The how: a message for the UN high-level meeting on NCDs
The Lancet Correspondence including Kristina Sperkova, IOGT International
This September’s UN General Assembly high-level meeting (HLM) on non-communicable diseases (NCDs) provides a strategic opportunity to propel the response—from “where do we want to be” to “how do we get there”.
The draft of the HLM’s political declaration prioritises universal health coverage, including affordable treatment, and promotion of mental health but falls short on the primary prevention of NCDs and promoting healthy societies as per Agenda 2030. The transition from health-harming to health-enhancing products and processes requires action across multiple sectors and strengthened public institutions. We propose an agenda for member state HLM negotiators (panel).
Panel: Proposed agenda for member state high-level meeting negotiators
- Assign accountability at the highest political levels
- Prioritise improving fiscal policies
- Mobilise additional financial resources
- Regulate the commercial determinants
- Address the growing impact of pollution and urbanisation on NCDs, injuries, and mental health
- Support meaningful civil society engagement
- Uphold principles of equity, human rights, and gender equality
- Foster independent accountability
Second, improving fiscal policies should be prioritised. Countries should implement a synergistic approach to taxing sugar (not just sugar-sweetened beverages but also sugary snacks), tobacco and alcohol, as well as unhealthy nutrients. The international community should provide technical advice on taxation and removing subsidies for processed foods, alcohol, and fossil fuels, and for divesting from tobacco, alcohol, and fossil fuels; governments should also support healthy local food systems.
Fourth, the commercial determinants of health should be more rigorously regulated. Evidence suggests that self–regulation cannot be relied on to deliver healthy outcomes. Building on experience from tobacco control, governments must regulate the alcohol, processed, and ultra–processed foods industries.
Sixth, support shoud be provided for meaningful civil society engagement. Agenda 2030 is premised on effective partnerships, including with civil society. The declaration must ensure meaningful engagement with and by affected communities, citizens, and public interest groups, explicitly highlighting their role in national multi sector planning and coordination platforms and independent accountability mechanisms. Countries should increase investment in the advocacy and service delivery functions of civil society and its networks.
Finally, independent accountability should be fostered. The declaration should call for an NCD Countdown 2030 that would encompass framing the response under existing human rights treaties, reliable reporting systems, independent monitoring, and review, and mechanisms to enhance and enforce compliance.
Members of the Friends of the UN HLM on NCDs
George Alleyne (PAHO), Phillip Baker (Deakin University), Fran Baum (Flinders University), Robert Beaglehole (University of Auckland), Chantal Blouin (Université Laval), Ruth Bonita (University of Auckland), Luisa Brumana (UNICEF), Kent Buse (UNAIDS), John Butler (NCD Child), Simon Capewell (University of Liverpool), Sally Casswell (Massey University, New Zealand), José Luis Castro (International Union Against Tuberculosis and Lung Disease/Vital Strategies), Mickey Chopra (World Bank Group), Helen Clark (The Helen Clark Foundation), Katie Dain (NCD Alliance), Sandro Demaio (Eat Foundation), Andrea Feigl (Harvard), Patricia Frenz (University of Chile), Peter Friberg (Swedish Institute for Global Health Transformation), Sharon Friel (School of Regulation and Global Governance, Australian National University), Amanda Glassman (Center for Global Development), Unni Gopinathan (University of Oslo & Norwegian Institute of Public Health), Lawrence Gostin (Georgetown University), Sofia Gruskin (University of Southern California), Corinna Hawkes (Centre for Food Policy), Sarah Hawkes (University College London), David Hipgrave (UNICEF), Paula Johns (ACT Health Promotion), Alexandra Jones (George Institute for Global Health), Sowmya Kadandale (UNICEF), Roger Magnusson (University of Sydney), Patricio V. Marquez (World Bank Group), Robert Marten (London School of Hygiene & Tropical Medicine), Martin McKee (London School of Hygiene & Tropical Medicine), Benjamin Mason Meier (University of North Carolina at Chapel Hill), Carlos A. Monteiro (University of Sao Paulo), Modi Mwatsama (UK Health Forum), Rachel Nugent (RTI International), David Patterson (HLDC), Stefan Peterson (UNICEF), Yogan Pillay (Ministry of Health, South Africa), Johanna Ralston (World Obesity Federation), Srinath Reddy (Public Health Foundation of India), Juan A. Rivera (National Institute of Public Health, Mexico), Sandhya Singh (Ministry of Health, South Africa), Sudhvir Singh (Eat Foundation), Tim Sladden (UNFPA), Richard Smith (London School of Hygiene & Tropical Medicine), Kristina Sperkova (IOGT International), Thaksaphon Thamarangsi (WHO), Francis Thompson (Framework Convention Alliance), Douglas Webb (UNDP)