We know that the global burden of disease is changing. Non-communicable diseases account for almost 90% of disease burden in the European region and for about 60% of all deaths worldwide. An ageing population, tobacco consumption, obesity, unhealthy diet, physical inactivity and alcohol are key contributing factors.
We have increasingly solid data on the situation of NCDs in poor countries. According to WHO, mortality from NCDs is set to increase over the next 10 years, most rapidly in low and middle-income countries. It is therefore timely to increasingly address NCDs as a global challenge.
The considerable progress that has been achieved in global health over the past decade shows that concerted efforts produce results. Child mortality is on the decline, there is better access to vaccines and life-saving antiretrovirals, and the health workforce has been recognised as most valuable asset of national health systems, not only as an expenditure.
Several of the MDGs, in particular those that concern women’s and children’s health and wellbeing, are however still far from being reached and require sustained attention and commitment. This will in particular be important in the next few years as the world gears up towards delivering on the MDGs by 2015.
In this regard, it is important to note that communicable diseases such as HIV, TB and malaria, and conditions that are behind maternal and child mortality, still constitute a greater share of the burden of disease for the poorest segments of the populations. Common communicable diseases and malnutrition are still the main causes of high child and maternal mortality in the poorest countries. The MDGs and their poverty focus must therefore continue to be given top priority by the global community. The Norwegian government will certainly do so.
The key therefore, Mr President, must be to move ahead in a way that reinforces national and global public health systems and that we avoid fragmentation and competition for scarce resources.
In this regard, there are useful lessons to be drawn from our experience with the MDG-related global health initiatives. I would in particular like to point to a few of them:
- The importance of designing international initiatives so that they are driven by countries themselves. National governments must take the lead. This is particularly important for NCDs because an effective response requires cross-sectoral action, including national legislation and regulation.
- The importance of strengthening national health systems to address infectious and non-communicable diseases holistically. External support should systematically contribute to strengthen national health systems and avoid fragmentation that we too often see in the health sector.
- Global health initiatives have to a large extent focused on service delivery and individual interventions, much less on prevention. By prioritising health promotion and cross-sectoral action, NCDs can play a significant added value by strengthening public health functions and the stewardship role of health ministries.
- Governments must from the start ensure inclusive partnerships with civil society and the private sector. This has been key to success in the AIDS response and also our experience in Norway when it comes to NCDs.
- It is more true than ever before that money matters, but money alone is not sufficient. Many countries are in a constrained economic situation with public budgets, including for ODA, under severe pressure. The emerging NCD movement is best placed to produce integrated plans with realistic resource needs that emphasise value for money and focus on actions that are needed in this phase. Leading up to 2015 we must expand the evidence base needed for decision-makers, support national leadership and cross-sectoral capacity, and document what works in different contexts.
We fully support the WHO Global Strategy for the prevention and control of NCDs. It provides an excellent framework for the work ahead. We encourage WHO to continue providing evidence and data in preparation for the High-level Meeting on NCDs in September next year.
To prepare for the High-level Meeting, the Norwegian Government will later this week host the UNDESA/WHO regional high level consultation on NCDs in Oslo. The 53 member states of the European region of WHO have been invited to attend.
Next year's High-level Meeting offers a key opportunity to galvanize Member States into action to reduce premature mortality from NCDs, with particular focus on the developmental challenges faced by developing countries. We look forward to an inclusive meeting involving a multitude of partners, where we can agree on near-term actions as well as a way to ensure that NCDs in the longer-term are aligned with the health MDGs and support the strengthening of national health systems in an effective and sustained way.
I thank you, Mr. President.