CARDIOVASCULARDISEASES CANCERS …

1 200 8-2 013 ActionPl anfor the Gl ob al St rat eg y for thePrevention and Cont rol ofNoncommunicab le Di seas esCAR DI OVAS CUL AR DISEASESCANCERSCH RONI C RESPI RA TORYDISEASESDI ABE TES World Hea lth Or gani zati on 2008Al l rights reserved. Public ations oftheWorldHeal thOrganizationcanbeobtained fromWHOP ress, World HealthOrganization,20 AvenueAppia,12 11 Geneva27,Switzerland(tel.:+412279 1 326 4; fa x: +4122 7914857; e-mail: ts forpermission to re produceortransla teWHOpubl ic ations whetherforsaleorfornoncommercialdistribu ti on sh ou ld bead dr ess ed to WHO Press,at th e aboveaddress(fax:+412279 1 480 6; e- nationsemplo ye d andth e pr esentationof themateria l in thispublicationdonot implytheexpre ssionof anyopinionwhatsoeve r onth e partof theWorld HealthOrganization co nce rn -ingtheleg al statusof anycountry,territory, cityorareaorofitsauthorities, orconcernin g thede limitation ofitsfrontiersorboundaries.))

2 Dotted linesonmapsrepresentapproximatebo rderlinesfo r whichthere may notye t befullag re ement .Thementionofsp ecificcompanies orofcertainmanufacturers products doesnotimplythattheyareendorsedor rec ommended bytheWorld HealthOrganizationin preferencetoothers ofa similar na turethatar e not ,thena mes of proprietaryproduct s are distinguishedbyinitialcapitalletters .Al l re asona bl e pre cautionshavebeentakenbyth e WorldHealthOrganizationto verifyth e in for-mation containedin , th e publishedmateria l is beingdistributed with-outwarrantyofanykind,either sponsibilityfortheinterpretationanduseof themateria l lieswiththereader. In no ev en t shall theWorld HealthOrganizationbeliable fo r da magesar ont cove r photos:ChrisdeBode- April Po jmar- GiacomoFrigerio- MarkoKokicDe si gn and layout:Blossom It al y - lo diiIntroduc tionivAc tionPlanfortheGlobalStrategyfo r th e Pre ven tionandControlof Noncommunicable Di seasesWorld HealthAs semblydo cumentA61/8 (A pril 2008)1 Resol utionof the61stWorldHea lthAss embly2008:Prev en tionandCo ntrolof Nonco mmunic ableDiseases :Imple men tationof th e GlobalStrategyWorld HealthAs semblyresol ution (May 2008)21Gl ob al Strat eg y forthePreven ti onandCon trol of Nonc ommunica bl e Di se ase sWorld Heal thAs semblydo cumentA53/14(March 2000)23 Resol utionof the53rdWorl d HealthAssembly2000.

3 Pr ev en tionandCo ntrolof Non co mmunic ableDiseasesWorld Heal thAs semblyresol ution (May 2000)31i20 08 -2 01 3 Act io n Pla n for theGlo ba l Strat eg y for thePr eve ntionand ControlofNo ncommu nicable DiseasesOneTwoThreeFou rFo re wor diiToday, noncommunicable diseas es(NCDs),mainl y cardiovascular dis-eases , ca ncers,diabe tesand chronic respiratorydiseases, representaleadingthreat to human fourdi seasesaretheworld' s biggestkil lers,causinganes timat ed35 milliondeathseachyear - 60%of all deaths globally - with80%in low-andmiddle-incomeco diseasesar e pre ve ntable. Upto 80%of heartdisease,stroke,andtype2 diabetes andovera th irdof cancer s could bepreventedbyelimina tingsh aredriskfactors, mainly tobacco use,unhealthydiet, physical inactiv ityandtheharmfuluseof al ad dressed,themortalityanddiseas e bur denfromthesehe althprobl emswill continueto increas e.

4 WHOprojects that, globally, NCDde athswil l increaseby17%over thenext ten yea will be se eninth e Africanregion(27%)andtheEasternMedite rr aneanre gion (2 5%).Thehighestabsolut e numberofde athswilloccu r in theWestern Pacifican d South-East andknowledge toad dr essthese cost-effectiv e st ra tegies existto preventan d controlth is , high-leve l commitmen t an d concreteac tionareoftenmissingatthenationallevel. NCDpr eve ntionandcontrolpro-gr ammesremain dra matically under-fundedat th e na tional andgl ob -alle ve lsandhave bee n leftoffth e globalde ve impactingthepoorestpe opleinlow-incomepartsofth eworld andimposinga heavyburden onsocioeconomicdevelopment,NCDprevention is currentlyabsentfromtheMille nnium DevelopmentGoals. Howev er,inall low-andmiddle-income countriesan d byanymeasure,NCDsac co unt fora largeen oughshareof th e diseaseburdenof thepo or tomeri t a seri ouspolic y re ngclosely withMembe r States, WHOhas , th ere fo re,developedthis Acti on plan toprevent NCDsfromoccurri ngand tohelpthemil-li onswhoarealreadyaffectedtocopewithth eseli fel is Ac ti on Pl an,en dorse d at theSi xt y-first World Hea lthAssemblyinMay 2008,is basedonth e so undvisionof th e GlobalStrategyforthePreven tion an d Con trol of Non co mmunic abl e Di se ases, endorsedattheFift y-thirdWorldHeal thAss embl y inMay alsoaimstobuild on theWHOF ramework Con ve ntion onTobacc o Co ntrol andtheWHOG lobalStrategyonDiet, Physi ca l Ac tivity an d provides MemberState s, WHO.

5 Andth e international communitywi tha ro admaptoes ta bl is h andstrengthen in iti ati ve s forthesurveil-la nce, prevention an d mana ge ment of NCDs .Furthermore,th e plan highlightsth e pressingneed toinvestin NCDpreven ti onasanintegralpart ofsusta in abl e soc io ec onomic develop-ment .NCDprev enti onisanAll -Gove rnmentresponsib il it ns iderablymoregainscanbeac hie ve d byinfl ue nc ingpoliciesofno n-healthse ctors th anbyhealthpolic ie s al on e. All stakeholderswi llne edtoin tensi fy andharmon izeth ei r efforts toave rt th esepreven table condi ti on s and tosav e millions fromsufferingneedlesslyan d dy Ala Alw anAssistant Dir ec tor -Gen er alNon com mun icabl e Dise ase s and Men tal He althWorld Heal th Org anizationTACKLINGTHE WORLD'SBI GGESTKILLERSANDADDRESSI NGKEY CHALLE NGESTOGLOBALDEV ELOPMENTINTHE21stCENTURY We kn ow what work s, we knowwhatit costsand we knowth at all cou ntr ies are at risk.

6 We havean ActionPlan to aver tmil lion s of pr em ature deathsand helppr omotea bet te rqua lit y of lif e for mil lions more."iiiIn troductionivThisdocumentis writ tenprimarily forth e communityof internati onalde ve lo pmentpa rtners, aswell asthose in govern men t andcivilsocie-ty co ncerned withurg entactionto ad dress therap id ly increasing bur-de n of noncommunicable diseases(NCDs) in low- andmiddle-incomecount rie s anditsse riousimplicationsforpoverty reductionandeco-nomicde ve cu ment:- makes thecasefo r urg entactionbetween 2008-2013 which, whenpe rformed collectiv elyinaccordan cewiththeAc tionPlanforth eGlobalSt ra teg y fo r thePr eventionan d Control of NCDs,willta cklethegrowingpublichealthbur provides theActionPlan's politicalframework en dorsedin May2008bydelega tionsfr omal l 193 Member States, in cl udin g requir ementstoreportongl obal pr ogr essin pre se nt s theov er ridingGl obalStrategy forthePre ventionandControlofNCDswhichur ge s MemberStatesto deve lopnationalpoli-cyframeworks,establishpr ogrammes,sh are th eirex periencesan dbuildcapacitytoad dre ss ,theimportanc e of addressingNCDshasgained increa sedrec ognitionover th e past dec creasinglydomin atinghealthcare needs inlow-an d middle-incomeco alStrategy' s po liticalframework,endorsedinMay2000.

7 AskedtheWHO Director -G eneralto continuegiving priority to thepre-ve nt io n andcontro l of NCDs,withsp ecialempha sis onde ve lopingcount rie s. Tothisend,theGlobal Strategyha s th reemainobjecti ves:- to maptheemergingep idemicsof noncommunicablediseasesandtoanalysetheir so cial, economic,be haviouralan d political determi-nants with pa rticularre ferencetopooran d disad va ntagedpopula-tions,in or dertopr ov id e guidan ceforpolicy, leg is la tiveandfinancialmeasures rel atedto thedevelopmentof anenviron mentsupportiveofcontrol;- to red uceth e level ofex posureofindividuals andpopulationstothecommonrisk factorsfo r no ncommunicable disease s, namelytobaccocon-sumpti on,unhealthy di et andphysicalinactivity,andtheirdeterminan ts;- tostrengthen he althca reforpeoplewithno nc ommunicabledis-eases bydevelopi ngnor msand guide lin es forco st-effect iveinterven-ti ons,withpriori ty gi ventoca rdiovascular di se ase s, ca ncers,chronicre spiratory di seasesanddiabe ther, theGlobalStrategysets outth e roles ofth e main playersinth e str uggleagainstnon communic able disea ses, namely: MemberStates, theSe cretari at and internationa l partn er HealthAssembly ga veWHOan importantadditi onalsetofmandatesin 2003and2004whe n it adopted theWHOFr ameworkConvention on Toba ccoControl,and th e Gl obal StrategyonDi et,Ph ys ic alActi vi tyan d Heal th , re spectively.

8 InSeptembe r 2008,therewere160 Partiestoth e WHOF ramework Con ve ntiononTobaccoControl, mak in g it oneofth e mos t succe ss fultreaties in theUnitedNation s history, having entere d in toforceforitsfi rs t 40 Partieson27Fe bruary progress has als o be en madeonth e implementation of th e recommen da tions ofth e Gl obalStrategyonDiet, Physi calActi vityand Hea lth : moreth an 30countrieshavealreadyimplemen tedpolic y options recommen de d 2007,th e Worl d Heal thAs se mbly re queste d th e Di rector-GeneraltotranslatetheGl oba l Strategyfo r th e Preve ntionand Control ofNCDsin to con creteacti on . Accordingly,an action plan wasde ve lopedin col-laborationwi thMember States based oncommentsmadeat the122ndse ssi on of theWHOE xecutiveBoard(Janua ry2008)andatinformal cons ultationswithWHOM ember Statesandotherstakehold -ers(February-March2008).

9 In 2008,th e Worl d HealthAss embly pa ssed re sol ngTheAc tion Pl an forth e Gl obal StrategyforthePreventionandCo ntrolofNon co mmunic able Diseases2. The pl an setsoutobjec -tiv es , actions tobeimplement edov erth esi x-yearperio dof2008 2013,andperfo rman ceindica tors toguideth e workof WHOatnation al,region al andgl obal le ve ls, witha pa rti cular focus on lowandmiddle-income countries and vulne ra bl e ev ent and Cont rol CARDIOVASCULARDISEASES , Canc er s, ChronicRes piratory Diseases and DiabetesAAccttiioonn PPllaann ffoorr tthhee GGlloobbaall SSttrraatteeggyy ffoorrtthhee PPrreevveennttiioonn aanndd CCoonnttrrooll ooffNNoonnccoommmmuunniiccaabbllee DDiisseeaasseess 11 World Health Assembly document A61/8 (18 April 2008)IN TROD UCTION 1. The global burden of n oncommunicable dise ases continues to grow; tackling it constitutes one of the majorchalle ng es f or development in the twenty-fi rst century.

10 Noncommunicable diseases, principally c ar diovasculardiseases, diabetes, CANCERS , and chronic respiratory di seases, c aus ed an estimated 35 million deaths i n 2005. Thi sfigure re presents 60% of all deaths globally, w ith 80% of deaths due to noncommunicable diseas es occurring inlo w- and m iddle- in come countries, and approximately 16 million deaths involving people under 70 year s of ta l deaths from noncommunicable diseases are projected to increase by a further 17% over the n ex t 10 rapidly increasing burden of these diseasesis affe cting poor and disadvantaged popu lations disproporti onately,co ntr ibuti ng to widening health gaps between and w ithin countries. As noncommunicable diseas es are largelypreve nta bl e, the number of premature deaths c an be greatly reduced. As requested by the Health Assembly in resoluti on , t he Secretariat drew up a draft action plan in order to guide Member States, the S ecr etariatand in ternat ional partne rs in working towards th e prevention and control of non communic ab le dis ea se s.