From May 10-16th, the WHO Independent High-Level Commission on NCDs released a draft of its first report for public consultation. The report provides a set of four recommendations to guide the global community toward #beatNCDs goals:
- Identify and implement a small set of priorities within the overall NCD and mental health agenda.
- Increase engagement with the private sector.
- Increase funding for action against NCDs.
- Strengthen accountability on action against NCDs.
The consultation gave us a great opportunity to discuss the recommendations with and listen to feedback from our colleagues and partners on social media and other platforms, and helped us to identify a number of points in which the report in its current state falls short—including youth engagement, private sector partnerships, and social inclusion, to name a few. Our response, copied below, focuses on the aims we’d like to see the report achieve.
AIM 1: Emphasizing the importance of grassroots and youth engagement
There are achievable, accessible actions that individuals can take to prevent and reduce the impact of NCDs on their personal lives and communities, but the report doesn’t address this important aspect of bringing about sustainable change. Governments should be encouraged to empower individuals at a grassroots level to understand risks and manage their own health through awareness and prevention.
This includes outreach and empowerment of youth, which is key to creating a culture of awareness and healthy life choices that can stop NCDs before they start. Including youth voices is critical to provide age-specific context, relevance and meaning to any initiative, thereby increasing its effectiveness for this impressionable and often vulnerable demographic. Instilling habits, education and values at an early age can bring significant social and financial gains in the long run.
AIM 2: Build a roadmap for private sector and technology engagement
To set Recommendation 2 (“Increase engagement with the private sector”) up for success, a roadmap needs to be provided, outlining how, who, and why. Most countries have yet to create a multisectoral action plan, and limited guidelines exist for guiding such action. This territory is unfamiliar and messy. Therefore the WHO needs to provide more specific guidance, and should both document and share success stories. Showcasing the return on investment (ROI) a private company can receive in a partnership is a critical, yet missing piece. Case studies and statistics that paint the business case and demonstrate the benefit to the bottom line will lead to increased private sector participation.
The report’s acknowledgement of the potential of technology (particularly Point 41) is noteworthy; however, there is little guidance on its utility and ethical underpinnings. There is a general need to upskill governments in order to keep up with the pace of technology. To increase data and technology usage (ethically and effectively), there will be a big knowledge gap to bridge. Ethics regarding data collection must also be considered, as well as ensuring that any advancements do not inadvertently exacerbate inequities. The use of advanced digital health technologies in resource-limited countries, for example, will only serve to help the small percentage of the population who can afford the technologies.
AIM 3: Make financial incentives for action clear
Recommendation 3 (“Increase funding for action against NCDs”) makes important points, yet the complexity of implementing such recommendations is not addressed. Support from finance ministers, economists, and the like is needed—particularly at the national and cities level (Recommendations 3a and 3b)—to guide the process. This can only be achieved if they are aware of the financial benefits of investing in #beatNCDs programs.
Given the multi-stakeholder collaboration required for implementation of Recommendation 3, contextualised case studies and data clearly outlining the short- and long-term benefits of each recommendation also need to be readily available to support buy-in and intersectoral consensus.
AIM 4: Reduce inequities in outreach and progress
To effect sustainable change, a country or government needs to have a strong foundation of infrastructure, technical skills and process know-how—this MUST come first. As such, tailored capacity building is needed for each country depending on its individual priorities. In lieu of more resource-intensive capacity-building efforts like workshops and trainings, more effective ways of knowledge sharing can be developed: case studies, storytelling, and step-by-step examples presented in clear and concise ways.
The report acknowledges that a shortage of resources often prevents evidence-based solutions from being implemented (e.g. in Point 27), but doesn’t address potential solutions in any depth. Programs to promote knowledge sharing, capacity building, and financing for NCD issues must be expanded in low- and middle-income countries (LMICs), which bear the brunt of the burden of NCDs in spite of having the fewest resources to support the long-term care that many of these diseases require.
We were disappointed by the report’s lack of specific attention to women, minorities, seniors, and marginalized groups. The innate inequities and unique demographic-based challenges these groups face must be acknowledged in order to be addressed in any meaningful way.
AIM 5: Improve accountability mechanisms for governments and civil society alike
We found the report’s Recommendation 4 (“Strengthen Accountability Mechanisms on NCDs”) to be lacking in the detail and depth necessary to encourage effective setting and meeting of targets. While it is perhaps true that accountability mechanisms should be simplified, the lack of detail in Point 46 makes this particular recommendation sound dangerously close to “moving the goalposts” on measuring progress. Governments must be given support and specific suggestions for collecting context-specific data on NCD indicators to track progress, and on setting short-, medium- and long-term goals that work in their national settings.
We also hope that the next draft will address accountability for NGOs and other organizations doing work in the NCD sphere. Civil society plays a key role in implementing policies on the ground, and in lobbying governments and policymakers to set measurable targets for NCD prevention and reduction. Civil society organizations should therefore also be encouraged to set clear targets and put monitoring and evaluation mechanisms in place to hold themselves accountable to their own goals.
FINAL THOUGHT: Innovate communications to maximise engagement and buy-in
The way in which this information is presented should be considered. For NCD messages to cut through the clutter and resonate with Governments, private sector and civil society alike, information needs to be presented in accessible and easy-to-digest ways. An opportunity to implement creative communications is Recommendation 4b, which calls for the establishment of a “Countdown to 2030” campaign for NCDs. In addition to improving accountability, this kind of campaign can build transparency and momentum. Strong communication expertise needs to be implemented to maximise engagement and visibility on NCD issues.