Excellencies, distinguished ambassadors and diplomats, our invited guests, ladies and gentlemen, including the many in health ministries, agencies, and civil society organizations that are following the webcast of this event,
The report we are launching today charts what is being done to reduce a very heavy global burden of premature mortality.
In fact, heart disease, stroke, cancer, diabetes, and chronic respiratory diseases are the biggest cause of premature mortality worldwide, with 82% of these deaths now occurring in low- and middle-income countries. The fact that most of these deaths could have been prevented sounds a loud and compelling call to action.
Since the start of this century, these diseases have become more prevalent. They have also become more democratic, driven as they are by universal pressures, like the global marketing of unhealthy products, rapid urbanization, and population ageing.
The marketing of unhealthy products, like cigarettes, alcohol, sugar-filled beverages, and foods that are rich in fat, sugar, and salt, is powerful and persuasive. Countering it needs attention and policies coming from the highest level of government.
The report’s emphasis is firmly placed on population-wide prevention, as expressed by 7 of the 9 global targets.
The first target tells us where the world needs to be, and can be, by 2025. The final target acknowledges that, even if every preventive measure recommended by WHO were implemented to perfection, countries will still see clinical cases of these diseases. These patients must be cared for and their conditions managed in affordable ways.
The report we are launching today is essentially a report card. So, what does this report card tell us? How good are worldwide efforts to turn back the rising burden of noncommunicable diseases?
I have to say, our efforts are not nearly good enough.
As the report shows, only 70 of WHO’s 194 Member States have a national plan for the prevention and control of NCDs in place and functioning well. Only 42 countries have systems for civil registration and vital statistics in place to monitor progress.
How can political commitment emerge when countries do not know the size and costs of the burden of NCDs or whether interventions are bringing a return on investments?
But we do know that specific interventions work. Wealthy nations with strong health systems and sufficient resources have given us a large body of instructive evidence of success.
This is understandable. These diseases were long associated with affluent lifestyles. Wealthy countries have been dealing with the causes and consequences of noncommunicable diseases for decades. They know why governments must fight back, and they know how to do it.
Their populations are well informed about the hazards of tobacco use. In a growing number of countries, smokers are ostracized, sometimes by laws, other times by public opinion, as endangering the health of others. Legislators have raised taxes on tobacco products and been rewarded with more money in public coffers and fewer young people getting addicted to nicotine.
Enraged civil society organizations have pushed governments to enact tough legislation that protects against drink-driving.
Any government, at any resource level, can do the same smart things.
But the shift of the NCD burden from rich populations to poorer ones is comparatively recent. Developing countries have a long way to go to catch up. But they also have the advantage of knowing mistakes made by others and avoiding those mistakes.
Fortunately, the full architecture needed to support immediate action is in place, from the foundation, that is, data on trends and their costs, evidence on affordable high-impact interventions, to the ceiling, that is, the commitment of heads of state and government expressed during the special session of the UN General Assembly in September 2011. On that, I want to thank and congratulate your political leaders for taking that brave step.
In the final analysis, this is what we are talking about. Which is stronger? The forces that drive these diseases or the powers of public health?
The health sector will never have financial resources that come even close to budgets for the marketing of tobacco, alcohol, and unhealthy foods and beverages. But public health has evidence on its side, and this evidence includes the costs of letting these diseases go unchecked, as measured in terms of immense human suffering, economic losses, and the costs of clinical care.
These diseases are a slow-motion disaster, as they take some years, if not decades, to develop and kill. But countries do have a highly visible warning signal that bad trouble is on its way: population-wide obesity.
You can get a sense of this warning signal from data in the report, which includes country-specific statistics on the prevalence of obesity and overweight. In several countries, more than 60% of adults are obese or overweight. In a few, more than 70% are obese or overweight.
I am happy to report that the high-level Commission on Ending Childhood Obesity, which I set up last year, met again this month. The evidence is coming together and the Commission is making good progress.
Ladies and gentlemen,
The 2014 "Global status report on noncommunicable diseases" delivers some stern warnings, but there are also some good reasons for optimism among its pages. Countries, rich and poor, are finding some innovative ways to fight back, the impact is being measured, and the results look good.
Let me remind you of a point made repeatedly throughout the report. Almost none of these successful initiatives has been conceived and implemented by the health sector acting alone.
The most successful interventions engage actors outside the health sector and are endorsed and supported at the highest level of government.
The report gives you good advice on how to do these things as well.
Thank you.