NCD Prevention Challenges and Opportunities A Canadian Perspective

1
NCD PreventionChallenges and OpportunitiesA
Canadian Perspective

• Global Forum on NCD Prevention
• and Control
• Rio de Janeiro, November 9, 2003
• Sylvie Stachenko

2
Present Reality

• Rapid rise of NCDs worldwide
• Challenge for global development
• Effect of globalization
• Impact on low and middle- income countries
• Need to take global action
• Need to move NCD prevention from important
  and not urgent into important and urgent

3
Myths Misconceptions

• NCDs perceived to be
• The preserve of wealthy countries and
  populations
• Not preventable
• Affecting mainly the elderly
• Treatable with modern medicine

4
Making the case for NCD prevention Building on
International Experiences

• Key Messages
• NCDs are a threat to all countries
• Prevention can be effective
• Failure to prevent will lead to greater burden
  and rising costs associated to NCDs

5
Vast body of knowledge on NCD prevention
existsBut not well communicated

• Successful community-based NCD preventive
  projects in both developed and developing
  countries
• Putting present knowledge to work
• Need for inventory of best practices for NCD
  prevention (e.g., case studies)
• Exploiting better these international success
  stories for visibility and communication
  purposes

6
Lessons Learnt

• Comprehensive population approaches
• Key focus on policy and environmental change
• Involve multiple settings
• Link to PHC services
• Link to supportive national policies
• Supportive infrastructure for monitoring and
  evaluation
• Importance of preventive dose
• Need for sustained and integrated efforts

7

• Can the projected increased toll of NCD worldwide
  be arrested or reversed?

8
Progress in Global Response

• Policy
• WHA Resolutions
• WHO Global Strategy for NCD Prevention and
  Control (May 2000)
• Development of WHO Global Strategy on Diet,
  Physical Activity and Health
• Norms and international legal instruments
• Framework Convention on Tobacco Control
• Surveillance
• NCD Surveillance WHO STEP Approach
• Advocacy
• International NGOs
• Broader alliances
• Capacity Development
• Regional Networks
• CINDI, CARMEN,
• WHO Collaborating Centres

9
Some Continuing Challenges

• Lack of national policies for NCD prevention and
  control
• Low resources - only 1/3 of countries have a
  budget line for NCD prevention control.
• Lack of NCD surveillance systems
• Fragmented and uncoordinated care
• PHC capacity to deal with NCDs is poor

10
The Global ForumAreas for Action

• Building and disseminating the knowledge base
  for NCD prevention
• Priority action on NCD common risk factors
• Strengthening Capacity
• Surveillance and Monitoring
• Strengthening NCD management and Care Services
• Expanding Partnerships

11
(No Transcript)
12
Canadian Investment in NCD Prevention to date

• Single diseases - Canadian Heart Health
  Initiative, Diabetes Strategy, Cancer Strategy
• Single risk factors - Tobacco Strategy
• Specific population groups - Children Strategy
• Commonality of risk factors for major NCDs
• Systems approach to delivery
• Partnerships

Towards an integrated approach to NCD
preventionnew wave of CARMEN/CINDI demonstration
sites
13
Building the Knowledge Base

• Importance to act now on what we already know
• National Best Practice Consortium for
  Integrated Chronic Disease Prevention and
  Health Promotion
• Supportive infrastructure for NCD preventive
  research
• CIHR
• Health Promotion Research Consortium
• New demonstration sites to evaluate and
  monitor integrated NCD prevention approaches

14
Strengthening Capacity

• Established governmental focal points for NCD
  both at national and provincial levels
• Enlarge public health capacity in NCD prevention
• Training Systems
• Coalition building
• Communication

15
Surveillance and Monitoring

• Development of a pan-Canadian strategy for
  integrated surveillance system for chronic
  diseases
• Which accommodates existing initiatives building
  on disease and risk factor surveillance systems
  but focussing on coordination among different
  levels and jurisdictions
• Stronger emphasis on data analysis,
  interpretation and dissemination

16
Towards a Integrated Healthy Living
StrategyInitial Focus on Diet and Physical
Activity

• Population Approach
• Intersectoral approaches
• Comprehensive, collaborative and in
  partnership with national, P/T, and NGO/NVO
  stakeholders
• Combined with
• High risk approach and disease specific
  strategies
• Canadian Diabetes Strategy
• Strategy for high risk groups (eg. obese,
  aboriginals)
• Includes primary, secondary and tertiary
  prevention

17
Partnerships are Key

• Multiplying resources and capitalizing on shared
  experience
• National Level
• Chronic Disease Prevention Alliance of Canada
• Canadian Institutes for Health Research
• International Level
• WHO Networks (CINDI and CARMEN)
• WHO NCD Policy Collaborating Centre
• Bilateral co operations

18
Global Forum

• Useful platform to scale up the NCD global
  response

19
Thank You!