As the UN begins its meeting to devise strategies to tackle NCDs, Indian public health activists say it was a wake-up call for the health authorities in India. Some of them expressed concern that the meeting may be used to push industry agenda
Honorary additional secretary of the Indian Cancer Society
It is the first time the government has agreed that the numbers (of people) killed by non-communicable diseases (NCDs) have long overtaken the communicable diseases numbers. Government was till now concentrating only on the communicable diseases like polio and AIDS. According to a WHO report, in terms of numbers, mortality from NCDs is 51,10,486 and mortality from communicable diseases is 44,024 for the year 2009-10.
As far as cancer is concerned, the government should start an awareness programme to detect early signs of cancer. As of now, the annual medical examination comprises only heart and lungs check-up; if the government includes ENT (ear,nose,throat) check up, then they can easily detect most cancers of the mouth and throat region. If they include a gynaecologist, then breast cancer and cervical cancers can be detected early. A simple examination in men can detect prostate, rectum and colon cancer. Also, this should start at the grassroots level.
Whether after the UN meeting the government will take up something like that is not sure. Health anyway is low on the government's priority list. Price of cancer drugs should also be looked into. The price of cancer drugs is horrendously high.
Associate Professor, head and neck department,
Tata Memorial Hospital, Mumbai
Tobacco has no use whatsoever, except causing death and disability, but continues to be a profitable consumer good. HIV, terrorism, natural disaster and global warming together kill fewer than those killed by tobacco and alcohol, but they caught the attention of UN much earlier. Of the four causative agents of the NCDs, tobacco and alcohol are predominantly industry-driven, whereas the other two—unhealthy diet and lack of exercise—are predominantly behaviour-driven. Bhutan is the only nation that has banned tobacco.
It always baffles me why tobacco-control pundits are always afraid to use the word ban or eradicate when the same is the selling point for non-communicable diseases. Patients and their families are ultimate victims of this state-supported genocide.
Head of tobacco control and health promotion,
Public Health Foundation of India
This summit is providing opportunity globally and nationally to increase awareness on the NCDs that are largely caused due to lifestyle-related changes. There will be increased funding for global health and NCDs will be aligned with the health priorities. With this meeting, the attention of global leaders will shift to the NCDs and there will be increased political commitment.
Just like after the last UN meeting on HIV/AIDS there was inflow of funds by various agencies, similarly this meeting may lead to increased funds being diverted to treating NCDs. Till the time NCDs are not tackled, the Millennium Development Goals (MDGs) of the UN cannot be met.
For tobacco control, we already have an international treaty in place, Framework Convention on Tobacco Control (FCTC). It is cost-effective from which middle and low-income countries would benefit. Accelerated implementation of the FCTC will be discussed at the global level.
Convener of Alliance Against Conflict of Interest (AACI), Member, Prime Minister's Council on India's Nutrition Challenges
This summit should not end up in a partnership with the members who have conflict of interest. From what I have heard, the declaration is already frozen and for the cancer prevention it is said that HPV vaccine will be used. In India, the efficacy of the vaccine has still not been established.
We will have to see how much India respects this declaration. The industry is pushing its agenda through the UN. The UN is also planning to form a separate body to monitor the progress of the follow up of the declaration signed at the meeting.
Medicins Sans Frontieres (MSF)—Campaign for Access to Essential Medicines
The negotiations within the country for the (UN) meeting are over. The government hardly consulted the civil society on the issue. Prevention is always stressed on in such meetings but there is rarely any talk on access to healthcare. This should be the focus. The developing countries do not have the resources to meet the promises made at the UN declaration.
|Sandeep P. Kishore
Medical Scientist Training Program Fellow
Weill Cornell / The Rockefeller University / Sloan-Kettering Institute
On day two of the meeting, there were two themes. One was on access to essential medicines and the other was on conflict of interest.
On access, several countries including Mauritius, Serbia, Thailand, Tanzania India stressed ensuring access to essential medicines and specifically noted intellectual property barriers. Of note, the International Atomic Energy Agency pledged to help make radiotherapies to treat cancer patients available.
But perhaps the most forceful and compelling message came from the Director General of the World Health Organization, Margaret Chan herself. She argued that the industry must understand the importance of price. In particular, she focused on the price and availability of insulin, arguing that this drug is not at all affordable globally and that now is the time for pharmaceutical manufacturers to help rectify that. She argued that companies should not be allowed to tap into the market unless the price is right for governments and households in the developing world.
Consumer International made a crucial distinction between public interest NGOs (PINGOs) and business and industry NGOs (BINGOs). The representative stated that BINGOs should not be involved in policy formulation but in the implementation of public policies. Thailand affirmed this difference as well stating that there is priority to corporations over global health. Thailand argues for global governance to protect health in trade domains and to exclude NCD risk factors from trade agreements like tobacco and alcohol.
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