- Date submitted: 1 Nov 2011
- Stakeholder type: Major Group
- Submission Document: Download
- Additional Document:
Young Professionals Chronic Disease Network Input to the Rio +20 United Nations Conference on Sustainable Development Compilation Document
The Young Professionals Chronic Disease Network (YP-CDN) believes that investment in youth is a cornerstone of sustainable development and represents a new opportunity for massive gains in health and development across all incomes. There is clear opportunity to influence behaviors, consumption patterns and lifestyles, the ability to transform youth into powerful advocates and build from the bottom-up the next generation of inspired regional, national and global leaders for development. It is this investment in human capacity, in people, that will sustain our future. As the next generation, a small part of the 3 billion youth under age 25 globally, we kindly offer our commitment, passion and energy towards realizing a strong sustainable development agenda.
Representing over 400 emerging leaders, students, youth and young professionals in over 40 countries, we developed a Youth Manifesto on non-communicable diseases (NCDs) for the United Nations High-Level Meeting on NCDs that took place September 2011 (attached) . There are fundamental links among the world?s leading killers and drivers of ill-health, the core risk factors (tobacco, poor diets, inadequate physical activity and harmful alcohol use) and sustainable development. We wish to generalize these recommendations in this instance.
To this end, the compilation draft should forcefully acknowledge that unhealthy consumption and lifestyles threatens sustainable development. Critically, nutrition shifts and demands for meat, fatty foods and palm oils, global mobility shifts away from walking/bicycling and towards more use of cars (as examples) threaten environmental sustainability and severely undercut health gains made in the past century. Reducing tobacco use, increasing physical activity and increasing fruit and vegetable availability would pay health and development dividends across all countries and must be on on the path towards sustainable development .
As the next generation, we view the UN GA High Level Meeting on NCDs, the Rio World Conference on Social Determinants of Health, and the Rio +20 Meeting on Sustainable Development as critically linked. They feed into a shared health, development and environmental sustainability platform. Here, in light of these meetings on social, economic and environmental determinants, we focus our comments on the poverty eradication theme for the compilation document:
First, we assert that NCDs are a development issue. NCDs impact the social, economic and environmental pillars of development. There is a fundamental connection between burgeoning NCDs and the failure/difficulty of reaching traditional Millennium Development Goal (MDG) targets . Integration of targets on NCDs, including tobacco control, into the core development agenda is a concrete first step. The recent High-Level Meeting on NCDs brought NCDs to the global agenda, but now is the time to successfully integrate the issues and relevant health indicators into the sustainable development agenda. The cost of inaction on NCDs by 2030 ($47 trillion) represents lost lives, livelihoods and a stolen future for the next generation which we represent . Health must feature prominently on the sustainable development agenda an we can no longer afford to ignore NCDs.
Governments, civil society organizations, development agencies, and the global public health community at large should expand the next round of development targets beyond MDG-specific targets to a combination of human and economic development goals that explicitly address primordial, primary, secondary, and tertiary prevention and the treatment of NCDs.
Second, we call for transformative, transdisciplinary education to foster the development of people who can successfully develop, implement and evaluate the interventions across sectors and disciplines. We call on public and private academic institutions to encourage interdisciplinary education of the public health workforce. Governments should invest in health professional education at the primary, secondary, undergraduate, graduate, and postgraduate level, stressing: 1) intellectual capital, 2) communication skills, and 3) cross-disciplinary networks [5,6].
Third, we call on governments and development agencies to actively seek input from young people on global development issues to harness their energy, creativity and leadership. We seek to ensure that the voices of young people, inclusive of students and young professionals, are meaningfully included in high-level negotiations and processes. This includes investments in youth leadership for global, regional and national processes and the inclusion of specific time-bound outcomes related to young people and NCDs in global health policy. Youth inclusion ensures not only representation from a key population, but sustainability as the youth leaders of today will be the adult leaders of tomorrow.
Fourth, we call for new commitments to enable universal and equitable access to NCD-related medicines, vaccines, diagnostic and health technologies that successfully balance the right to health against that of trade interests. In particular, we call on equitable access to medicines at affordable prices and for policy makers to make full use of the flexibilities embodied in the TRIPS Agreement and confirmed by the 2001 Doha Declaration, to ?protect public health and, in particular, to promote access to medicines for all? without any restrictions on the scope of diseases. Additionally, we support the full implementation of the WHO Global Strategy and Plan of Action on Public Health, Innovation and Intellectual Property, as committed by governments in the Rio Declaration on Social Determinants of Health.
Fifth, we call on policy makers to assert the rights of the child and conceptualize health across the life-course. There is increasing evidence that NCDs that may manifest during adulthood are impacted by critical events and exposures during childhood, infancy, and in utero. In addition, children are increasingly affected by NCDs in the first instance. Although NCDs affect many young people, most prevention measures are not targeted towards youth. It is young people who will bear the brunt of the economic, social and emotional burden of NCDs throughout their lives. Here, governments and international research and funding bodies should direct more funds to translation trials that can add externally valid evidence to support extensive implementation of science-based findings into real-life settings.
. Young Professionals Chronic Disease Network. Youth Manifesto on Non-Communicable Diseases. Global Heart. 6(4): 201-10.
 Yasmin von Schirnding and Derek Yach, World Health Organization. Unhealthy consumption threatens sustainable development. Rev Saúde Pública 2002;36(4):379-82 . Stuckler D, Basu S, McKee M (2010) Drivers of Inequality in Millennium
Development Goal Progress:
A Statistical Analysis. PLoS Medicine. 7(3): e1000241 . Bloom, D.E., Cafiero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A., & Weinstein, C. (2011).The Global Economic Burden of Non-communicable Diseases. Geneva: World Economic Forum. . Kishore SP, Siegel KR, Kelly B, Vedanthan R, Ali MK, Koplan JP, Narayan V, Fuster V. ?Preparing
the University Community to Respond to 21stCentury Global Public Health Needs?, Global Heart Journal, 2011; 6(4), 183-90. . Huffman MD, Siegel KR, Kishore SP, Bitton A. ?Regarding the Prevention of Global Chronic Disease: Academic Public Health?s New Frontier?, Am J Public Health, Oct 2011;doi:10.2105/AJPH.2011.30040
The Young Professionals Chronic Disease Network (YP-CDN; www.ypchronic.org) is a global network promoting research, policy and advocacy work on non-communicable diseases (NCDs). It capitalizes on the energy, innovative thinking, and courage of young people to challenge the status quo. The YP-CDN participates in the local and global knowledge economy using social media to create virtual platforms for sharing knowledge and ideas. Members are students and budding experts in their fields -public health professionals, doctors, sociologists, anthropologists, philosophers, nutritionists and architects.
In 18 months, YP-CDN has expanded from a small group of 12 medical and public health students to a vast network of 230 people of many disciplines spanning more than 30 countries across 6 continents. On the one hand we have set into motion a grassroots social movement to address the escalating burden of NCDs. By connecting and empowering young people and communities at the global level we give them a voice at the political negotiating table. On the other hand we inform evidence-based policy-making through the development of technical reports, peer reviewed articles, and policy position statements. We held our first meeting at the Harvard Endemic NCD Conference on March 2-3, 2011; over 50 individuals were in attendance from around the world. The photo above profiles the new community.
Contributors: Sandeep P. Kishore, Karen Siegel, Aria Ahmad, Amina A Aitsi-Selmi, Mohammed K.Ali, Phillip Baker, Sanjay Basu, Asaf Bitton, Jerry Bloomfield, Gene Bukhman, Eleanor Emery, Andrea Feigl, Karen Grepin, Mark Huffman, Kiti Kajana, Shweta Khandelwal, Kavitha Kolappa, Chenhui Liu, Naaznin Lokhandwala, Vishal Marwah, Modi Mwatsama, Nicole Novak, Paul Park, Christina Parsons Perez, Matthew R. Price, Nikka Rapkin, Hester Rice, Ben Seligman, Sumit Shah, Joao da Silva, Devi Sridhar, David Stuckler, Rajesh Vedanthan, Justin Zaman
Governments, civil society organizations, development agencies, and the global public health community at large should re-frame NCDs as a barrier to development by explicitly including NCDs as a target for ?technical assistance, capacity building, program implementation, impact assessment of development projects, funding, and other activities,? as recommended by the Institute of Medicine.
o Governments, civil society organizations, development agencies, and the global public health community at large should expand the next round of development targets beyond MDG-specific targets to a combination of human and economic development goals that explicitly address primordial, primary, secondary, and tertiary prevention and the treatment of NCDs.
o Governments should include NCDs and NCD risk factor data collection across all age groups to understand the current burden of NCDs and long-term effects of NCDs and to provide more reliable future projections of the NCD burden.
o Governments should implement programmes that tackle the social determinants of NCDs with particular reference to the following: access to information, lifestyle choices, therapies, and financing.
o Governments should engage local, regional, national, and global communities in health-related priority setting, ensuring fair representation from all stakeholders, including civil society.
o All stakeholders should engage with the private sector in reducing the amount of salt, sugar, and saturated fat content in the food supply and should eliminate trans fats intake, with an emphasis on minimizing price shocks that disproportionately harm poor populations.
o Governments should implement the Framework Convention on Tobacco Control in its entirety to reduce global tobacco consumption by 30% in 10 years. Special commissions should be instituted to target informal sector tobacco consumption practices.
o Governments should include ?health across the lifespan? as a central pillar of all policies (?health in all policies?) to enhance the conditions and health system in which people are born, grow, live work, and age.
o Governments, civil society organizations, development agencies, and the global public health community at large should strengthen maternal and child health programs to reduce maternal and infant mortality rates by 75% as a means to assert women and children?s health rights.
o Governments and private sector actors should implement recommendations from the WHO policy document, ?Set of Recommendations on the Marketing of Foods and Non-Alcoholic Beverages to Children?
o Governments and development agencies should actively seek input from young professionals on global development issues to harness their energy, creativity and leadership.
o Governments should invest in health professional education at the primary, secondary, undergraduate, graduate, and postgraduate level, stressing: 1) intellectual capital, 2) communication skills, and 3) cross-disciplinary networks.
o Educational institutions should build leadership capacity in young professionals by developing and implementing cross-disciplinary and trans-national leadership programs that address NCDs.
o The WHO and civil society should improve the affordability and availability of global level internships, scholarships and other training opportunities for young people, particularly for trainees from LMICs.
5. Enable global access to essential drugs and health technologies
o Governments should mandate generic substitution of medicines and utilize compulsory licenses to reduce the cost of managing chronic diseases by expanding global financing bodies like The Global Fund and UNITAID for the provision of essential NCD medicines and diagnostics.
o The WHO should swiftly enable pre-qualification for the 34 NCD medicines in the WHO Primary Essential Medicines for NCDs (PEN).
o Government ministries should support local supply chain management through increased accountability and incentives
o The WHO should survey the availability and financial cost of diagnosis and treatment of NCDs, including catastrophic health spending, among WHO member states and work with the World Bank and others to develop financial safety nets for populations in need.
o Augment and align global health funding from donor agencies, member countries and private industry with areas of greatest public health gains, as measured through estimated age-adjusted death rates and DALYs.
o Governments should identify regional-and country-level secondary economic gains or losses from interventions that impact NCDs, including interventions outside the health system, in order to achieve a ?health in all policies? policy as done in Finland.
o Governments should introduce NCD Action plans at the ministerial level including NCDs as a line-item in national budgets but also taking care to integrate NCD prevention and control into current priorities.
o Governments and international research and funding bodies should direct more funds to translation trials that can add externally valid evidence to support extensive implementation of science-based findings into real-life settings.
Governments, civil society, development agencies and global public health organizations should:
o Empower and engage communities, particularly youth, to promote equitable access to education and leadership.
o Incorporate the voice of the empowered community in decision-making.
o Work to increase local communities' awareness of risk factors for NCDs and their long term effects, thereby enabling individuals to take control of their own health and amplifying the positive effects of societal changes on health.
1. Promoting the view that these diseases should not be viewed solely as ?the fault? of the individual, but that NCDs are societal problems that require societal solutions. We will lobby our specific governments, promoting NCD awareness on university campuses around the world to this end.
2. Contributing to the development of a vision of a future society rooted in a social determinants of health approach and to work towards integrating the multitude of global agendas, including climate change and sanitation.
3. Performing research to create new knowledge realize health gains across the life course, including how they relate to the rights of the child, and to share current research with governments to accelerate progress.
4. Lobbying our individual academic institutions to introduce lectures on the global burden of disease, social determinants of health, and the relation of NCDs to development priorities land leveraging interdisciplinary training opportunities to tackle the complexities of real-world implementation.
5. Monitoring the WHO Essential Medicines List (EML) concept including adding NCD medicines to the EML, ensuring their listing in national EMLs; monitoring whether medicines make it to shelf and partner with grassroots organizations to prevent drug stock-outs.
6. Encouraging synergies and fostering dialogue between public health (clinical-and population-based) and related disciplines, such as urban planning or agriculture, as well as actively recruiting alternative, non¬medical sources of revenue in partnership with our peers who work in these disciplines.
7. Contributing to the development of a highly skilled movement through peer-to-peer support and capitalize upon opportunities offered by seniors in the field to develop intellectual capital, influence, and cross-disciplinary networks. We will continue to use virtual communities (web 2.0 technologies) to produce a dynamic and barrier-breaking health movement.