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Addressing Non-Communicable Diseases (NCDs)

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Non-communicable diseases are creating rapidly rising health issues across many nations.  The main NCDs include cardiovascular disease, cancer, diabetes and chronic respiratory illnesses and share common behavioral risk factors, including smoking, unhealthy diet, physical inactivity, and the harmful use of alcohol. The World Health Organization (WHO) estimates that 60 per cent of global mortality, or 35 out of 59 million deaths in 2005 were caused by NCDs. Six of the top ten risk factors leading to death are NCDs. This burden is particularly high in low and middle-income nations, where 80 per cent of all deaths caused by NCDs occur. While many still believe that the biggest health challenges in developing nations continue to be infectious diseases, this view is long outdated. NCDs today are a greater threat to global economic development than fiscal crises, natural disasters, corruption, or malaria, tuberculosis, and HIV/AIDs. Addressing NCDs more broadly represents a crucial link between single issues such as alcohol and tobacco and the broader development agenda, including the discussion on what should follow after the Millennium Development Goals expire in 2015.


NCDs have recently come more forcefully onto the global agenda. A September 2011 High-Level Meeting on NCDs convened by the United Nations (UN) General Assembly marked a watershed in the global response, but the commitments to this agenda remain shallow and continue to fall short of effectively addressing the global harm caused. A 2010 report of the Center for Global Development found that less than three percent of all global health funding in 2007 ($22 billion) was targeted at NCDs.  This stands in stark contrast to the fact that addressing most NCDs is relatively inexpensive and measures of prevention and treatment have a proven track record of success. We know this from the experiences of developed nations, but we have yet to apply it in much of the developing world. For example, raising taxes on and restricting the marketing of tobacco and alcohol are very effective, while distributing relatively cheap medicines (aspirin, asthma inhalers, beta blockers, etc.) will greatly reduce injury and death from NCDs.


Despite the fact that the global community could make a lot of progress very fast on NCDs, the agenda continues to be stuck in mere rhetoric. At the 2011 High-Level Meeting many of the problems slowing down action were on display. Food, tobacco, and alcohol industries hold a tight grip on governments and slow down policies harmful to their profits as much as possible. NGOs with their focus on specific issues were afraid that their ‘cause’ might lose out or argued that their issue was not adequately represented in the first place. And unlike the case of HIV/AIDs a decade earlier, there was barely any public interest, let alone street demonstrations by victims of the diseases and their supporters. Some observers argued that the NCD agenda is simply too broad and cannot be addressed effectively at the global level. As a case of complex collaborative governance, NCDs are a key issue not just because of their global burden of disease, but also because the emerging responses offer ample opportunities to research the failures and successes of strategies deployed to limit the harmful effects of NCDs. Students of global governance have variously studied the role of scientists, NGOs, industry, the public, intergovernmental organizations, and governments in addressing major challenges. In the case of NCDs, all of these groups play crucial roles, but even on the least controversial issues they have yet to produce effective collective action.

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