September 21, 2011
UN Calls Special Session on Non-Communicable Diseases
The annual meeting of the United Nations (UN) General Assembly is underway in New York. We're used to seeing either the UN - or the World Health Organization (WHO) - play a leading role in the containment of infectious disease outbreaks, whether acute (e.g., H5N1 flu pandemic) or more chronic (HIV/AIDS). But there has been more pressure for international public health authorities to also focus on the effort to reduct the health burden of non-communicable diseases (NCD) - cardiovascular disease, diabetes, cancer, and chronic respiratory disease. Advocacy efforts to get the NCD agenda into center stage on the international public health agenda have culminated in the UN responsiveness seen this week. A 2011 report from the UN declared its new focus: "Non-communicable diseases represent a new frontier in the fight to improve global health. Worldwide, the increase in such diseases means that they are now responsible for more deaths than all other causes combined." This week, a special UN session was devoted to the NCD public health agenda. The session had been planned for several years, and a draft political declaration had been prepared in advance for adoption at the meeting this week. While no one quarrels with the recognition that the NCD health burden is staggering, the declaration notes, in so many words, that the prevention of NCD (reducing risk factors, including environmental and social adversities) and control of NCD (providing medical services and pharmaceuticals) inevitably draws in a large menu of social and political controversies that are no more amenable to consensus now than before. In that sense, it will be interesting to see how the NCD framing of health disparities summons political will to address the same. Also, to what extent does the elevation of NCD health issues translate to defining such health conditions as "national emergencies" which could invoke the Article 31 of the TRIPS Treaty - authorizing compulsory licensing mechanisms which have been used to alleviate limitations on drug access for infectious diseases (e.g., AIDS)? The UN has used language in its statements ("epidemic proportions") which calls attention to the magnitude of the NCD burden; Dr. Margaret Cho, the director of WHO, has called NCDs "a slow-motion disaster." Thus, this week's meeting and attention accelerates some reframing of public health needs, with the possibility that progress toward allevating both NCDs and non-NCDs ensues, using this egalitarian lens.