16 November 2012
Last summer it looked as though governments would never agree on Global NCD Targets – or if they did, they would be minimalist and not what was needed to catalyse change. IDF has been working towards a global monitoring framework for diabetes and NCDs as part of a longer term strategy that started well before the UN Summit on NCDs last year – and last week we finally got what we’ve been asking for.
The UN Summit was a watershed event that signalled major progress for diabetes and NCDs. However, we felt let down that it ended without governments agreeing to targets on NCDs. We were fearful that the Political Declaration would remain only on paper – all bark and no bite – as you can’t hold anyone to account for a commitment they have not made.
But things are changing. Governments are rising to the diabetes and NCD challenges placed before them and are beginning to turn political commitments into tangible actions. After nearly two years of consultations, negotiations and sustained advocacy, last week governments agreed the first set of global NCD targets and a global monitoring framework. Finally a bite to go with their bark.
We saw the first NCD target adopted at the World Health Assembly in May of this year to reduce mortality from NCDs 25% by 2025. And just last week governments agreed to a remarkable set of nine global NCD targets and 25 indicators! This was a major breakthrough for diabetes and NCD advocacy, signalling a new era of action and accountability.
We went into the Member State consultation last week facing scepticism and reluctance to adopt a meaningful number of targets. Targets on salt, blood pressure, physical activity and tobacco had wide support, but targets critical for diabetes – such as access to essential medicines access and multidrug therapy – were not expected to survive the consultation.
But Member States surprised us with their enthusiasm in the process. Negotiations went long into the night, and when the chair wanted to call a halt because it was late, countries said ‘we’re not finished yet’. They came together constructively and agreed to a set of targets that addressed the full range of Member State concerns and priorities. There was a genuine sense that Governments have understood the urgency of diabetes and NCDs.
The targets adopted are game changers. Countries will report their progress against these targets as they already do so for HIV/AIDS – which will improve data collection and drive success. Targets address prevention and treatment for diabetes and NCDs, and will uphold basic human rights such as access to essential medicines and technologies.
IDF has worked hard to ensure diabetes did not get buried in NCDs and we have succeeded, as diabetes is now the only one of the four major NCD diseases that has its own global target. The target agreed to ‘halt the rise in obesity and diabetes’ was aptly described by the Canadian delegation as “a stretch target that will motivate and inspire us!”
We strongly support NCD prevention targets but we also advocated relentlessly to get targets on access to essential medicines and on multidrug therapy onto the negotiating table and then keep them there. We called for targets that would improve treatment for the millions of people currently living with diabetes and NCDs, and governments responded by agreeing a target for 80% availability of affordable basic technologies and essential medicines and that 50% of eligible people receive drug therapy and counselling (including glycaemic control) to prevent heart attacks and strokes. Given that IDF estimates 100 million people globally don't have access to the diabetes medicines they need, these were targets we could not compromise on, and we were thrilled to see them agreed.
During two days of challenging negotiations, IDF and NCD Alliance were on hand to provide guidance on what is really needed on the ground. I thank the Member States who championed our cause and insisted that NGOs be admitted as observers to the negotiations.
Now the pressure is on governments to take the agreed upon NCD targets and indicators and make progress happen. The targets must not remain disembodied – they need to be incorporated into a broader framework and driven by a partnership. The next major pieces of work in the WHO pipeline are the 2013-2020 Global Action Plan for NCDs, and the options for a Global NCD Partnership (presented by UN Secretary General in October) will be discussed by Member States on 28 November.
The NCD targets were part of a longer term IDF plan (the Diabetes Roadmap to the UN Summit) and supporting implementation of those targets is part of our second plan (the Diabetes Roadmap to the Future Development Agenda). We will mobilise the IDF network to provide expert technical support to governments to trim these targets into a real plan of action and we will mobilise our network to monitor results.
The NCD targets agreed this week won't change the world tomorrow – but they will change the world, and they demonstrate that the world has already changed for diabetes and NCDs.