2004

Pan AmericanHealthOrganization

Noncommunicable diseases in the Americas

post UN commitments & advances

Branka Legetic, MD, MPH, PhDPAHO-WHO Regional Adviser onPrevention and control of NCDs

Diabetes

Chronic respiratory disease

Cancer

Cardiovascular diseases

TOTAL NCD DEATHS 2008

3,9 M

Other NCDs

FACING THE FACTS IN THE AMERICAS: disease burden

149 million smokers

25% persons >15 years old obese

Approx. 200 million people living with an NCD in the Americas

36% deaths are below age 70 years

Potential life expectancy gain in the absence of selected risks to global &

regional health,

NCDs and Development Agenda

2004

Pan AmericanHealthOrganization

POST UN HLM and PAHO

NCD Regional Strategy 2012 Plan of Action with regional targets and indicators

2. Technical cooperation with Member States

3. Continue advocacy in global forums: Social Determinants, G8/G20, Summit of the Americas, etc.

4. Promote multi-sector partnerships• Pan American Forum for Action on NCDs

5. Broader engagement in NCDs with other regional UN agencies

2012

2004

Pan AmericanHealthOrganization

2004

Pan AmericanHealthOrganization

OBJECTIVE 1: Multi sector policies and partnerships1.1: To establish multi-sector partnerships and integration of NCD prevention policies into sectors outside of health

OBJECTIVE 2: NCD risk factor reduction & protection2.1: To reduce tobacco use and exposure to second-hand smoke[1].2.2: To reduce the harmful use of alcohol[2]. 2.3: To promote healthy eating and active living (salt, Trans fat)

OBJECTIVE 3: Health System Response to NCDs3.1 To strengthening the capacity of primary health care providers3.2 To implement a model of integrated management of NCDs 3.3. To secure supplies for NCD drugs. 3.4. To secure coverage of multi-drug therapy

OBJECTIVE 4: NCD surveillance and research4.1.quality of NCD and risk factor surveillance systems, including cancer registries4.2. improve utilization of NCD and risk factor surveillance systems to plan and monitor NCD program

Regional Action Plan 2013 :

CARMEN Network 2012CARMEN Network 201234 MembersMembers

Argentina, Anguilla, Aruba, Barbados Bahamas, Bolivia, Brazil, Canada, Colombia, Costa Rica, Cuba, Curacao, Chile, Dominica, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Mexico, Nicaragua, Panama, Paraguay, Peru, Puerto Rico, St Kitts & Nevis, St Lucia, Trin. & Tobago, Uruguay, Surinam,

Prospective MembersProspective MembersVenezuela, Bolivia

Special Special • USA-Mexico (border)

Collaborating Collaborating membersmembersSLU,USF,NHLBI,CDC,PHAC, RAFA,ILSI,F&V, CI, HCC, IHF,

BBrasiliarasilia 2012 2012

260 participants from:

Government officials from 36 countries

24 private sector/companies

45 CSOs & academic organizations

6 International Organizations

UN Declaration calls on Member States to:– Advance the implementation of multisectoral, cost-effective

population-wide interventions in order to reduce the impact of the common NCD risk factors -- tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol

– Initiate the implementation of interventions to reduce salt, sugar and saturated fats, and eliminate industrially produced trans-fat.

– Promote increased access to cost-effective vaccinations to prevent infections associated with cancers.

– Promote increased access to cost-effective screening programmes as determined by national situations..

– Strengthen health systems to deliver cost-effective treatment services.

Advances: policy

• NCD Policy Observatory: with Public Health Agency, Canada – Policy Monitoring (national capacity survey & registry

of laws for diabetes, obesity & CVD)

– Research: case studies: C Rica, Brazil; T&T, Barbados

– Development/revision of National Action plans:Belize, Ecuador,. Rica, Paragvay

– Policy dialogues/advocacy: e.g., • CARICOM Summit of Heads on chronic diseases• CARMEN MERCOSUR, SICA, CAN

2004

Pan AmericanHealthOrganization

Advances: Promotion and Prevention

• Ratification and full implementation of FCTC

• Trans Fat Free Americas Initiative : Argentina, Chile, Brazil, Ecuador, Mexico, Canada, Colombia, Central America,

• Regional Salt reduction initiative : Argentina, Barbados, Brazil, Canada, Chile, Colombia, C Rica, Mexico, Paraguay, Uruguay, US.

• Urban Planning and development of public transport to improve physical activity: 38 cities in Americas; Ciclovia network, Active cities reward

winners

Pirapora, Brasil (medio ambiente

urbano)Belo Horizonte,

Brasil (movilidad y transporte)

Ciclopaseo, Quito (recreación y

deporte)

TransMilenio, Bogota (mención

especial)

Advances : Integrated Management

• Integrated Chronic Care model

• CAMDI – Central American Diabetes Intervention• VIDA Project Mexico on integrated chronic care• TATI project – Peru on cervical cancer screening• TATI 2 Honduras, Bolivia, El Salvador• CVD control through community workers Chile,

Guatemala, Argentina• CVD risk assessment approach Argentina, Ecuador,

Jamaica,

• NCD drugs and basic technology in PAHO Strategic fund to reduce cost of drugs ;

• HPV Vaccine in PAHO Revolving fund

Chronic care passportPriorities for CVD

CARMEN School: continuous education on line

Monitoring changes toward 2025

www.paho.org/chronicdisease

Thank you!