Multi-sectoral Consultation on Non-communicable Diseases and Development
16 May 2013, New Delhi.
RECOMMENDATIONS AND WAY FORWARD
The
Multi-sectoral Consultation on Non-communicable Diseases and Development held
in New Delhi on 16 May 2013 was attended by a broad range of Government,
Non-Governmental, Inter-Governmental and development agencies, which generated
a plethora of ideas for further collective action. Following recommendations
emerge from the discussions at the Consultation to guide our further efforts at
national and sub-national levels:
Action by the Health sector:
·
Undertake
Intra-sectoral integration: A multi-sectoral framework
for comprehensive prevention and control of Non-communicable Diseases (NCDs)
requires strong intra-sectoral integration of NCDs within programmes of each
agency. For e.g. NCDs need to be integrated into existing health programs,
alongside creating linkages with non-health programmes.
·
Prevention and control
of NCDs to be emphasized through planning and
implementing a health promotion approach including by engaging Indian systems
of medicine. Health system needs
to be reoriented from a prescriptive to preventive approach and strengthened
for improved health care. In the case of hypertension, for example, this could
include promotion of physical activity, meditation, early detection and
effective control of high blood pressure.
·
Policy interventions: As proposed by the Planning Commission in the 12th
Five-Year Plan, a package of policy interventions is essential for combating
the escalating threat of NCDs. These include, but are not limited to, raising
tobacco taxes, enforcing band on tobacco and alcohol promotions, regulating
advertising of food with high sugar, salt and trans-fat content, salt reduction
in processed food and urban planning policies that promote physical activity
and improve access to affordable, healthy food.
Integration across governmental departments/ ministries
·
Adopt
a “Whole of Government” approach: Linkages
between NCDs and Health, Environment, Agriculture, Urban planning, Trade,
Development and other relevant programmes need to be explored and
operationalised for synergistic advocacy, action and policies across Government
agencies, under the leadership of the Head of Government. A multi-sectoral
coordination mechanism under the Prime Minister’s leadership and coordinated by
the Ministry of Health & Family Welfare that brings together all relevant
Ministries and civil society is critical to advance synergistic action on NCDs
in a manner that curbs the epidemic and contributes to the nation’s
development.
·
Address
equity and vulnerability concerns: As NCDs
aggravate poverty and social and economic inequities, their prevention and
control need to be factored into social welfare and development programmes at
all levels for better developmental outcomes. Special focus should be placed on
protecting vulnerable populations and high-risk groups such as women and
children. School health promotion programmes and healthy food supply in schools
and through maternal and child health programmes of government and
non-governmental entities are to be fully explored to this end.
·
Ensure
“Health in all Policies”: The socio-economic
determinants of NCDs call for sharing of common concerns and planning
collective action with a “Health in all Policies” approach. “Health audits”
were recommended across Ministries, agencies and programmes across sectors. For
instance, cabinet notes of the Government can be required to be vetted for
health impact of proposed policies and programs of various Ministries.
·
Behaviour
Change Communication campaigns dissuading
harmful behaviours such as use of tobacco and alcohol, and promoting healthy
lifestyles are to be further strengthened as recommended by the 12th
Five-Year Plan.
·
Enlist
convergence & synergy in programming:
Integration needs to begin by exploring convergence and synergy between the
goals of programmes, departments and agencies within and across sectors. Identify areas of convergence across
government programmes and those outside of it. For instance, education, law and
community services need to be delivered in a coordinated manner to create
enabling environments that facilitate healthy individual choices to prevent
NCDs.
Integration into national and international development goals
·
Integrate
NCDs into national development agenda: Long-term
sustainability and effective prevention and control of NCDs demand their
integration into the country’s development programmes.
·
Integrate
NCDs into future international development agenda
Similarly, Government of India needs to inform and influence international
dialogue on future development agenda to specifically prioritise and include
NCDs among its goals and indicators.
Action by NGOs and development agencies
·
Mobilise
Non-Governmental action: Mobilise
Non-Governmental organisations working on a broad range of issues related to
NCDs and developments to influence and support relevant Government Ministries
and agencies to move towards the common goal of implementing policies and
programmes that reduce the NCD burden and contribute to national development.
·
Prioritise
social determinants of NCDs in development funding: Development
partners and inter-governmetnal agencies need to recognize action on NCDs as
critical to improving development and afford the issue higher priority and
offer coordinated support.
Sensitization &
capacity building
·
Policy makers,
judiciary, law enforcers, non governmental agencies and development partners
need to be sensitized at relevant fora to work towards agreed goals of
development and prevention and control of NCDs. For instance, a sensitized
judiciary can require legislative action to address various NCD risk factors as
it has done in the case of tobacco use.
Engage media
·
Media is to be
adequately sensitized and engaged to promote NCD prevention and control, not
only at individual level, but also to influence Governmental policies to be
conducive to supporting behavior change at population level.
Address Research Gaps
·
Create the
architecture to foster multi-sectoral research and gather evidence on the
linkages between NCDs and development to inform synergistic programming across
sectors.
·
Research the impact of
promotion of unhealthy lifestyle on risk behaviour and identify strategies that
work in curbing these exposures.
Avoid conflict of
interest
Safeguards are to be
developed to protect policies and programmes aiming to prevent and control NCDs
from the undue influence of industries and other vested interests contributing
to the NCD burden.
Nada India team participated in the one day consultation organised by Public Health Foundation of India on 16th May 2013.