Fighting Noncommunicable Diseases: How Physicians Can Help

Neil W. Schluger, MD

Disclosures

September 15, 2011

In This Article

Editor's Note:

Neil Schluger, MD, is the Chief Scientific Officer for the World Lung Foundation, an organization that works to prevent and manage lung disease worldwide, and a partner of the NCD Alliance. Dr. Schluger has written this article in advance of the United Nations High-Level Summit, which will take place September 19 and 20 in New York City. The NCD Alliance and its member organizations campaigned for the summit as a means to bring global awareness to the growing threat of noncommunicable diseases such as cancer, heart disease, diabetes, and lung disease.

The United Nations High Level Meeting on Non-Communicable Diseases (NCDs) will be held in New York later this month. This meeting was designed to add important global public health issues to the United Nations Millennium Development Goals, and it presented a tremendous opportunity for the global community to commit itself to action on many important diseases. NCDs such as cancer, heart disease, diabetes, and lung diseases kill about 36 million people every year, mostly in the world's poorest countries.

At the start of negotiations, experts from across the world envisaged heads of state gathering to agree on achievable targets for NCD reduction. As the process advanced, an allergy to accountability became evident throughout the entire international system. In August, news coverage and insider reports revealed that negotiations had completely broken down. The parties reconvened in early September and, thanks in part to the voice of civil society, the meeting has been salvaged. Kudos to lung health advocates in particular, who acted quickly and effectively to ensure tobacco control remained a central part of the solution.

We now expect that NCDs will, for the first time, be on the global agenda. Countries have also agreed to establish national NCD plans by 2013. In lung health, we made great strides: the final declaration document will include strong language on tobacco taxes, and a push to accelerate implementation of the world's first global health treaty, the Framework Convention on Tobacco Control. We also expect the first recognition of the role inefficient cooking stoves play in lung health. They cause some 3 billion people, especially poor women and young children, to be exposed to toxic particles that cause severe lung and respiratory conditions. Up until now this issue has been largely ignored.

Nevertheless this watershed event, which could help turn the tide against cancer, diabetes, heart disease and, of course, lung disease, has been watered down. Commentators like the British Medical Journal clearly identified lobbying behind the scenes, from the tobacco industry and other industry groups, that have systematically sought to weaken the outcome.

Leadership has been lacking from many rich countries. The United States, the European Union, Canada, and Japan, among others, who should be beacons of support and encouragement to the world's lower-income countries, largely retreated into the false comfort of vaguely worded promises. They all initially objected to language in the summit's draft declaration regarding increased tobacco taxes. Most of the final sticking points were related to trade and patent protection policies that would reduce the profits of drug companies. So where do we find leadership to monitor and guide progress?

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