16 April 2012
As the second WHO consultation on NCD targets draws to a close, I am increasingly impatient for a result that will drive change for diabetes and the other NCDs. While we have recently seen huge breakthroughs for NCDs in the wider UN system, the target process remains dangerously off the mark.
Twelve months ago, in the fervour of Summit preparations, we urged governments to adopt a set of targets for NCD prevention and control that would be the backbone of the Political Declaration. Our reasoning was simple – if you don’t have a clear vision of where you want to go, you won’t know when you get there. Political commitments must be backed by measurable targets and delivery dates - or they are just words.
But our ambitions were cut last year by a rushed WHO target scoping process which governments did not support. Instead, we got a commitment that targets would be agreed by the end of 2012. Not ideal, but we recognized the technical complexity of scoping globally applicable targets to cover four diseases.
But now, a third of the way through 2012, the prospect of robust targets being adopted at the World Health Assembly in May is increasingly remote. The latest WHO discussion paper on the targets has slashed the number of targets by half, discarded many important prevention targets, and completely ignored the rights of people living with diabetes and NCDs to essential medicines and technologies. And these proposals, it seems, are based on the views of just 21 UN Member States!
So why has this process proved so hard? The reasons are both political and technical. Governments say they have too many targets to report against and they don’t have the data to report on diabetes and the other NCDs. And that is exactly the point. These targets will for the first time oblige all governments to collect data on NCDs and report back to the UN on a regular basis. Bold, ambitious targets in the Declaration of Commitments for HIV/AIDS in 2001 drove governments to act, collect data and deliver change on the ground. If governments are to deliver the promises they made at last year’s Summit then we need the same now for diabetes and the other NCDs. Again, I quote Margaret Chan on NCDs: "what gets measured, gets done."
So what needs to be measured? Firstly: access to treatment. We need targets on access to essential medicines and technologies for people with diabetes and other NCDs now. We need to know who has access to what - governments need this information to plan services that meet the right to health of their citizens with NCDs. And secondly, prevention: although prevention was the cornerstone of the Political Declaration, the current targets contain nothing to drive change on the global obesity epidemic or excessive alcohol consumption.
We need now to hear from the other 170 or so governments who have not expressed views on the NCD targets. And we need governments to demonstrate leadership by committing to reporting progress on diabetes and the other NCDs every two years and adopting an overarching target for a 25% reduction in NCD mortality by 2025 at WHA this May.
Last year at the UN Summit governments agreed on the “urgent need” to combat NCDs but for many that sense of urgency seems to have evaporated when they left New York.
We have been patient but every day we see lives cut short and unnecessary suffering caused by lack of action. The NCD epidemic won’t just go away – and neither will we.