WMA urges United Nations to abandon Silo Approach to Non Communicable Diseases

(19.09.2011) The United Nations has been urged by the World Medical Association to change its strategy towards non communicable diseases by widening its activities to include other preventable diseases.

In a speech today (Monday) at the UN's High Level summit on NCDs in New York, the WMA President Dr. Wonchat Subhachaturas said he had concerns about the present narrow disease-orientated approach to non communicable diseases being adopted by the UN.

‘With the focus mainly on cardiovascular disease, cancer, diabetes and chronic respiratory disease, we fear that governments will concentrate only on improvements in these areas, detracting from other significant needs of other major NCD threats, such as mental disorders, musculoskeletal diseases, oral diseases and accidents. The effect of this vertical or 'silo' approach will be to deprive other important areas of health care of necessary resources.'

Welcoming the inclusion of mental disorders, oral disease and eye diseases to the political declaration of the UN summit meeting, Dr. Subhachaturas said that the burden of disease from NCDs was often multiple and chronic, and the illness and suffering of the individual numerous - only a combined, primary care based, collaborative and whole-person view could succeed.

‘We advocate a complete approach that links individual risk factors with social and economic determinants of health, conditions in which people are born, grow, live, work and age, and the influences of society. From the outset, member states must address NCDs with social determinants of health and communicable diseases - and not in isolation.'

He asked why a child born today should have an expected lifespan which was less than that of his or her parents.

‘Sadly this is the risk we now run if we don't all work together on strategies to reduce the burden of both non communicable and communicable diseases after this United Nations meeting ends. That is the unpalatable heritage that today's infants will receive.'

He said there should be an emphasis on access to effective health care as a human right. Defining health success as a mere statistical challenge deprived individuals of the health care to which they were entitled.

‘We are deeply concerned that the current discussion, especially disease targets, reduces health care to very limited technical provisions. This approach forgets the all too important person-centred care and people-centred public health care approaches. These are vital to all and currently absent from far too many health systems.

‘The way forward is to develop health care systems based on a core of solid primary care. These cannot be reduced to serving particular interests. Illnesses are not confined to one disease category in an individual patient. We know that a patient may have a mental disorder, diabetes, and high blood pressure - all at the same time.

He said that the WMA, along with other health professions in the World Health Professions Alliance, were appealing to member states to pay more attention to preventing, treating and rehabilitating NCDs, many of which had reversible causes. He urged them to take immediate and sustained action to beat this serious threat to human health and development and to:

  • adopt a holistic approach based on common risk factors.
  • extend the scope from a limited number of diseases to the broad field of NCDs
  • ensure equitable access to health care as a human right so as to address the dramatic disparities within and between countries.
  • promote a common approach that addresses the link between non-communicable diseases and the social determinants of health, with a particular focus on the broader factors that influence behaviour and associated health risks.
  • emphasize primary health care as the way to strengthen health care systems through a comprehensive approach integrating prevention, specialised treatment and rehabilitation.