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2018 United Nations High-Level Meeting on Non-communicable Diseases

The United Nations (UN) adopted a UN Political Declaration on Non-communicable Diseases (NCDs) on 27 September 2018. Supported by advocacy efforts by ESMO and other societies, the Declaration includes a specific paragraph about cancer, which says that UN Member States will promote access to affordable diagnostic, screening, treatment and care as well as vaccines that lower the risk for cancer, as part of the comprehensive approach to its prevention and control, including cervical and breast cancers.

The UN Political Declaration on NCDs represents a major win for the oncology community. Its main goal is to lower health risks and to improve patient outcomes through Universal Health Coverage in order to reduce deaths from NCDs by 25% by 2025 and 33% by 2030. These are ambitious goals whose implementation will require the engagement of all stakeholders.

The UN Political Declaration complements the 2017 WHO ‘Cancer Resolution’ which is the reference document for actions by the WHO and its Member States across the entire continuum of cancer care.

As part of its global policy efforts, ESMO attended the 3rd United Nations High-level Meeting on NCDs in September 2018. ESMO submitted a statement to the UN Secretariat to raise awareness that 30 to 50% of cancer deaths can be avoided with investments in prevention, early detection, and cancer treatment, and that essential cancer medicines, vaccines, and opioids are affordable. The statement highlights the ESMO Magnitude of Clinical Benefit Scale as a tool to assist governments to prioritize the reimbursement of new innovative expensive cancer medicines that have the highest clinical benefit for patients.

Before the 2018 UN High-Level Meeting on NCDs, ESMO and ASCO issued a joint public statement on cancer urging all UN Member States to make sure that cancer was included in the 2018 UN Political Declaration on NCDs.

In the joint statement, ESMO and ASCO advocated for the UN Member States to increase prevention, screening and early detection as well as to ensure the principle of ‘access for all’, which means making quality cancer services available to everyone who requires them.

The ESMO-ASCO statement was instrumental in achieving the inclusion of a specific text on cancer in the 2018 UN Political Declaration on NCDs.

During the 2018 UN High-Level Meeting on NCDs, Heads of State and Government reviewed progress their Member States made to reduce deaths from NCDs since the first UN meeting on the topic in 2011. Recent UN and WHO reports show that progress made to date is inadequate to avoid a preventable global health crisis.

The 2018 UN Political Declaration on NCDs addresses the need to strengthen health systems, improve access to safe, affordable, effective quality essential medicines and vaccines, and to properly plan for a well-trained and equipped oncology workforce to deliver optimal cancer care and achieve Universal Health Coverage. The Declaration reaffirms health as a basic human right and as the precondition for sustainable global development and achievement of the 2030 UN Sustainable Development Goals.

The UN General Assembly has held 3 High-level Meetings on the Prevention and Control of NCDs in 2011, 2014, and 2018. The UN Political Declarations from these meetings summarize the actions that governments commit to implement in order to reduce the burden of NCDs worldwide.

In 2011, the WHO transformed the UN commitments on NCDs into a  WHO Global Action Plan on the Prevention and Control of NCDs 2013-2020, with voluntary targets countries commit to achieve by 2025 when the UN will hold another High-level Meeting on NCDs.

In 2014 the UN HLM on NCDs produced an UN Outcome Document on NCDs that set national time-bound commitments for 2015 and 2016 to develop multi-sectoral strategies to reduce NCD risk factors, improve care, and monitor progress.

The 2018 UN HLM on NCDs adopted a UN Political Declaration on NCDs that focused on measuring the progress countries achieved to meet their 2011 and 2014 goals and to accelerate the process to achieve those in 2030.

2018 publications by the WHO and The Lancet support countries to implement WHO and UN Resolutions and to understand the costs associated with achieving the goals:

  • Saving lives, spending less: a strategic response to noncommunicable diseases’, outlines the health and economic benefits of implementing the most cost-effective and feasible interventions (WHO Best Buys) to prevent and control NCDs in low- and middle-income countries. An additional investment of US$1.27 per person per year would reduce deaths from NCDs by 15%, save  8 million lives, produce a positive return on investment of US$7 for every $1 invested, and generate 350 billion in economic growth, all by 2030.
  • A healthier humanity: the WHO investment case for 2019-2023
    • To provide a billion more people with universal health coverage
    • To protect one more billion people from health emergencies
    • To provide a further billion people with better health and well-being
  • The Lancet article NCD Countdown 2030: worldwide trends in NCD mortality and progress towards SDG target 3.4 says that more than half of the world’s countries are not on target to reduce premature NCD mortality by 33% by 2030. The report is the first from NCD Countdown 2030, an independent annual monitor of progress on reducing the worldwide burden of NCDs. The NCD Countdown 2030 is a collaboration between the WHO, The Lancet, the NCD Alliance, the WHO Collaborating Centre on NCD Surveillance and Epidemiology at Imperial College London, and researchers and practitioners from all regions.

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