Sharing knowhow and joining forces towards Health for All

MMI Network News, December 2010

WHO NCD advocacy poster
WHO NCD advocacy poster

Noncommunicable diseases: Let us get involved! (Editorial)

Dear reader,

I recently attended a teleconference of the “Common Interest Group” of the NCD Alliance, a lobby network lead by four international federations representing the four main noncommunicable diseases (NCDs ) – cardiovascular disease, diabetes, cancer, and chronic respiratory disease. The teleconference provided an update on the preparations under way for the UN Summit on Noncommunicable Diseases in New York in September 2011. I will first share some of this information with you, followed by action proposals for interested civil society organizations. 

It is increasingly recognized* that noncommunicable diseases are “the leading cause of death and disability worldwide and will cause over three quarters of all deaths in 2030”. NCDs are a result of poverty - disproportionately affecting lower and middle income countries and the poorer segments of all societies - but also lead families and countries into poverty. In May 2010, the UN resolution 64/265 was passed to organize a UN Summit with focus on the “four most prominent non-communicable diseases, namely, cardiovascular diseases, cancers, chronic respiratory diseases and diabetes”, and the “common risk factors of tobacco use, alcohol abuse, unhealthy diet, physical inactivity and environmental carcinogens”. With good attendance of heads of government and states, the Summit scheduled for September 2011 should lead to global and country commitments for a coordinated and multi-sectoral response and measurable targets.
The NCD Alliance is pushing for an action-oriented outcome statement that includes the following key points:

  • Governments to be accountable and measured on NCD plans
  • Framework Convention on Tobacco Control (FCTC) to be fully implemented
  • A global commitment to prevention of NCDs
  • Globally agreed-upon approaches to NCD treatment and care
  • Resources to deliver NCD interventions
  • A commitment to include NCDs in the MDG successor goals
  • No separate financing mechanism, but a full integration of NCDs into health promotion, prevention, and service delivery, as well as inclusion of NCD concerns into relevant sectors of society

Key events leading up to the UNS are mainly the WHO EB meeting in January, the regional WHO meetings in February, a Ministerial Conference on NCDs in Moscow, in April, and the World Health Assembly in May 2011. In addition, the President of the UN General Assembly is considering a civil society task force or advisory committee for the Summit.

Civil society efforts to prepare for the UN Summit have been driven by the NCD Alliance and its member organizations, providing a disease-specific perspective. It is crucial that civil society organizations involved in international health cooperation (“Health NGOs” such as the members of the Medicus Mundi International Network) and advocating for the right to health become fully engaged. They contribute different, but essential experiences, such as:

  • NCDs face similar myths of “blaming the victims” that have been addressed by NGOs working on HIV, human rights, and gender issues
  • WHO is strongly promoting addressing NCDs at the community and primary care level. This is where our organizations can bring a wealth of expertise
  • Many NGOs are involved in health systems strengthening efforts and can develop or may already have innovative approaches and solutions to integrate NCDs
  • Integration of NCDs will require a strong and competent health workforce, an issue addressed by the Medicus Mundi International Network.

Therefore, I recommend to interested organizations

  • To share and show-case their positions and activities related to NCD integration in primary health care and national health systems and contribute to national and global advocacy efforts.
  • To consider becoming a member of the “Common Interest Group” (CIG) of the NCD Alliance ( and to promote within this group a broad, systemic approach to NCDs.
  • To join country and regional alliances that are emerging in preparation for the UN Summit and advocate for the full integration of civil societies into country delegations to the summit, including non-disease specific NGOs working at the community level, with hospitals, businesses, schools, in agriculture, gender, human rights, etc.

As stated eloquently by Sir George Alleyne, former Director of PAHO, who gave a presentation during the CIG teleconference, the UN Summit is an occasion for governments to coalesce on an issue that concerns all, and it is only the second time that such a meeting has placed health concerns on the world stage. He urges us all to be bold in the demands we make from world leaders and to avoid disease divisiveness in our efforts.

Wishing you a wonderful holiday season -- not forgetting about healthy foods and exercise!

Bettina Schwethelm
Medicus Mundi Switzerland - Network Health for All

*Geneau, R. et al., Raising the priority of preventing chronic diseases: A political process. 2010. The Lancet, 376, 1689-1698. For more resources, please refer to the thematic focus of this MMI Network Newsletter.

DEBATE: get involved in NCD?

Further statements are welcome.

Thematic focus: Noncommunicable diseases

Papers and positions
  • Raising the priority of preventing chronic diseases: A political process
    Robert Geneau et al. in: The Lancet (2010)
  • The hope and the promise of the UN Resolution on non-communicable diseases
    George Alleyne, David Stuckler, Ala Alwan in: Globalization & Health (2010, PDF)
  • Health transition in Africa: practical policy proposals for primary care
    D Maher et al. in: Bulletin of the World Health Organization (2010)
  • Where have all the donors Gone? Scarce donor funding for non-communicable diseases
    Rachel Nugent and Andrea B. Feigl, CGDev Working Paper 228 (2010)
Key references
  • WHO: 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases
    "Working in partnership to prevent and control the four noncommunicable diseases — cardiovascular diseases, diabetes, cancers and chronic respiratory diseases and the four shared risk factors - tobacco use, physical inactivity, unhealthy diets and the harmful use of alcohol" (2008)
  • UN General Assembly resolution on the prevention and control of noncommunicablediseases
    UN GA Resolution A/RES/64/265, April 2010
MMI thematic guide
  • Noncommunicable diseases - high on the political agenda in 2011
    Our thematic guide to internet resources leads you beyond the limits of the Medicus Mundi International Network. Contents: (1) Global initiatives and thematic leaders; (2) Papers and positions; (3) Advocacy; (4) Key resources; (5) Conferences: announcements and documentations.

MMI Network: News, Events and Resources

MMI Network News: Cordaid
Winners of Cordaid HIV and AIDS Award 2010 | The 2010 edition of the Cordaid HIV and AIDS Award was on Sexual and Reproductive Health (SRH) for Women living with HIV. The Review Panel congratulates both award winning organisations! The Award recipient for the category "community based organisation" is the Ntankah Village Women Common Initiative Group, Cameroon. The Award recipient for the category "faith based organisation" is the Cameroon Baptist Convention Health Board. Find out more about the winners’ work and trends around SRH for women living with HIV by reading the Review Panel Report.

MMI Network Resources: EPN
Guidelines for effective and efficient pharmaceutical services

The Ecumenical Pharmaceutical Network (EPN) has developed 25 guidelines for effective and efficient pharmaceutical services, to support health facility managers, pharmaceutical personnel and all those involved in pharmaceutical service delivery to increase access to medicines and improve the quality of patient care.

MMI Network Member: DWA Cuamm
60 years of Doctors with Africa Cuamm
Padova, 11 November 2010

The Italian member of the Medicus Mundi International Network Doctors with Africa Cuamm celebrated its 60th Anniversary with a series of events in October and November 2010. The President of Italy, Giorgio Napolitano, participated at the main ceremony on 11 November in Padua, when the title of Doctor Honoris Causa was conferred to the former Cuamm director Don Luigi Mazzucato by the University of Padua and the organization launched its new campaign on free access to maternal and newborn care.

MMI Network Campaign: Cordaid and Wemos
Enough = Enough | The MMI Network members Cordaid and Wemos, together with many other Dutch development organizations, join forces to stop further budget cuts. The new Dutch government is planning a second round of budget cuts on international aid meant for entrepreneurial men and women living in developing countries, and the organizations supporting them. This would result in a net reduction of over a third of the total development budget. That’s why development organizations are saying ENOUGH=ENOUGH!

MMI Network Topic: Health systems financing
Community health insurance and universal coverage

In 2005, the World Health Assembly explicitly urged its member states to strive and plan for universal coverage, within the particular macroeconomic, socio-cultural and political context of each country. This paper assessing community health insurance in the itinerary towards universal coverage. | Our colleague Bart Criel, ITM Antwerp, contributed to this WHR Background Paper. (W. Soors et al, 2010, PDF)


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Feedback to last MMI Network News

Universal health coverage and its caveats

The editorial by Remco van de Pas, Wemos, in the November issue of the MMI Network News was also forwarded to two listservs (Afro-Nets and PHM Exchange). This led to some interesting feedback: 

„I agree with what is written. It depicts well the situation here in Nyala, South Sudan. There is a war from years, people are poor, agriculture that was florid because of enough rain is abandoned, food is distributed in camps. Children malnutrition is a problem every year. Maternal mortality is high, vaccination coverage is 31% (!). So, in this scenario one is surprised to see that most of health care is provided through private medicine. Inside the main governmental hospital of Nyala there is a 'second' hospital, totally private, where you may find all laboratory and investigation facilities including CT scan and specialist consultations performed by the same doctors of the hospital. Antenatal care in Nyala is not free: mothers have to pay for the examination AND for tablets of ferrous-sulphate. Delivery is also not for free. Most mothers opt to deliver at home ...but also here they must pay the midwife or TBA. This situation is well known to Sudanese doctors, they are professional and skilled. But their salaries do not allow them to maintain decently their families, therefore private medicine becomes the 'obvious' source of income. (Massimo Serventi, Nyala Pediatric Centre, on PHM Exchange)

„Here is a response to the question “What to do?” in relation to UN employees and in particular of course those of the World Health Organization. They can advocate for two essential things: (1) A fair international economic order so that sovereign states may provide quality public services for their people, financed through redistributive tax systems, from adequate national resources in their own hands and without interference from the international financial institutions acting in the interests of rich country transnational corporations, and (2) National health systems providing comprehensive public services, with universal coverage, free at the point of care. The evidence is available and has been for 50 years that this is the most efficient use of resources if the aim is health for all - NOT of course, if the aim is shareholder profits for private companies in the services sector. Massimo is completely right to say that pointing the finger at individual doctors is not appropriate. The object of social justice critiques is systems and not individual persons. (Alison Katz on PHM Exchange)

„No, it is not human to expect health workers to sacrifice their (and their families) needs in order to provide free services. Governments and donors (including the Worldbank) MUST ensure that health workers are paid decent wage before the likes of the bank criticizes workers for taking informal charges. Personally, I think the best solution is to send policy makers from the bank (and similar institutions) to live and provide services in developing countries under exactly the same situations of health workers there. Perhaps then, big decision makers can realize that health workers are not inherently "corrupt" but that they do not have many options! (Mohga M Kamal-Yanni, Oxfam GB, on PHM Exchange)

Network News, November 2010:

International Health Policy: MMI Updates

Since we started to use the real-time short messaging service "Twitter", we published there already more than 700 bits and pieces of news on international health policy. Each update is 140 characters or less - these are the rules of the game. Just enough for a headline, eventually an author, a date, the source – and a shortened link to the website where you find the full information. Have a look at a selection of our “tweets” published during the last month:

  • Why do patents still pose a threat to drug access after the Doha Declaration? Fiona Rae, Winner HAI Essay Competition
  • Who has responsibility for health in a privatised health system? Marge Berer in: Reproductive Health Matters
  • Child health and the missing link: Working with the private sector for better results. A Harding et al., PMNCH 2010
  • Although ethics is the proper language of medicine, human rights is the proper language of public health. C Schuftan
  • A global framework convention on health - Would it help developing countries to fulfill their duties? M Heywood/J Shija
  • Indonesia: Petition opposing the Social Protection Business Bill (health insurance vs. free health services) PHM-Exch
  • Burden of endemic health-care-associated infection in developing countries. B Allegranzi et al. in: The Lancet
  • Is the WHO becoming irrelevant? Why the world's premier public health organization must change or die. JC Chow in: FP
  • Achieving the health-related MDGs. It takes a workforce!
  • WHO to define information standards for traditional medicine
  • The published research paper: important indicator of successful op.research at programme level? Zacharia & al. in: TMIH
  • Do communities ever ask for a community based insurance? Discussion on: international health policies blog
  • The Pope, condoms, and contraception: Let's get this conversation started. Frances Kissling on: RH Reality Check
  • International health organisations and recruitment of health workers. Marko Kerac continues a debate in The Lancet
  • To give is better than to receive: compliance with WHO guidelines for drug donations 2000-2008. L Bero et al. in: WHO-B
  • Human rights – a central concern for the global HIV response. Statement by WHO DG Margaret Chan on World AIDS Day
  • The future of health worker migration, Binod Khadria, background paper to World Migration Report 2010
  • Partnership for Maternal, Newborn and Child Health: Delhi Declaration 2010 "From Pledges to Action and Accountability"
  • Health professionals: transforming education to strengthen health systems in interdependent world. Frenk et al., Lancet
  • Pay For Performance (P4P) programs in health services: What is the evidence? R.M. Scheer, WHR Background Paper 31
  • The relative efficiency of public and private service delivery. Justine Hsu, WHR Background Paper 39
  • Improving health system efficiency as a means of moving towards universal coverage. WHR Background Paper No 28
  • The Joint Action and Learning Initiative on National and Global Responsibilities for Health. WHR Background Paper No 53
  • It is time to talk about people: a human-centered healthcare system. Meghan M Searl et al. in: HARPS
  • Successes and challenges in implementing the NGO Code of Conduct for Health Systems Strengthening. HAI study, 2010
  • What’s the “universal health coverage” push really about? Adam Wagstaff on World Bank blogs
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