UN Summit on Non-Communicable Diseases (NCDs)

WCRF International was proud to represent the WCRF global network and cancer prevention by attending the United Nations High-Level Summit on Non-Communicable Diseases (UN Summit on NCDs) in New York in September 2011. This represented a once-in-a-lifetime opportunity to mobilise the world to take action to reduce rates of cancer and other NCDs.

About the UN Summit on NCDs
Facts about NCDs and nutrition and physical activity
How the WCRF Global Network has contributed to the UN Summit and its follow-up
WCRF International Response to the UN Political Declaration updated 18th Nov 2011
UICC Statement on UN Summit on NCDs
NCD Alliance Statement on UN Summit on NCDs
WCRF International Press Conference: UN Summit on NCDs

About the UN Summit on NCDs

Cancer is a non-communicable disease (NCD), which means it is not an infectious disease that can be passed directly from person to person¹.

Cancer, heart disease, diabetes and lung disease are considered to be the major NCDs because they are key causes of death and illness in all parts of the world.

In September 2011 there was a United Nations (UN) Summit on the four major NCDs. The last global health problem to be discussed at such a high level was HIV and AIDS ten years ago.

The fact that world leaders united to discuss what to do about cancer and other NCDs demonstrated the scale of this health and development challenge. It also signals that a global effort is needed to combat NCDs.

The aim of the UN Summit was to bring Heads of State and other representatives from the UN member states together to agree on commitments to tackle the growing global burden of cancer and other NCDs.

These commitments are agreed in an official Political Declaration, which details the commitments made by countries around the world.

The prevention of NCDs was one of the most important topics at the UN Summit because it is the only cost-effective solution in the long term.

WCRF International was engaged in a number of policy and advocacy activities leading up to the UN Summit to make sure that the Political Declaration included clear and measurable actions to address risk factors, such as unhealthy diets and physical inactivity, to help people around the world live longer, healthier lives free from cancer and other NCDs.

We will continue to press for global and national actions to make it easier for people to make healthier diet and lifestyle choices.

Watch a WHO video about NCDs below:

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Facts about NCDs and nutrition and physical activity

• The four major NCDs are: cancer, heart disease, diabetes and lung disease
  
• Globally, two in every three deaths are caused by NCDs
  
• NCDs are a serious problem in all regions of the world and affect high-, middle- and low-income countries alike
  
• NCDs share a number of common risk factors, such as tobacco use, obesity, unhealthy diets and physical inactivity
  
• There are evidence-based actions that, if implemented, will help tackle this important global health priority
  
• A commitment to prevent NCDs is the only cost-effective solution in the long term.

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How the WCRF Global Network has contributed to the UN Summit and its follow-up

WCRF International drives policy and advocacy activities on behalf of the WCRF global network, including our work to support the UN Summit on NCDs.

We shared our expertise in a number of ways to ensure we capitalised on this opportunity to promote the prevention of cancer and other NCDs through healthy diets, physically active lifestyles and the maintenance of a healthy weight.

Some of our key areas of work were:

• Leading the NCD Alliance Nutrition, Physical Activity and NCD Prevention Working Group
  
• Producing policy briefing papers to strengthen the advocacy efforts of like-minded organisations around the world
  
• Representing the WCRF global network and highlighting the importance of cancer prevention at the UN Civil Society Hearing on NCDs
  
• Contributing an evidence-based response  to the World Health Organization (WHO) online consultation on NCDs
  
• Mobilising the WCRF global network national charities in support of the UN Summit
  
• Working with our global science and policy colleagues to ensure high-level, expert-led promotion of NCD prevention
  
• Lobbying world leaders ahead of the UN Summit to ensure they are aware of the changes that will help reduce the burden of cancer and other NCDs
• Developing specific and measurable recommendations for action in the areas of obesity, food, physical activity, alcohol and multilateral governance for health. These will be targeted at the UN, WHO and Member States to ensure full implementation of the Political Declaration.

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WCRF International Response to the UN Political Declaration

November, 2011

The United Nations Political Declaration on the Prevention and Control of Non-Communicable Diseases (NCDs) provides a solid foundation for action to reduce the growing global burden of cancer, heart disease, diabetes and respiratory disease. We now look to world leaders and member states, the United Nations, the World Health Organization, and other key actors to set ambitious targets and to drive forward effective changes that will reduce rates of cancer and other NCDs worldwide.

The Political Declaration shows that world leaders are united in agreement that prevention must be the ‘cornerstone’ of the global response to NCDs. Central to the Political Declaration is the understanding that action is needed at many different levels and across many different sectors. Implementation of health-promoting cross-sector policies and actions to address the shared NCD risk factors of tobacco, unhealthy diets, physical inactivity and alcohol consumption would have a widespread and positive impact in terms of preventing cancer and other diseases.

We call on member states, the United Nations (UN) and the World Health Organization (WHO) to be bold and ambitious in setting global and national targets to reduce the burden of NCDs. This is one of the key outputs provided for in the Political Declaration, and, as recognised in the Declaration, these targets should push comprehensive and evidence-based concrete action to address the diverse and complex drivers of the NCD epidemic. Targets should include an overall reduction in the incidence of new cases of NCDs, a reduction in the prevalence of major NCDs and obesity, and global targets for the adoption of NCD action plans. The World Cancer Research Fund global network would like to see solid action in the following three key areas:

1) A united and co-ordinated global response to NCDs
National governments should work together with the UN and WHO to develop and commit to ambitious and comprehensive targets. Sound leadership across government to work with the full range of relevant UN agencies (e.g. FAO, WHO, UNDP) will then be required to promote and implement cross-sector action to meet these targets. This will ensure a co-ordinated, cross-border response to NCDs. All trade agreements and infrastructure development policies should be subject to health impact assessments and cross-sector food policy should address the full spectrum of nutrition-related issues (under nutrition, food security, over-nutrition, sustainable agriculture).

2) A strong global and national focus on reducing obesity rates
Obesity is an independent risk factor for most of the major NCDs and is the product of the modern obesogenic environment. While obesity shares many risk factors with other NCDs, specific action to tackle the drivers of the obesity epidemic will bring direct benefits in terms of reducing the global burden of NCDs.

We propose an overarching goal of year-on-year reduction in prevalence of obesity and overweight in all age groups to below 5% of the population or any population sub-group. To achieve this, comprehensive national obesity strategies, including cross-sector policies and legislative action in the areas of food and nutrition, physical activity and alcohol are key.

3) Solid commitment to improving diet, and physical activity levels, and to reducing alcohol consumption
We are calling for a number of clear targets for improving diets, physical activity levels and to reduce alcohol consumption levels. These goals will only be realised through comprehensive and co-ordinated global and national action:

• Plant Foods – population average consumption of non-starchy vegetables and of fruits to be at least 600g per day.
• Energy-Dense Food – average energy density of foods to be lowered towards 125 kcal per 100g and population average consumption of sugary drinks halved every 10 years.
• Dietary Salt – reduction of mean population intake of salt to less than 5 grams per day.
• Total Fat – limit total fat to 15-30% of energy intake.
• Trans Fat – total elimination from the food supply by 2020.Saturated Fat – limit saturated fat intake to less than 10% of energy intake.
• Sugars – limit intake of free sugars to less than 10% energy.
• Physical Activity – proportion of the population that is sedentary halved every ten years.
• Alcohol – proportion of the population drinking more than the recommended limits reduced by one third every 10 years

All of the above recommendations are in line with those developed by the NCD Alliance expert working group on Nutrition, Physical Activity and NCD Prevention, which WCRF International chairs. For more detail about the recommendations, please see our forthcoming publication Nutrition, Physical Activity, Alcohol, and NCD Prevention: From Ambition to Action, which will soon be available to download from wcrf.org. The working group previously developed a briefing paper setting out the evidence for action to prevent NCDs through changes to food, nutrition and physical activity.

Marilyn Gentry, President of the World Cancer Research Fund (WCRF) global network, said: “The Summit was truly a landmark in the history of global health and put non-communicable diseases (NCDs) firmly on the international agenda. It was only the second time a UN meeting of this level has addressed a health issue and this reflects the fact that NCDs affect every country, from the richest to the poorest.

“I have been pleased to see the Summit acknowledge the importance of prevention in tackling NCDs, as prevention is the simplest and most cost-effective solution to minimise the societal and personal impact of diseases such as cancer.”

Dr Kate Allen, Director of Science and Communications for WCRF International, said: “We are pleased that the Political Declaration demonstrates real understanding of the impact that elements of the modern environment can have on people’s ability to make healthy choices that can reduce risk of cancer and other NCDs. We are also encouraged by the commitment to develop cross-sector action at the international, regional and national level, as many of the drivers lie outside of the control of national ministries of health.

"The Political Declaration should be seen as a starting point for action. We will continue to push for clear and ambitious global and national targets and meaningful changes, as outlined in our post-Summit recommendations, to promote the sort of comprehensive and effective actions the world so badly needs to reduce the burden of NCDs."

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UICC Statement on UN Summit on NCDs

September 19, 2011

The Union for International Cancer Control, which WCRF International is a member of, today issued the following statement about the UN Summit on NCDs:

Every month 600,000 people die of cancer, which with the right strategies, could otherwise be prevented or treated.

In response to this situation and the epidemic of other non-communicable diseases (NCDs), the United Nations (UN) authorised a High-Level Meeting (HLM) to address the prevention and control of these diseases. The outcomes document generated by the HLM - known as a Political Declaration - is only the second of its kind to address a health issue on a global scale, the first being the outcomes document from the 2001 UN General Assembly Special Session on HIV/AIDS.

UICC, on behalf of its member organisations, strongly supports the call for global plans for the prevention and control of NCDs, and welcomes cancer specific commitments to:

• Give greater priority to early detection, screening and diagnosis of NCDs including cancer screening programmes (particularly breast and cervical cancer).
• Increase access to Hepatitis B and HPV vaccines as part of national immunisation programmes to prevent infection-related cancers.

“Whilst specific targets to reduce deaths from NCDs may not have been achieved at the HLM, there is much to be encouraged by”, commented Cary Adams, CEO of the Union for International Cancer Control (UICC). “More work is now needed to convince governments to commit to reducing avoidable deaths from NCDs by 25% by 2025 - a target that the World Health Organization (WHO) believes is achievable.”

Now that the direction of the UN Political Declaration is known, UICC is committed to working with Governments, WHO, UN Agencies, civil society and other stakeholders to implement the Declaration’s commitments. UICC will continue to advocate for additional measures to ensure the global cancer burden is reduced.

The Political Declaration of the UN High-Level Meeting on NCDs is now an important campaigning tool for the global cancer community. UICC will use it to scale-up its advocacy campaign and support its member organisations to lobby governments to meet and implement commitments to reduce the overall impact of the global cancer burden.

“The process of addressing NCDs globally has been set in motion in the most powerful way, said Mr Adams “UICC is serious about holding the UN and the world’s governments’ accountable”.

UICC and its members will begin the next phase of their advocacy campaign at the World Cancer Leaders’ Summit in Dublin in November where a response to the UN HLM will be outlined in detail.

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NCD Alliance Statement on UN Summit on NCDs

September 20, 2011

The NCD Alliance welcomes agreement by leaders of the 193 UN Member States on a Political Declaration recognizing the scale of the global NCD crisis and the urgent need for action ahead of a High-Level Meeting of the UN General Assembly on 19-20 September.
“The NCD Alliance and the 2,000 members in its global network have worked tirelessly to ensure the draft Political Declaration, to be agreed by governments next week, moves beyond rhetoric and vague pronouncements to include concrete commitments”, said Ann Keeling, Chair of the NCD Alliance. “While it falls short in several key areas, the Declaration is a strongly-worded document that will accelerate international progress on NCDs and provide a framework for saving millions of people from preventable death and disability due to NCDs.”

An overarching goal and set of time-bound targets is missing from the draft, however it contains an agreement to develop, in 2012, a comprehensive global monitoring framework for NCDs and agreed to hold a comprehensive review in 2014, which the NCD Alliance believes should include a follow-up High-Level Meeting. This review will provide an opportunity to track commitments made in the present Declaration and assess progress on the global targets and indicators that Member States should deliver on. It will also provide an opportunity to ensure that NCDs are integrated with other health priorities in future internationally-agreed development goals when the
current Millennium Development Goals end in 2015.

Agreement was reached on several issues of contention during hard-fought negotiations including commitments in the Declaration to increase access to affordable, safe, effective and quality medicines; and to palliative and rehabilitative services particularly at the community level. It also includes a commitment to accelerate implementation of the Framework Convention on Tobacco Control, to eliminate industrially-produced trans-fats in foods, and to implement interventions to reduce consumption of salt, sugars and saturated fats. In addition, Member States have agreed to introduce policies and actions aimed at promoting healthy diets and increasing physical activity in the entire population.

While the Declaration acknowledges the importance of increasing taxes to reduce tobacco consumption, the language on curbing the harmful use of alcohol is particularly weak, with no reference at all to essential measures on the price and availability of alcohol.

Regrettably, Member States have ignored calls from the NCD Alliance to agree measures to protect children from the marketing of alcohol but have committed to implement WHO recommendations to restrict the marketing to children of foods high in fats, sugar and salt; and to reverse the rising trends of obesity in children, youth and adults.

The Declaration calls for increased resources for NCDs through domestic, bilateral and multilateral channels and it recognizes that resources devoted to dealing with NCDs are not commensurate with the magnitude of the problem. However, it falls short of any concrete commitments and only requests Member States to investigate options for potential sources of funding.

Throughout negotiations, the NCD Alliance has strongly urged Member States to agree to the creation of a global partnership of UN organizations, governments and civil society to coordinate and implement commitments made in the Declaration. Although Member States did not reach agreement on this, they are requesting the UN Secretary-General to present them with recommendations in 2012 outlining options for such a UN partnership. The NCD Alliance believes NGOs must be involved in the process of a set of voluntary global targets and indicators.

Member States have also developing these recommendations and that this need not take another year. This process can be up and running early in 2012.

The Declaration highlights that collaboration at national, regional and international levels is needed to tackle NCDs. The private sector can be an important part of the solution to effective implementation of NCD interventions. The NCD Alliance insists that policy development is firewalled against potential conflicts of interest, and supports the establishment of an ethical framework and a code of conduct to guide government, NGO and private sector partners. Importantly, the Declaration recognizes the fundamental conflict of interest between the tobacco industry and public health.

NCDs have finally made it to the global ‘top table’ and onto the radar of world leaders at the UN General Assembly in New York. The Declaration, once adopted on 20 September, means NCDs will stay on the UN agenda for years to come. It has taken the hard work and determination of many people around the world to get to this point and tremendous progress has been made in the last two years.

The NCD Alliance and a broad range of NGOs and allies from other sectors, particularly governments, have played an important role in the process to date. This is just the beginning. We are ready to put the resources of our network behind the implementation of measures to save lives, improve the lives of people with NCDs, and prevent the future growth of the NCD epidemic.

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WCRF International Press Conference: UN Summit on NCDs

Speakers include

• Marilyn Gentry, CEO, WCRF International
• Kate Allen, Director – Science and Communications, WCRF International
• Martin Wiseman, Medical and Scientific Advisor, WCRF International
• Paul Lincoln, Chief Executive of the National Heart Forum - speaking on behalf of the UK Chronic Disease and Development Task Force
• Cary Adams, Chief Executive Officer of the Union for International Cancer Control – speaking on behalf of the NCD Alliance

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1. There are certain viruses, such as HPV (Human Papillomavirus), that can be passed from person to person, which can sometimes lead to the development of cancer, but the viruses themselves are not ‘cancer’.