|Year : 2019 | Volume
| Issue : 2 | Page : 58-61
Proceedings of meeting of the World NCD Federation, Africa Region: Framing the noncommunicable diseases response and realizing sustainable development goals for the African region; December 12–14, 2018
Department of Community Medicine, Faculty of Medicine, Midlands State University, Gweru, Zimbabwe
|Date of Web Publication||10-Jul-2019|
Prof. Davison Munodawafa
Department of Community Medicine, Faculty of Medicine, Midlands State University, Private Bag 8055, Gweru
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Munodawafa D. Proceedings of meeting of the World NCD Federation, Africa Region: Framing the noncommunicable diseases response and realizing sustainable development goals for the African region; December 12–14, 2018. Int J Non-Commun Dis 2019;4:58-61
|How to cite this URL:|
Munodawafa D. Proceedings of meeting of the World NCD Federation, Africa Region: Framing the noncommunicable diseases response and realizing sustainable development goals for the African region; December 12–14, 2018. Int J Non-Commun Dis [serial online] 2019 [cited 2019 Jul 19];4:58-61. Available from: http://www.ijncd.org/text.asp?2019/4/2/58/262468
| Background to the Meeting|| |
As noncommunicable disease (NCD) burden continues to grow globally as well as in low- and middle-income countries, there is an imperative to pursue opportunities and solutions that lead to risk mitigation, health promotion, and health system strengthening through integrated services for NCDs. The primary aim of integration is to reduce cost, improve efficiency, and achieve better health outcomes in relation to NCDs. The momentum around Sustainable Development Goals (SDG) and Universal Health Coverage (UHC) provides an opportunity to shift focus away from vertical health programs toward an integrated approach, particularly at primary healthcare level.
The World Health Organization (WHO) 13th General Programme of Work (GPW13) sets out WHO's strategic direction – strategic priorities, goals/impacts and outcomes, and strategic and organizational shifts for 2019–2023. Under the outcome 1.1, 1.2, and 1.3, of the GPW13, the WHO will efficiently and effectively increase coverage of essential health services by providing guidance and technical assistance to enable countries to strengthen their health systems and establish a strong foundation for integrated primary healthcare. This will help scale up context appropriate interventions that include prevention, early detection, treatment, and rehabilitation, with a view of achieving a 20% reduction in premature NCD death by 2023. Further, the 2011 UN Political Declaration on NCDs provides the mandate for multisectoral action and whole-of-government and whole-of-society responses. It mandates governments to work across sectors, including industries as broad as health, education, agriculture, sports, and environment; it also calls for intersectoral cooperation between UN agencies, governments, nongovernmental organizations, and the private sector.
Pursuant of the above, this meeting was planned as a joint collaboration between the World NCD Federation (WNCDF), Chandigarh, India, and the WHO, Regional Office for Africa, NCD Directorate, together with the University of Botswana [Figure 1]. The specific objectives of the meeting were: (1) to discuss the latest advances and trends in detection, prevention, management, and surveillance of NCDs in Africa region within the context and framework of health system strengthening, UHC, and the SDG target on NCDs; (2) to share experiences, best practices, challenges, and bottlenecks of establishment and implementation of high-level multisectoral coordination mechanism for NCDs within the framework of an overarching multisectoral coordination mechanism for health in Africa; (3) to discuss opportunities and challenges for scale-up of NCD best buys within the African context and come up with recommendations on best practices; (4) to discuss how NCD prevention and control interventions can be accelerated in the region to meet the SDG of one-third reduction in premature mortality.
|Figure 1: Faculty and organizing team for the meeting of the World NCD Federation, Africa Region held in Africa|
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The following are objectives of the WNCDF.
- To organize professional activities, meetings, and trainings at global, regional, and national level to promote public health approaches for the prevention and control of chronic NCDs
- To build partnerships with like-minded professional associations and promote evidence-based public health interventions so that scarce resources are used optimally in developing countries
- To work for capacity building for surveillance, monitoring, and implementation of NCD prevention and control policies and program and evaluation at national, regional, and international level
- To promote implementation research in NCDs by capacity building and supporting national, regional, and international multi-centric studies.
| Meeting Proceedings|| |
The meeting started at 09:00 h following registration. Prof. Davison Munodawafa, the Africa Coordinator of the WNCDF, welcomed all participants to the meeting. The aim and objectives of the meeting were presented and adopted. The WHO was represented at this meeting by Mr. Moagi Gaborone, National Program Officer, WHO Botswana, who is in charge of Health Promotion, Noncommunicable diseases, and Social determinants of health.
Prof. Thakur, President of the World NCD Federation: Values and direction of the federation
- Prof. Thakur highlighted the formation, background, objectives, mission statement, structures, membership (individual, institutional), and the main activities including publications
- The Chandigarh Call for Action (2017) provided the way forward under the theme “Development of WNCDF Center for Evidence-Based Research”
- The key issues which emerged from the presentation include (i) the need to come up with a concrete Plan of Action for the Region which we can be published in a peer-reviewed international journal, recognizing this inaugural meeting of the WNCDF in the African Region; (ii) identifying key issues for the next regional meeting; (iii) meeting should be action oriented on specific issues; (iv) the key issue is implementation at primary care level; (v) the need to focus on mobilizing from internal resources due to limited financing for health promotion; (vi) policy linkage must be strong: political actors must be integrated right from the beginning so that scaling up will be practicable; (vii) learning lessons from HIV and AIDS targeted interventions and leveraging institutions on influencing policy.
Prof. Thakur: Technical presentation on evidence-based policies, strategies, and guidelines for prevention, surveillance, and management of noncommunicable diseases in primary and secondary healthcare settings: Global perspective”
The issues raised include:
- NCD morbidity and mortality rates global, regional picture and projections up to 2030
- Top risk factors for NCDs being high blood pressure, diet lacking vegetables, high body mass index, and high consumption of sodium, tobacco, and alcohol
- Interconnections between NCDs and communicable diseases also highlighted that NCDs are a threat to achieving SGD #3
- Approaches to primary prevention include population strategy and the strategy for high-risk groups.
- Technical resources identified include:
- Global NCD agenda: Vision and global map
- WHO Package for the Prevention of NCDs
- The WHO Global Strategy NCDs: Nine targets for 2025.
Prof. Thakur highlighted innovative approaches requiring full engagement of national governments, development partners, civil society, and communities. These include supporting national efforts to implement the WHO targets and guidelines; WHO best buys; policy options for resource mobilization, for example, dedicated taxation on alcohol, cigarettes, and sugary products to raise funds for the NCDs prevention and control.
Prof. Collins Airhihenbuwa: Culture matters in prevention and governance for noncommunicable diseases in Africa and the Global South
The key issues raised include:
- Implementation of a culture informed framework as key to bringing needed change in NCD control and prevention at community level
- The need for ownership by intended beneficiaries, in this case, the Africans people, on the setting of the health agenda and its implementation including funding
- The tendency is to rely on donors to fund interventions which is strongly discouraged as the interests of the beneficiaries and those of the donors tend to differ. The views of the donor often override that of the intended beneficiaries.
Culture has to be at the center of our strategies on combating NCDs. Responding to NCD from a cultural informed vantage point should become one of the signature contributions of the regional response. The use of a cultural framework should allow the region to address NCD from a position of strength by building on positive aspects of behavior and practices that begin at the level of in families/households. Advancing a cultural informed framework for the implementation of sustainable interventions enable us:
- To aid in the development of appropriate messages and discourses in the current response to NCDs
- To ensure that positive aspects of African culture are incorporated in the implementation of intervention programs
- To help promote culturally based fundraising strategies from individual, family, and community traditions on altruism and philanthropy
- To help foster ownership of regional solutions as key to sustainable NCD programs
- To come up with a meaningful NCD symbol/logo that reflects prevention strategies
- To promote family-based NCD intervention models that recognized the positive and negative elements in behaviors and relationships
- To identify ways to get young people involvement in NCDs response.
- To help address generational differences in cultures including the role of social media in contemporary culture
- To promoting health aging in the context of NCDs
- To advocate health promotion in schools focusing on prevention of NCDs
- To help integrate NCD response into activities designed for youth-focused ministries and organizations and to promote awareness on NCDs through leadership training development among youths.
The day started with a brief presentation titled, “Botswana on national NCD response: A country case study by Gaborone Moagi, WHO Country Office, Botswana.”
Participants from Zimbabwe, South Africa, Swaziland, Botswana, Nigeria, Zambia, and Lesotho presented multisectoral actions on NCDs. South Africa and Botswana presented the strengthening of multisectoral action through legislation and taxation that has had an impact in reducing consumption of alcohol, tobacco, and sugary products while at the same time raising finances through taxation.
Prof. Hans Onya: “Surveillance, monitoring, and evaluation of noncommunicable disease programs”
The presentation raised the following key points:
- It identified the critical role for the regional chapter of the WNCDF as that of supporting the development of uniform measures to collect data on NCD in the region. This allows: (i) for accurate data to inform plans of action; (ii) promotion and undertaking evidence gathering, monitoring, and implementation using uniform assessment to capture data from countries, to identify existing gaps and strengths; (iii) proffering of innovative surveillance strategies for capturing NCDs and communicable diseases and generation of data for policy (iv) for coordination high level stakeholder mapping for both regional and country levels (v) for mobilizing African response to the existing NCDs (vi) for a development of a Monitoring and Evaluation framework, keeping in view the 9 targets under global monitoring framework (vii) us to promote research and formulate measurement of the nexus between of climate change and NCDs and other health issues.
of. Rakesh Kapoor, World NCD Federation: Cancer control strategies in developing countrie
The key discussion issues raised include:
- In terms of current practice, there is more emphasis on treatment while prevention and palliative care are neglected. Prevention can avert over 30%–40% of premature deaths from cancer in developing countries per year while palliative care can reduce suffering and improve the quality of life of the remaining life
- An effective national cancer control program responds to population needs through the implementation of evidence-based interventions across the health-care continuum
- An early detection program aims to detect cancer early to increase cure rates, improve survival, and reduce mortality, and it is only effective if linked to diagnosis and treatment programs
- Effective population-based cancer control is possible and includes responding to population needs across the health–cancer continuum from prevention to end of life care; balanced implementation of cost-effective and affordable interventions; integration of comprehensive services across all levels of care with other NCDs and focus on primary care and community levels; well-organized diagnosis and treatment programs by institutional strengthening in medical colleges that are linked to early detection and to palliative care; generate evidence cancer registries.
The rafting team met to prepare a working document for the meeting outcome or communiqué, which captures the Plan of Action. This process was led by Prof. Collins Airhihenbuwa.
The day was dedicated to the presentation of agreed actions and framework for implementing purposes of building consensus among all participants. The efforts resulted in a six-point action framework and a Gaborone Call for Action on NCDs under the following themes:
- Evidence-informed surveillance systems for NCDs; (ii) capacity building/strengthening/development to respond to gaps/missing links and best practices in NCD prevention and control strategies; (iii) advancing a cultural informed framework for the implementation of sustainable interventions; (iv) to mainstream youth and the elderly as part of leadership in response to NCDs in the broader lifelong approach; (v) to develop plans to support partnerships for national capacity building at country level and regional fundraising and management of funds; (vi) advocacy and lobbying for the regulation and policy enforcement on salt, sugar transfat, and tobacco.
The meeting ended at 13:30 following closing remarks by Prof. Munodawafa, Coordinator, WNCDF Africa Region, and Prof. JS Thakur, President, WNCDF.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.