive efforts (see the Women for a Healthy Future petition).
We did our part to prepare for the UN Summit, but did our elected representatives in governments around the world really do theirs? By not agreeing to final language about what the world should do to tackle NCDs, our public leaders broke our trust.
The first sign of trouble came when the name of the UN Outcomes Document was suddenly changed to Political Declaration. The Outcomes Document had the promise of being action-oriented with commitments for which we could hold our governments accountable. A Political Declaration has the danger of being a set of platitudes, much political jargon and maybe some promises, with little clear accountability.
How can our leaders get away with not articulating clearly how the world would ensure that promises made are kept?
We agree with WHO’s Dr. Margaret Chan – what doesn’t get measured, doesn’t get done. Our world leaders should set measurable targets, or agree by when they will set them, if more time is needed for technical deliberation. The targets by the WHO are a good place to start. The same member states that are not agreeing to NCD targets committed just weeks ago to enabling HIV/AIDS treatment for 15 million people by 2015. Let us now commit to a 25% reduction in NCD mortality by 2025. The world, including civil society, will help make this happen.
But the disagreements now between the rich countries led by the US and EU and the rest of the world led by Group of 77 (G77), have reached an impasse. Financing, accountability, misperceived threats to trade and debates on access to NCD medicines have taken center stage. Failure to act to rectify this stalemate would be a human rights violation.
Yes, we realize that the current global economic climate means that some see NCDs as a new expense item in a shrinking global health budget or a threat to economic growth.
Reams of data, however, show it is not just cost-effective but cost-saving to tackle NCDs. The cost of inaction surges into the trillions of dollars.
And, on moral and ethical and simply human grounds, we can’t afford to ignore NCDs.
The fact is that 36 million people die from NCDs each year. That is nearly 100,000 people every day, 80% of these from the poorest countries.
And here is an incredible solution: NCDs are largely preventable through lifestyle changes. 80% of diabetes and heart disease, and 40% of cancers can be prevented by avoiding tobacco, increasing physical activity, and improving diet.
Our advice to member states? NCDs are complex, and you can’t do it all. Agree on the top 3 – 5 action items, set measurable targets, tell the world when you will achieve them, and get on with implementation. Experts have told us the top 5 priority actions. What you have to do is marshal the political will.
Having led many global health commitments to date, and as the world’s biggest investor in global health, the US government has a big voice in shaping NCD discussions throughout the world. And this role comes with heavy responsibilities.
We urge the US government to start from the basics, thinking of the impact of diseases on people everywhere, and how to improve health outcomes. That is smart foreign policy. Firmly tackling NCD risks at the global level serves everyone’s interest, even at home.
We are serving notice to the US — and the EU and Canada and Australia — that NCDs as a global health and development issue is here to stay because health is a basic human right. Let us not squander the incredible opportunity that the upcoming UN summit presents. Let’s not water this down to a mere World NCDs Day. We want real action and measurable outcomes.
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We are passionately engaged and determined not to duck our responsibility. We expect our leaders to do the same.
The world will not stop hearing from us on this.
Mr. Sandeep P. Kishore is Co-Chair of the Young Professionals Chronic Disease Network.
Dr. Nalini Saligram is Founder and CEO of Arogya World.
Neither author is involved with UN negotiations on the NCDs Outcomes Document.