Minister of Health and Care Services Anne-Grethe Strøm-Erichsen:
Reduction of the disease burden, focusing on prevention and non-communicable diseases
Excellencies, ladies and gentlemen,
• The White Paper on Global Health recognizes the “double burden of disease” which is now hitting low income countries. It sets out how we will continue our efforts against communicable diseases, such as Aids, TB and Malaria, but also how we will contribute to tackling the rising tide of NCDs.
• Poor people should not suffer the double burden of disease. For the sick child with diarrhoea or the middle aged woman with diabetes type 2, it is of no interest whatsoever if the suffering is caused by a communicable or a non-communicable disease. The desire and the expectation are to get well. The health worker who meets these patients will also treat them regardless of which category of disease they may belong to.
• Today, I have been asked to focus on prevention and non-communicable diseases. I will do so bearing in mind that any patient deserves the best treatment we can offer with the resources we have available.
• Prevention is the key to fight against non-communicable diseases (NCD). We know that preventing chronic diseases is a great investment – for the benefit of people and for the economy. If we do it right, prevention of NCDs will contribute to economic growth and reduce inequalities in health within and between countries.
• In order to prevent, national governments must take the lead. Risk factors such as tobacco and obesity must be addressed, using policy instruments at population level. At the same time, we should be very conscious about the broader factors which contribute to premature mortality due to NCDs. This means we also have to address and monitor social inequalities in health. If all progress on NCDs is made within higher socioeconomic groups, we will lose the poor people and we will fail.
• National health systems must be strengthened. In particular I would like to underscore the importance of a vigorous primary health care organism which is the heart of the health system. But an effective strategy does not rest with the health sector alone. All countries should be encouraged to develop a public health policy based on the idea “health in all policies”. Cross-sectoral action is needed in order to respond effectively to the NCD challenge. We need active involvement of sectors like urban planning, finance, industry, trade, education, culture and agriculture. NGOs also have a crucial role to play by creating awareness and pushing decision makers.
• For example, the education sector and better road infrastructure can both facilitate physical activity and thus contribute to reducing NCDs as well as health inequalities.
• We know from experience that setting targets and goals are useful in order to achieve progress. ”What gets measured gets done”. In this regard, the World Health Organization has a leading role.
• It was decided, at the High Level Meeting on NCDs in New York on 20. September last year that we will develop targets, indicators and a monitoring framework for countries to apply in their national settings. In this way we will focus efforts for prevention and control of NCDs, ensuring a result - oriented and cost-effective approach.
• From my perspective as a Health Minister I would also like to emphasize the importance of preventing the four common risk factors tobacco smoking, alcohol, diet and physical activity. I am therefore very much in favour of introducing internationally agreed specific exposure targets regarding tobacco smoking, alcohol and obesity.
• Cooperation and coherence are at the core of the Norwegian approach to address non-communicable diseases and related public health issues. Let me quickly give you one example of what we have done to address this nationally: Since the challenge of non-communicable diseases cannot be properly addressed by the health sector alone, Norway has developed cross-sectoral strategies for all four main risk factors - where a range of Ministries have committed themselves to common public health goals. We have also developed a common national strategy for reducing inequalities in health. This is important in order to look beyond the immediate risk factors and also take into account factors such as income redistribution, an inclusive labour market and gender equity.
• Reducing tobacco consumption is one of the most efficient measures to prevent NCDs. However, tobacco industry has taken legal action against a number of Parties to the WHOs Framework Convention on Tobacco Control, including Norway. This is unacceptable. No Party to the Tobacco Convention (FCTC) should allow tobacco industry to intimidate us in fulfilling our legal obligations to protect public health. I have noted with satisfaction that you, Margaret Chan, has spoken strongly against this untimely interference from “big tobacco” on several occasions.
• On my initiative Ministers of Health from Australia, Norway, United Kingdom and Uruguay along with a senior representative of the New Zealand Government, met in the margins of the High Level Meeting on NCDs in New York on 20. September last year to exchange views and experiences in dealing with tobacco industry challenges to domestic tobacco control efforts.
• In this meeting we agreed on the following key messages :
o Implementing the WHO Framework Convention on Tobacco Control (FCTC) can make the greatest single contribution to preventing non-communicable disease.
o Tobacco control policies must be protected from the commercial and other vested interests of the tobacco industry. ’Tobacco use is a global problem that calls for the widest possible international cooperation.
o Parties to the FCTC should work together to ensure dissemination of accurate information about the FCTC.
• Finally, I will ensure you all that I am fully committed to further support WHO in its leading global role in the fighting of diseases whether they are of communicable or non-communicable origin. In particular, together with my international colleagues whom I met with in New York in September last year, and in close collaboration with the Minister of Foreign Affairs, I will explore new ways and means to increase support to the global work against tobacco and respond to the threat from “big tobacco”.