COMMENTARY

Docs Lobby UN to Take Action on Chronic Diseases

David J. Kerr, MD

Disclosures

July 25, 2011

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Hello. I'm David Kerr. I'm Professor of Cancer Medicine at the University of Oxford, and President of the European Society of Medical Oncology, which I represented at a recent United Nations (UN) Summit meeting held in New York. You may know that in an unprecedented move, for the second time only in its history, the UN is going to hold a high-level conference to discuss health, we hope, which will be attended by heads of state and prime ministers. The topic that will be discussed is chronic diseases and noncommunicable diseases.

The only time in the UN's history that it has met specifically to discuss health was around the AIDS epidemic. From that came UNAIDs and the extraordinary advances made globally against the AIDS epidemic. For those of us involved in chronic disease management, cancer, diabetes, cardiovascular disease, and respiratory diseases, we have come together to form an NCD (Non-Communicable Diseases) Alliance to lobby the UN Summit at the very highest level, so that action is taken when heads of state meet at the end of September.

The follow-up meeting allowed those of us involved in a societal sense to be able to push our views to the UN so that our input will be gathered and put to heads of state when they come to meet in the assembly at the end of September. We put together an action plan that calls for 10 different things -- a series of actions around leadership and international cooperation. Of course, we need to see the World Health Organization (WHO) at the forefront of this work, but we in the different societies would like to work with them to support each other. We would like to see a greater degree of international cooperation with those countries that have strong healthcare systems supporting countries with weaker healthcare systems, so that we exchange ideas and exchange knowledge, create and even up partnerships, and move forward that way.

We would like to see the NCD Alliance continue because how often do you come to room in which you find leading oncologists, leading diabetologists, leading cardiologists and respiratory physicians working together, singing from the same hymn sheet? Actually, we are usually lobbying against each other and competing for the same resources. At last, we have come together in what is a true partnership and alliance that seems very powerful.

The second area of action is about prevention. We want some very clear, crisp commitments from the summit and from global leaders. Of course, we need to improve our efforts in tobacco control, particularly in middle- and low-income countries. We would like to see dietary improvements with reductions in saturated fats, salt, and glucose. We would like to see better food labeling. We would like to see governments make efforts to reduce the harmful effects of alcohol. Of course, we would also like to see how we can work in partnership to improve levels of physical activity that are so important across the spectrum of chronic disease.

With respect to treatment, we need to strengthen healthcare systems. Rather than trying to deliver cancer care or cardiac care or to manage diabetes separately, we need to take an approach in which we work laterally or, as I heard one delegate at the UN say, to work diagonally to strengthen primary healthcare systems. In doing so, we will make an impact on all the chronic diseases that we are discussing and looking at. Of course, we need to improve accessibility to drugs, to affordable cancer care, to vaccines -- to the whole gamut.

A final set of commitments that we would seek from the UN and from our leaders is that following the summit meeting, we imagine there will be warm words. But we need action to come from this. Again, we would like to stay involved as the NCD Alliance to monitor how governments put these warm words into effective action so that we can report back to the UN and in a global sense, make real progress.

The numbers are extraordinary: 53 million deaths every year from the chronic diseases I mentioned, 9-10 million premature deaths every year in those under 60 years of age, which of course are incredibly harmful to any developing or burgeoning economy. In Europe, for example, 85% of all deaths are the result of chronic diseases that we have brought together in this alliance. It is an extraordinary problem, but one which is increasingly faced by the developing world. Two thirds of all deaths in the world today are the result of chronic diseases. We must face up to it.

Global leaders, who will be attending the UN meeting, please listen. Let's go beyond rhetoric. Let's go beyond the semanticism of clever words. Let's come up with action because the world demands it, our patients need it, and there is an opportunity for us to work together in partnership and do something which is extraordinary. As always, I would be happy to take any questions or respond to any comments. Thank you.

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