Can CHOGM take the reins in the face of NCD disaster?

The 2009 CHOGM meeting held in Port of Spain joined the call to put NCDs on the global agenda. AAP

CHOGM: As the leaders of Commonwealth nations prepare to meet in Perth this week, The Conversation is examining the role of the biennial Commonwealth Heads of Government (CHOGM) Meeting.

In our latest piece in this series, Rob Moodie from the Nossal Institute for Global Health argues Commonwealth countries must work together to prevent a “slow motion disaster” when it comes to non-communicable diseases.

The Commonwealth Heads of Government (CHOGM) meeting later this week provides a unique opportunity to advance discussions about how to curb the spread of non-communicable diseases (NCDs) in these countries by working collaboratively.

Last month the United Nations (UN) General Assembly convened a High-level Meeting on the Prevention and Control of Non-communicable Diseases in New York.

At the time, Margaret Chan, Director General of the World Health Organisation (WHO) described NCDs as a “slow motion disaster… that is breaking the bank”.

At one stage during the meeting, the prime minister of Trinidad and Tobago asked attendees to raise their hand if they were affected or had a family member affected by NCDs – approximately a third of us raised our hands.

What are NCDs?

NCDs principally comprise cancer, diabetes, cardiovascular disease and chronic respiratory diseases.

They share four main risk factors — smoking, unhealthy diets, physical inactivity, and the harmful consumption of alcohol.

NCDs are no longer problems just facing old people in wealthy countries.

These diseases currently account for more than all other causes of death combined, and are estimated to have been responsible for 36 million deaths, or 63% of all deaths globally, in 2008.

They disproportionately affect the poor in low- and middle-income countries, which includes many Commonwealth countries.

Significantly, NCDs kill at a younger age in lower income countries — 29% of NCD deaths in these countries occur among people under the age of 60, compared with 13% in high-income countries.

Kamla Persad-Bissessar, Prime Minister of the Republic of Trinidad and Tobago, addresses the high-level meeting on NCDs. UN

Getting on the agenda

In 2007, Caribbean countries encouraged the UN General Assembly to have the High Level Meeting on NCDS (it is only the second time in the UN’s history that a health issue has been dealt with by the General Assembly).

The 2009 CHOGM meeting held in Port of Spain joined the call.

Representing nearly one third of the world’s population, the 54 member states of the Commonwealth provide an eclectic experience of NCDs.

The Pacific and Caribbean countries are particularly badly affected with very high levels of risk factors, such as overweight, obesity and tobacco smoking.

But despite the huge disease and economic burden of NCDs, only 3% of development assistance goes to their prevention or treatment.

If we are to act according to the evidence, then increases in development assistance for health have to be channeled to NCDs.

What’s more multilateral agencies such as the WHO need to be strengthened if they are to act on the globe’s behalf to prevent and control NCDs.

Share and share alike

The battles against NCDs won’t be won with words. They need resources and skilled people, which the member states of the Commonwealth possess and can share.

After all, the Commonwealth should really be sharing knowledge and experience.

Countries such as the United Kingdom, Canada, Australia, Singapore and New Zealand are donor countries with considerable expertise in NCD prevention and control.

Meanwhile, countries such as Malaysia, have burgeoning expertise in NCDs thorough their Health Promotion Board.

Large countries, such as India with world class institutions like the Public Health Foundation of India, Bangladesh with ICCDR, and Pakistan with non-governmental organisations, such as HeartFile, have high levels of impressive expertise in tobacco control and curbing cardiovascular disease.

South Africa is contemplating the development of a Health Promotion Foundation based on the VicHealth (earmarked tobacco tax) and Thai Health (tobacco and alcohol surcharge) models as ways of increasing resources at the same time as diminishing demand for unhealthy products.

But what we don’t need are situations such as what happened during the development of national alcohol policies of four Commonwealth countries Lesotho, Malawi, Uganda and Botswana.

This process was sponsored by alcohol producer SABMiller and the International Center on Alcohol Policies, an alcohol industry-funded organisation – and carried out by an Australian consultant!

To date CHOGM has been instrumental in getting NCDs onto the political agenda.

Even though NCDs have to be dealt with by individual countries, the commercial and industrial drivers of these epidemics can only be dealt with by international networks - and the Commonwealth has a very important role to step up to for this.

Read more:

Our complex relationship with India

That sinking feeling: will the Pacific be heard at CHOGM 2011?

A long line of discrimination, but should the succession to the throne be changed?

Why the Commonwealth must take action against Sri Lankan war crimes

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