Excellencies, ambassadors, distinguished participants in the global coordination mechanism, representatives of sister UN agencies, civil society, and industry, ladies and gentlemen,
I welcome this first major meeting on noncommunicable diseases in the new era of sustainable development.
The inclusion of NCDs under the health goal is an historical turning point. Finally, these diseases are getting the attention they deserve. Through their 169 interactive and synergistic targets, the SDGs seek to move the world towards greater fairness that leaves no one behind.
Business as usual will not work. The emphasis is on implementation that brings measurable results within countries. Let me highlight three words: country, implementation, results.
You all know the statistics. NCDs, with their heavy costs to societies and economies, put a brake on socioeconomic development. The probability of dying prematurely from an NCD is four times higher for people living in developing countries. These people develop disease earlier, get sicker, and die sooner than their counterparts in wealthy countries.
Including these diseases in the new development agenda sends a strong signal. The international community really understands that addressing NCDs is a route to greater and more inclusive prosperity.
Health benefits greatly from the agenda’s broad and integrated approach that tackles multiple economic, environmental, and social determinants of health.
The relationship between the five NCD-related health targets and many others is dynamic and the benefits are reciprocal. This integrated approach with its cross-cutting elements breaks new ground for health.
At last, it gives us a framework for policy coherence and integrated action across multiple sectors. As the root causes of NCDs lie in non-health sectors, prevention depends on this kind of broad collaboration and cooperation.
Integrated approaches are further encouraged by inclusion of a target for universal health coverage. This means ensuring that everyone can obtain essential health services of high quality without suffering financial hardship. This means removing sources of waste in the delivery of health services and making them more efficient.
A health system organized around the principles of UHC offers the best chance of preventing NCDs, detecting them early, and providing essential care, also in the community.
Even if all preventive measures are implemented to perfection, health services will still see clinical cases of heart disease, cancer, diabetes, and chronic respiratory disease.
Consensus is growing that the SDGs, including national NCD responses, will not be primarily financed from aid budgets. Moving forward, countries are expected to make their tax systems more efficient and introduce measures to combat tax evasion and illicit tax flows.
This marks a fundamental change in patterns of health financing, where more of the burden is placed on domestic budgets. The Addis Ababa Action Agenda emphasizes that price and tax measures on tobacco represent a revenue stream for financing the SDGs in many countries.
Today, you will be taking stock of the fitness of the existing architecture for international cooperation to support scaled-up action on NCDs. One of the biggest problems is the mismatch between the tremendous health and economic burden of these diseases and the meagre resources available for their prevention and control.
You will identify barriers, but you will also look at innovations that can get around these barriers in different country contexts.
You will take a closer look at the mobilization of financial resources through tobacco taxation. You will consider contributions from the private sector and philanthropic foundations, and explore the use of multi-donor trust funds and loans. In doing so, we are fully aware of the need to guard against conflicts of interest.
The 2011 political declaration identified prevention as the cornerstone of the international response to NCDs. Reducing premature deaths need not be expensive. Abundant evidence shows the effectiveness of banning all forms of tobacco advertising, restricting or banning alcohol advertising, and replacing trans fats with polyunsaturated fats. With strong political commitment, national authorities can take these policies on board.
A vaccine prevents liver cancer associated with hepatitis B infection. Simple screening and early intervention prevent cervical cancer. These are two of the most prevalent cancers in the developing world. WHO has also identified best buys for preventing heart attacks and strokes.
I have two concluding remarks. The first is a warning. Experience tells us to expect interference, by powerful economic operators, in the new targets for tobacco, alcohol, and NCDs, including many that are diet-related. Be aware of the political struggle, but this is a battle worth fighting.
So-called “sin taxes” on health-harming products represent a revenue stream for financing national NCD responses in many countries. But industry interference can block implementation of these low-cost, self-financing measures.
Of all the demand-reduction measure sets out in the WHO Framework Convention on Tobacco Control, increasing taxes and prices for tobacco products is by far the most effective. It is also the least implemented, largely because of interference by the tobacco industry.
Second, never underestimate the power of civil society and public opinion. In some US cities, efforts to impose taxes on soda were effectively blocked by the beverage industry.
However, extensive media coverage of the issues, including the risk that consumption of sugary beverages increases the risk of obesity, diabetes, and other diseases, led to a sharp reduction in consumption. In the end, mayors got what they wanted, though not through the intended way.
Is public opinion, sometimes outrage at industry practices, a resource we ought to use more?
I will leave you with these thoughts and look forward to hearing the outcome of your deliberations.
Thank you.