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WPR/DHP/NHP(1)/2011.1 Report series number: RS/2011/GE/08(KOR) English only REPORT REGIONAL HIGH-LEVEL MEETING ON SCALING UP MULTISECTORAL ACTIONS FOR NONCOMMUNICABLE DISEASE PREVENTION AND CONTROL Convened by: WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC Seoul, the Republic of Korea 17 to 18 March 2011 Not for sale Printed and distributed by: World Health Organization Regional Office for the Western Pacific Manila, Philippines April 2011 NOTE The views expressed in this report are those of the participants in the Regional High-Level Meeting on Scaling Up Multisectoral Actions for Noncommunicable Disease Prevention and Control and do not necessarily reflect the policies of the World Health Organization. This report has been prepared by the World Health Organization Regional Office for the Western Pacific for governments of Member States in the Region and for those who participated in the Regional High-Level Meeting on Scaling Up Multisectoral Actions for Noncommunicable Disease Prevention and Control, held in Seoul, the Republic of Korea, from 17 to 18 March 2011. Financial support was provided by the Korea Foundation for International Healthcare (KOFIH). SUMMARY Noncommunicable diseases (NCD) are a significant public health concern for countries and areas in the Western Pacific Region and have been identified as one of the four priorities of the Regional Director. The Regional Action Plan (2008-2013) is guiding NCD prevention in the Region. There is renewed interest in NCD at the global level with a United Nations General Assembly Resolution leading to a High-Level Meeting of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases in September 2011. All WHO regions are organizing high-level NCD meetings in the run-up to a United Nations high-level meeting on NCD. NCD prevention and control efforts have to be scaled up in the Western Pacific Region Member States through high-level political commitment, multisectoral actions and health systems strengthening in addition to resource mobilization for NCD prevention and control. The meeting of senior policy-makers from ministries of health, finance and planning and foreign affairs from Member States along with experts was organized in Seoul, the Republic of Korea, from 17 to 18 March 2011. The objectives of the meeting were: (1) to strengthen high-level political commitment and to place NCD prevention and control as a top priority in the national health and development plans; (2) to promote health in all policies and identify key policy intervention areas in health and nonhealth sectors, which have a strong impact on lifestyle and NCD risk factors for populations; (3) to identify key areas in health systems strengthening based on the values and principles of primary health care with a focus on health promotion and NCD prevention and control; and (4) to strengthen partnerships for NCD and to identify opportunities for mobilizing resources for NCD prevention and control. The Regional High-Level Meeting on Scaling Up Multisectoral Actions for Noncommunicable Disease Prevention and Control consisted of six sessions. The first session set the scene on the WHO Western Pacific regional situation and its strategic response to NCD; economics of the worldwide obesity epidemic; and the health and socioeconomic burden of NCD (challenges and opportunities), including presentations and discussions on the economic burden of NCD in the world. The second session included presentations and panel discussions on the national strategic response to NCD on national policies and programmes. The third session included presentations and panel discussions on multisectoral actions for comprehensive and integrated approaches to reduce major risk factors and social determinants. The fourth session was comprised of country presentations and panel discussions on health systems strengthening to address NCD prevention, treatment and care. The fifth session tackled partnerships for NCD, including presentations on NCD alliance, promoting NCD in the development agenda and a panel discussion on partnership for strengthening national capacity and improving service delivery and research. ii The sixth and final session included deliberations on the draft Seoul Declaration and endorsed it. Mechanisms for communicating with the United Nations General Assembly High-Level Meeting on the outcome of this meeting were discussed. The key recommendations from the meeting are contained in the Seoul Declaration. It is the desire of the participants at the meeting that this declaration be disseminated widely and taken forward to the forthcoming First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control in April 2011 and possibly to the United Nations High-Level Meeting on the Prevention and Control of NCD in September 2011. CONTENTS Page SUMMARY ................................................................................................................................ i 1. INTRODUCTION ............................................................................................................... 1 1.1 Background ................................................................................................................... 1 1.2 Objectives .................................................................................................................. 1 1.3 Participants ................................................................................................................. 1 1.4 Organization ............................................................................................................... 2 1.5 Opening ceremony ..................................................................................................... 2 2. PROCEEDINGS .................................................................................................................. 2 2.1 Session 1 – Health and socioeconomic burden of NCD: challenges and opportunities ........................................................................................................ 3 2.2 Session 2 – National strategic response to NCD: national policy and programme .......................................................................................................... 4 2.3 Session 3 – Multisectoral actions: comprehensive and integrated approaches to reduce major risk factors and social determinants ................................................. 4 2.4 Session 4 – Health systems strengthening to address NCD prevention, treatment and care ...................................................................................................... 5 2.5 Session 5 – Partnerships for NCD .............................................................................. 7 2.6 Session 6 – Seoul Declaration and next steps ............................................................ 7 3. CONCLUSIONS ................................................................................................................. 9 ANNEXES: ANNEX 1 - LIST OF PARTICIPANTS, TEMPORARY ADVISERS, RESOURCE PERSONS, OBSERVERS AND SECRETARIAT ANNEX 2 - MEETING PROGRAMME ANNEX 3 - WHO REGIONAL DIRECTOR OPENING REMARKS ANNEX 4 - NADI STATEMENT ON THE NCD CRISIS IN PACIFIC COUNTRIES AND TERRITORIES ANNEX 5 - SELECTED PRESENTATIONS Keywords Noncommunicable diseases – prevention and control / Risk factors / Partnership 1. INTRODUCTION 1.1 Background Noncommunicable diseases (NCD) are a significant public health concern for countries and areas in the Western Pacific Region and have been identified as one of the four priorities of the Regional Director. The Regional Action Plan (2008-2013) is guiding NCD prevention in the Region. There is renewed interest in NCD at the global level with a United Nations General Assembly Resolution leading to a High-Level Meeting of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases in September 2011. All WHO regions are organizing high-level NCD meetings in the run-up to a United Nations high-level meeting on NCD. NCD prevention and control efforts have to be scaled up in the Western Pacific Region Member States through high-level political commitment, multisectoral actions and health systems strengthening in addition to resource mobilization for NCD prevention and control. A meeting of senior policy-makers from ministries of health, finance and planning and foreign affairs from Member States along with experts was organized in Seoul, the Republic of Korea, from 17 to 18 March 2011. Pacific island countries consulted in February in Nadi, Fiji, and produced the Nadi statement on the NCD crisis in Pacific island countries and areas as their collective voice. 1.2 Objectives The objectives of the meeting are: (1) to strengthen high-level political commitment and to place NCD prevention and control as a top priority in the national health and development plans; (2) to promote health in all policies and identify key policy intervention areas in health and nonhealth sectors, which have a strong impact on lifestyle and NCD risk factors for populations; (3) to identify key areas in health systems strengthening based on the values and principles of primary health care with a focus on health promotion and NCD prevention and control; and (4) to strengthen partnerships for NCD and to identify opportunities for mobilizing resources for NCD prevention and control. 1.3 Participants The meeting was attended by 31 participants, temporary advisers and resource people from 16 countries and areas in the Region, namely: Australia, Brunei Darussalam, Cambodia, China, Hong Kong (China), Japan, Kiribati, the Lao People's Democratic Republic, Macao (China), Malaysia, Mongolia, New Zealand, the Philippines, the Republic of Korea, Singapore and Viet Nam. Observers from 17 organizations and agencies also were present. - 2 - Five WHO staff from the Western Pacific Regional Office and one from WHO Headquarters in Geneva, Switzerland, served as the Secretariat. The list of participants, temporary advisers, resource people, observers and members of the Secretariat is presented in Annex 1 and the programme of the meeting is presented in Annex 2. 1.4 Organization The Regional High-Level Meeting on Scaling Up Multisectoral Actions for Noncommunicable Disease Prevention and Control consisted of six sessions. The first session set the scene on the WHO Western Pacific regional situation and its strategic response to NCD; economics of the worldwide obesity epidemic; and the health and the socioeconomic burden of NCD (challenges and opportunities), including presentations and discussions on the economic burden of NCD in the world. The second session included presentations and panel discussions on the national strategic response to NCD on national policies and programmes. The third session also included presentations and panel discussions on multisectoral actions for comprehensive and integrated approaches to reduce major risk factors and social determinants. The fourth session was comprised of country presentations and panel discussions on health systems strengthening to address NCD prevention, treatment and care. The fifth session tackled partnerships for NCD, including presentations on the NCD Alliance, promoting NCD in the development agenda and a panel discussion on partnership for strengthening national capacity, improving service delivery and research. The sixth and final session included discussion and finalization of the draft Seoul Declaration, the mechanism for communicating with the United Nations General Assembly High-Level Meeting on the Prevention and Control of Noncommunicable Diseases. 1.5 Opening ceremony The meeting was opened by Dr Chin Soo-Hee, Minister of Health and Welfare, the Republic of Korea, and Dr Shin Young-soo, WHO Regional Director for the Western Pacific. Dr Shin's opening address is attached as Annex 3. The meeting commenced with a video keynote address by Dr Ala Alwan, Assistant Director-General, Noncommunicable Diseases and Mental Health, WHO Headquarters, in which he stressed the importance of addressing the common risk factors for NCD to reduce disability, morbidity and premature death. NCD are a threat to economic development and impede poverty-reduction initiatives, including achievement of the Millennium Development Goals. There is a need to accelerate national and global actions against NCD. He also shared with the meeting the global response to NCD by WHO which will culminate in the United Nations High-Level Meeting on the Prevention and Control of NCD (UN HLM) in September 2011. 2. PROCEEDINGS The meeting continued with a brief introduction and a discussion of the draft Seoul Declaration, which is one of six regional declarations leading up to the UN HLM on NCD. - 3 - It was followed by the presentation of the Nadi Statement on the NCD crisis in Pacific island countries and territories by Dr Kautu Tenaua, Minister of Health and Medical Services, Kiribati, attached as Annex 4. The meeting was briefed on the issues faced by the Pacific islands and the response agreed to in the Nadi Statement endorsed in February 2011. The key point from this declaration is the concern of Pacific nations on the health and economic burdens imposed by the rapidly developing epidemic of NCD at the individual, family, community and national levels. In view of the NCD crisis, and the inadequate response to date, the following urgent actions are required in the Pacific: political leadership at the highest level to take responsibility for and address the crisis at national and regional levels; the right multisectoral policy environment to mainstream the response; support for priority cost-effective interventions and monitor their implementation and expand the evidence base through research and surveillance; adequately resource and sustain the response; ensure full accountability of all sectors for their respective contributions; significantly strengthen advocacy and community engagement to maintain a focus on the NCD crisis; and strengthen health systems to effectively respond to the crisis. 2.1 Session 1 – Health and socioeconomic burden of NCD: challenges and opportunities 2.1.1 The WHO Western Pacific regional situation and its strategic response to NCD The presentation outlined the NCD burden in the Region. A key finding is that the death rates from NCD are now higher in the low- and middle-income countries than in the high-income countries in the Region. The major risk factors are prevalent in the Region, especially tobacco use among men, and high body mass levels in most the countries. The comprehensive WHO/Western Pacific Regional Office response was summarized and the roadmap towards and after the UN HLM outlined. The Regional Committee Meeting in October will be preceded by a regional forum on NCD, which will focus on post-UN HLM issues. 2.1.2 Economics of the worldwide obesity epidemic This presentation reviewed the global and regional obesity situation and the opportunities and difficulties in responding to the obesity pandemic. The high rates of obesity in the Region were described and the need for (sub) region-specific cut points stressed. It was proposed that the obesity epidemic is the result of technological advancements that have changed the relative costs of food consumption (decreasing) and physical activity (costs increasing, especially the opportunity costs). There is not enough information about the health costs of obesity in the Region. Addressing obesity will require strong government action since the private sector inevitably under-invests in prevention. It was proposed that not enough is known about the causes of the obesity epidemic. Successful strategies will need to change the costs and/or benefits of obesity-related behaviours and will need to be multidimensional (and likely include drugs and devices). Incentives and disincentives may have a role, but more research is needed and the best chance of success may be to focus on youth and even earlier. 2.1.3 Economic burden of NCD in the world This presentation summarized the reasons for the World Economic Forum placing such importance on NCD as a global economic threat and the actions taken in response by the forum. Costs are major, both direct and indirect, but not yet clear. There is a lack of data from different regions. Most studies are disease-specific, making them difficult to compare and to argue for - 4 - NCD at large. There is also a lack of strong evidence of costs incurred outside the health sector and direct links to major global risks savings. There is a need for a costs and savings rationale that speaks to business and government. The discussion emphasized a need to ensure that healthy foods and beverages and physical activity make commercial sense as well as having a public health rationale. The focus on the health and well-being of children is based on the long-term goal of prevention, even though it does not have a purely economic justification. 2.2 Session 2 – National strategic response to NCD: national policies and programmes 2.2.1 NCD prevention and control – Australia's perspective This presentation reviewed the disease and risk factor burdens in Australia and the national response which has had notable successes, especially in tobacco control, although obesity, health inequalities and the ageing population present significant problems. The National Health Reform Agenda (2011) provides an opportunity to reduce the lifestyle risks in Australia. 2.2.2 Strategic response to NCD epidemic in China The key challenges are the high rates of NCD and the high prevalence of risk factors, especially smoking, and, increasingly, obesity. Various programmatic responses are in place across the full range of strategies although the response is in need of urgent strengthening. 2.2.3 National policy and programme on NCD prevention and control in Mongolia The burden of NCDs is high in Mongolia and risk factors prevalent, especially heavy alcohol consumption and low fruit and vegetable intake. A feature of the response is the new Health Promotion based on a 2% tobacco tax (2007) and, recently, a 1% tax on alcohol and a 2% VAT on imported drugs. Progress is hampered by the influence of the alcohol and tobacco industries. 2.2.4 A national policy and programme on NCD prevention and control in Viet Nam The burden of NCD is high and the response has, until recently, been organized in a vertical fashion. A more integrated approach is under development. 2.2.5 Discussion The discussion emphasized the challenges of more effectively responding to the NCD, especially in low resource settings where both finance and human resources are scarce. The importance of win-win strategies involving multiple partners was emphasized and the need for a regulatory response in many situations. Innovative financing will be a useful option and should be considered more widely. Local priorities will vary but key strategies are cheap and affordable, e.g. tobacco control and salt reduction, and should be part of a coherent, funded and planned response. 2.3 Session 3 – Multisectoral actions: comprehensive and integrated approaches to reduce major risk factors and social determinants 2.3.1 Multisectoral action for behaviour change and health promotion foundations - 5 - The health sector has a key leadership role in the response to NCD across the full range of strategies. Health promotion foundations are an important financing mechanism and the evolving regional experience with these foundations is encouraging. Multisectoral action is critical and there are good regional examples of success; bisectoral approaches are a useful starting point. However, barriers to more effective action are strong, e.g. obesity, especially in childhood, and are a result of "commercial successes and market failures". The auto industry is a key factor in the obesity epidemic. International multisectoral action and global networks will strengthen local resolve. In summary, national development is difficult without controlling NCD and it will not be easy to control NCD without the ownership and participation of development agencies. 2.3.2 Promoting a healthy lifestyle – Singapore’s experience Singapore has a relatively young population with good health indicators. There is a focus on prevention although obesity is increasing and there is concern that a tipping point might soon be reached which could lead to escalating rates of obesity. Both top-down and bottom-up approaches are required and are in place. The successful "Mee Rebus" story (healthy noodles with brown rice) was described; it involved a response from the 3Ps – private sector, people and the public sector (whole-of-government approach). 2.3.3 Healthy diet and physical exercise – Hong Kong experience NCDs are the main health issue in Hong Kong and the burden will increase as the population continues to age. A full range of strategies has been developed and implemented. Multisectoral actions are in place, e.g. involving health and education sectors. The major challenges include maintaining political will; the sustainability of current efforts; and the coordination of multiple partners and stakeholders, all with a different agenda. 2.3.4 Discussion The question of what works in low resource settings was posed by the chair. The answers include the need for environmental policies and mechanisms to integrate medical and preventive services; capacity-building; social mobilization and promotion; engagement of all partners, especially the public; support from international partners; and extra resources. A small number of performance targets, as used in New Zealand, will be helpful and monitoring progress is essential. The overall aim is to develop an environment which facilitates healthy behaviour choices. The importance of being alert to possible tactics of the food and beverage industries was stressed. They will build on the experience of the tobacco industry, which continues to influence tobacco control policies. The public health community needs to develop criteria for working with industry. 2.4 Session 4 – Health systems strengthening to address NCD prevention, treatment and care This session had presentations by Dr Hendrik Bekedam, Professor Li Liming, Dato' Dr Hasan Abdul Rahman and Dr Mark Jacobs on strengthening health systems for NCD and by Professor Soonman Kwon on sustainable financing for NCD. 2.4.1 Health systems and NCD There are differences in the requirements for management of communicable and noncommunicable diseases, and resources and capacities for NCD vary in the region. There is a need to move towards integrated services for all common conditions, regardless of cause. Most Member States in the Region have NCDs as part of a national health plan but not all have a strong national political commitment and not all are funded. The ultimate goal is to provide a mix of population-based and individually-based services across the NCD risk continuum. In addition, - 6 - there is a need for patient-centred and a continuum of care; treatment at the appropriate level; a shift towards multidisciplinary teams; empowerment of patients and peers; and cost control. Above all, to get started, NCD must be included in the costed national health plans based on capacities and resources. 2.4.2 Strengthening primary health care for NCD prevention and control Integrated community-based NCD Prevention and Control began in 1997 based on an integrated community hospital-based diabetes project and a national community-based hypertension project (reduction in hypertension). Healthy cities provide valuable practice for NCD prevention and control. 2.4.3 Sustainable financing for NCD Health systems financing, including the amount and mix of health care financing, varies among Member States in the Region. It is rare to have a financing scheme targeting NCD. An unresolved issue concerns the optimum amount of spending; this depends on health expenditures and health outcomes. Most low- and medium-income countries face high out of pocket (OOP) payments, which discriminate against the poor, especially if the prices of medicines are high. The benefit package needs to cover both medical care and pharmaceuticals and there is a need to monitor the level and amount of spending. Innovative additional sources of NCD financing are available, e.g. increases in the tobacco tax that have a major impact on smoking and in generating extra revenue for prevention and service delivery. 2.4.4 Health systems strengthening and NCD – Malaysia’s experiences There are two components of the health system: public (majority of patients) and private (majority of facilities). Efforts to strengthen NCD management at the primary health care level began in the 1990s based on a National Strategic Plan for Prevention and Control of Diabetes as an entry point for health systems strengthening. The next approach is 1 Care (blueprint in 2013), which aims to integrate public and private services, where payments are linked to the performance of doctors. 2.4.5 Improving NCD service delivery: quality, access and coverage – Experience from New Zealand NCD services cover the full spectrum of activities, from population-based approaches to individually targeted care. There have been improvements in quality, access and coverage though significant health inequalities remain. NCD risk factor trends vary – obesity increasing, tobacco and cervical cancer decreasing. Approaches to improving NCD service delivery include national health performance targets. Three of six relate to NCD: shorter waits for cancer treatment, better help for smokers to quit and better services for cardiovascular diseases and diabetes mellitus. Other measures for NCDs include fruit in schools – one piece of fruit for each of 100 000 students in low socioeconomic areas; green prescriptions for physical activity, now extended to 5-18 years; "care plus" – improved management of patients with complex problems; regional cancer control networks; and Let’s Beat Diabetes – long term sustainable change to prevent or delay complications, especially for Maori and Pacific people using the life course approach. Key aspects to success include continuity of care for NCD, a mix of national, regional and local programmes, involvement of service providers and providing information, including monitoring and evaluation. - 7 - 2.4.6 Discussion Challenges include scaling up of nonhealth sector involvement; engagement of communities; building political support; sustainability of health care financing; establishing country-specific targets and tools; creation of enabling and a positive environment for a healthy lifestyle; and addressing reliance on food imports, especially processed food. Health information systems need strengthening in all countries. A fundamental question is whether NCD are really on national agendas; not all participants are convinced. 2.5 Session 5 – Partnerships for NCD 2.5.1 NCD Alliance The NCD Alliance was established in 2009 and was made up of four international nongovernmental organizations (NGOs), 900 associations with strong partnerships and networks. It is the recognized leader in civil society with the important task of producing disease-specific and NCD indicators and targets and to foster leadership and to persuade donors and philanthropic organizations to invest in NCDs. The NCD Alliance has published its suggestions for the outcome document for the UN HLM on NCD (see NCDA website (http://www.ncdalliance.org/). 2.5.2 Promoting NCD in the development agenda Development of an integrated NCD prevention and control programme in the Philippines started in 2000, culminating in an administrative order, the National Policy on the Prevention and Control of Chronic Lifestyle-Related Noncommunicable Diseases. Challenges include adoption by the national government and localization by local government units; mobilization of human and financial resources and development of an appropriate financing mechanism; organization of health delivery systems (strengthening primary care); development and standardization of performance indicators and information systems for NCD; and strengthening partnerships with professional organizations, NGOs and international agencies. 2.5.3 Discussion The discussion focused on the role of the Union for International Cancer Control, the Southeast Asia Tobacco Control Alliance, the Framework Convention Alliance, the United Nations Economic and Social Commission for Asia and the Pacific, the World Economic Forum, the Asian Development Bank and the World Bank. All agencies are active in NCD prevention and control and wish to increase their engagement. There is a need to coordinate these actions. Selected presentations are attached as Annex 5. 2.6 Session 6 – Seoul declaration and next steps The main outcome of the meeting was the Seoul Declaration on Noncommunicable Disease Prevention and Control in the Western Pacific Region. A draft was available to participants and was discussed on two occasions at the meeting before the final version was presented, revised again and then endorsed by all participants. - 8 - The Seoul Declaration will be distributed widely and discussed by Member States and other interested stakeholders. It is expected that the declaration will be presented at the forthcoming First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control to be held in Moscow, Russia, from 28 to 29 April 2011. SEOUL DECLARATION ON NONCOMMUNICABLE DISEASE PREVENTION AND CONTROL IN THE WESTERN PACIFIC REGION Recognizing the serious and rapidly increasing adverse impact of NCD, including cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, on individuals, families, communities, health systems and national economies, and the high prevalence of the risk factors, the countries and areas of the WHO Western Pacific Region participating at the Regional High-Level Meeting on Scaling Up Multisectoral Action for Noncommunicable Disease Prevention and Control, declare their commitment to: (1) provide strong and sustained high-level political support for NCD prevention and control programmes to reduce premature NCD death and disability and health inequalities; (2) ensure a supportive multisectoral whole-of-government policy environment and a coordinating process to mainstream the response to NCD involving all stakeholders, including civil society and, where appropriate, the private sector to protect health and to ensure that healthy choices are the easier choices; (3) reduce the common NCD risk factors (tobacco use; diets high in total fat, saturated and or trans-fats, salt and sugar; the harmful use of alcohol; and physical inactivity); and (a) in line with WHO action plans and using the full range of options, including legislation, regulation, fiscal measures and healthy public policies and, in particular, accelerate towards the full implementation of the Framework Convention on Tobacco Control; and (b) by addressing the social determinants of health and by leveraging the power of local governments and civil society actions; (4) strengthen and integrate health systems, based on primary health care to ensure that NCD prevention and control is part of a funded, coherent, balanced, realistic and comprehensive health planning process that is financially feasible and to: (a) deliver services for NCD and their risk factors using team-based care and the most appropriate health professional for the patient’s needs and including affordable and cost-effective drugs, technologies and services to support evidence-based priority interventions; and (b) work towards continuity of quality care from prevention to palliative care across the whole health system and promote a people-centred approach with synergies with other programmes; (5) prioritize human and financial resources and infrastructure to ensure equitable coverage of priority evidence-based NCD programmes; and - 9 - (6) provide integrated but practical monitoring and accountability systems based on strengthened health information systems and, as appropriate, a small number of quantified and timed targets and indicators to assess progress nationally to be reported publicly and to WHO and, if appropriate, to the United Nations General Assembly. In support of these commitments, participating countries and areas request the global community, through the United Nations High-Level Meeting on the Prevention and Control of NCD, to act in a coordinated way to support global and national multisectoral efforts by: (1) raising the priority of NCD on their agendas; (2) strengthening synergies between NCD programmes and other development priorities, including the Millennium Development Goals and the future global development agenda; and (3) mobilizing additional resources and supporting innovative approaches to financing NCD prevention and control. 3. CONCLUSIONS The meeting emphasized the pressing health, social and economic burdens imposed by NCD in all countries in the Region. Although there have been many successes in reducing NCD death rates at all ages in several countries, their response is still inadequate. WHO has led the development of a full range of strategies to respond to the main risk factors for NCD, notably the Framework Convention on Tobacco Control (FCTC), which has been ratified by all countries in the Region, and global and regional strategies for diet and physical activity and to reduce the harmful effects of alcohol. To date, implementation of these strategies has been incomplete at the national level. For example, tobacco use remains high in many countries, especially among men, and the key elements of the FCTC are not yet being fully implemented. There are many positive examples of national NCD prevention and control programmes, including bisectoral and multisectoral programmes, from which important lessons can be learnt for all countries in the Region. Explicit and transparent approaches to working with the food and beverage industry towards independently monitored targets require discussion and agreement. A key requirement is that national NCD prevention and control programmes are an integral, and costed, component of national health plans. The cost of implementing key NCD interventions is relatively low -- for example, for tobacco control and salt reduction programmes and primary health care-based strategies to reduce the risk of NCD, especially cardiovascular diseases. Most countries would benefit from extra resources and innovative funding mechanisms such as health promotion foundations in place in several countries in the Region. They generally have been successful in reducing harmful consumption and raising extra revenue. Strengthening health systems to respond to all priority conditions regardless of cause is an outstanding challenge in all countries. A stepwise approach may be useful beginning at the primary care level and, for example, training existing staff in cardiovascular risk assessment and management and in simple tobacco cessation approaches. - 10 - There is considerable support available for national prevention and control activities from regional and international agencies, including from WHO. The NGO community is a valuable partner for national and regional efforts. Evaluation and monitoring are essential components of all NCD programmes with attention to learning lessons and modifying approaches as appropriate. The key recommendations from the meeting are contained in the Seoul Declaration. It is the desire of the participants at the meeting that this declaration be disseminated widely and taken to the forthcoming First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control in April 2011 and possibly to the United Nations High Level Meeting on the Prevention and Control of NCD in September 2011. ANNEX 1 LIST OF PARTICIPANTS, TEMPORARY ADVISERS, RESOURCE PERSONS, OBSERVERS AND SECRETARIAT 1. PARTICIPANTS BRUNEI DARUSSALAM Dr Norhayati KASSIM, Senior Medical Officer, Head of Health Promotion Centre, Ministry of Health, Jalan Commonwealth Drive, Bandar Seri Begawan. Telephone: (673) 2384220. Facsimile: (673) 8722086. E-mail: norhayati.kassim@moh.gov.bn CAMBODIA Dr PRAK Piseth Raingsey, Director, Preventive Medicine Department, Ministry of Health, #151-153, Blvd. Kampuchea Krom Phnom Penh. Telephone: (855) 128620. E-mail: pisethsey@yahoo.com. CHINA, PEOPLE'S REPUBLIC OF Dr GONG Sen, Director for Social Policy Research Office, Research Department of Social Development, State Council Development Research Centre, 225 Chaoyangmen Nei Dajie Beijing 100010. Telephone: 010-65236662. E-mail: gongsen@drc.gov.cn LAO PEOPLE'S DEMOCRATIC REPUBLIC Ms Sisomboun OUNAVONG, Deputy Director General, Ministry of Planning and Investment, Sithanneua Village, Sikhottabong District, Vientiane. Telephone: +856-21-222213 Facsimile: +856-21-217010. E-mail: osisomboun@yahoo.com Professor VANG Chu, Director of Cardiology Department, Mahosot Hospital, Director, National Institute of Cardiology, P.O. Box 5202, Vientiane Municipality. Telephone: 856-20-54303999. E-mail: wachuvang@gmail.com MONGOLIA Ms Otgonbayar CHIMIDDORJ, Officer, Development Financing and Cooperation Department, Ministry of Finance, 15160 United Nations Street 5/1, Government Building 2, Chingeltei District, Ulaanbaatar. Telephone: +976-11-266415. Facsimile: +976-11-262272. E-mail: otgonbayar_ch@mof.gov.mn PHILIPPINES Dr Ma. Virginia ALA, Director IV, Health Policy Development and Planning Bureau, Department of Health, San Lazaro Compound Rizal Avenue, Sta. Cruz, Manila. Telephone: +632-711-5377. Facsimile: +632-781-4362. E-mail: marvie_ala@yahoo.com REPUBLIC OF KOREA Mr Ki-hwan KWEON, Director, Human Rights and Social Affairs Division, Ministry of Foreign Affairs and Trade, 37 SeJong-no, Jongno-gu, Seoul. Telephone: 82-2-2100-7264. Facsimile: 82-2-2100-7934. E-mail: khkwon92@mofat.go.kr VIET NAM Dr NGUYEN Son Tuong, Deputy Director, Department of Labor, Culture and Social Affairs, Ministry of Planning and Investment, No. 6B Hoang Dieu Street, Badinh District, Ha Noi. Telephone: +8491 359 6898. Facsimile: +0084 804 4577. E-mail: tuongson66@hotmail.com / sonnt@mpi.gov.vn 2. TEMPORARY ADVISERS Mr ANG Hak Seng, Chief Executive Officer, Health Promotion Board (Singapore), 3 Second Hospital Avenue, Singapore 168937. Telephone: 6435 3500. Facsimile: 6438 3848. E-mail: ang_hak_seng@hpb.gov.sg Dr Truong Dinh BAC, Head of Division of Noncommunicable Diseases Control and School Health, General Department of Preventive Medicine, Ministry of Health, Ha Noi, Viet Nam. Telephone: (84) (4) 3 7368378. Facsimile: (84) (4) 3 7367379. E-mail: truongdinhbac@gmail.com Ms Jenny HEFFORD, Chief Regulatory Officer, Department of Health and Ageing, GPO Box 9848, Canberra ACT 2601, Australia. Telephone: +61 (0)2 6289 8408. Facsimile: +61 (0)2 6285 1994. E-mail: Jenny.Hefford@tga.gov.au Dr CHAN Tan Mui, Coordinator of Chronic Disease Prevention and Health Promotion Unit, Health Bureau, P.O. Box 473, Macao SAR (China). Telephone: 853-28533525. Facsimile: 853-28533524. E-mail: tmchan@ssm.gov.mo Dr Eric Andrew FINKELSTEIN, Deputy Director and Associate Professor, Health Services Research Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857. Telephone: 6516 2338. E-mail: eric.finkelstein@duke-nus.edu.sg Dr Mark JACOBS, Director of Public Health, Ministry of Health, P.O. Box S013, Wellington, New Zealand 6145. Telephone: +64 4 816 4481. Facsimile: +64 4 496 2191. E-mail: mark_jacobs@moh.govt.nz Dr JADAMBA Tsolmon, Vice Minister of Health, Ministry of Health Mongolia, Olympic Street-2, Government Building VIII, Ulaanbaatar, Mongolia. Telephone: +976-51-261742. Facsimile: +976-11-320916. E-mail: tsolmon@moh.mn Dr Byungyool JUN, Director-General of Disease Policy, Ministry of Health, 75 Yulgong-ro, Jongro-gu, Seoul 110-793, Republic of Korea. Telephone: 822-2023-7540. Facsimile: 822-2023-7551. E-mail: byjun@mw.go.kr Dr KONG Lingzhi, Deputy Director General, Department of Disease Control and Prevention, Ministry of Health, No. 1 Xi Zhi Men Wai Nan Lu, Beijing 1000044, People's Republic of China. Telephone: 0086-10-68792368. Facsimile: 0086-10-68792514. E-mail: klz1953@yahoo.com Dr Soonman KWON, Deputy Dean, Department of Health Policy and Management, School of Public Health, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea. Telephone: +82-2-880-2721. Facsimile: +82-2-745-9104. E-mail: kwons@snu.ac.kr Dr LAM Ping-yan, Director of Health, Department of Health, Government of Hong Kong Special Administrative Region, 21st Floor, Wu Chung House, 213 Queen’s Road East Wan Chai, Hong Kong. Telephone: (852) 2961 8888. Facsimile: (852) 2893 9613. E-mail: pylam@dh.gov.hk Dr Jong-Koo LEE, Director/Deputy Minister, Korea Centers for Disease Control and Prevention, 643, Yeonje-ri, Gangoe-myeon, Cheongwon-gun, Chungcheonbuk-do Seoul 363-951, Republic of Korea. Telephone: +82-43-719-7000. Facsimile: +82-43-719-7003. E-mail: docmohw@mw.go.kr / docmohwl@korea.kr Professor LI Liming, Chairman, Chinese Academy of Medical Sciences and Peking Union Medical College, 9 Dong Dan San Tiao, Dongcheng District, Beijing 1000730, People's Republic of China. Telephone: 8610-65105905. Facsimile: 8610-65124876. E-mail: Lmlee@pumc.edu.cn / Lmlee@vip.163.com Professor Alan Rob MOODIE, Chair of Global Health, Nossal Institute for Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Level 4, Alan Guilbert Building, 161 Barry Street, Carlton, Victoria 3010, Australia. Telephone: +61 3 83441993. Facsimile: +61 3 93476872. E-mail: r.moodie@unimelb.edu.au Dato’ Paduka Hj Abd Salam bin Abd MOMIN, Permanent Secretary, Ministry of Health, Commonwealth Drive BB3910, Bandar Seri Begawan, Brunei Darussalam. Telephone: +673 2383667. Facsimile: +673 2381920. E-mail: salam.momin@moh.gov.bn Dr Bounkouang PHICHIT, Deputy Minister of Health, Ministry of Health, Samsanthai Road Simuang Village, Vientiane, Lao People’s Democratic Republic. Telephone: 85621-214003. Facsimile: 85621-214003. E-mail: sn_24lao@yahoo.com Dato’ Dr Hasan Abdul RAHMAN, Deputy Director General of Public Health, Ministry of Health, Level 12, Block E7, 62590 Putrajaya, Malaysia. Telephone: 603-88832544. Facsimile: 603-88895601. E-mail: hasar@moh.gov.my Professor Myongsei SOHN, Dean, Graduate School of Public Health, Yonsei University, 250 Seongsanno, Seodaemun-gu, Seoul 102-752, Republic of Korea. Telephone: 02 2228-1505/1870. Facsimile: 02 392-8133. E-mail: msohn53@yuhs.ac Dr Lo VEASNAKIRY, Director of Planning and Health Information Department, Ministry of Health, 151-153, Blvd. Kampucheakrom, Phnom Penh, Cambodia. Telephone: +855 23 426 372. E-mail: veasnakiry@online.com.kh Dr Mario C. VILLAVERDE, Undersecretary of Health, Department of Health, Building 14 San Lazaro Compound, Rizal Avenue, Sta. Cruz, Manila, Philippines. Telephone: (632) 931-1275. Facsimile: (632) 711-6967. E-mail: mcvillaverde@doh.gov.ph 3. RESOURCE PERSONS Professor Robert BEAGLEHOLE, Professor Emeritus, University of Auckland, Auckland, New Zealand. Telephone: 649 4463376. E-mail: r.beaglehole@auckland.ac.nz Dr Kautu TENAUA, Minister of Health and Medical Services, Ministry of Health and Medical Services, P.O. Box 268, Bikenibeu, Tarawa, Kiribati. Telephone: (686) 28100 ext 201/202. Facsimile: (686) 28152. E-mail: ktbwenawa@gmail.com 4. OBSERVERS ASIAN DEVELOPMENT BANK (ADB) Mr Gerard SERVAIS, Southeast Asia Department, Asian Development Bank, 6 ADB Avenue, Mandaluyong City 1550 Metro Manila, Philippines. Telephone: +63 2 632 4431. Facsimile: +63 2 636 2444. E-mail: gservais@adb.org AUSTRALIAN AGENCY FOR INTERNATIONAL DEVELOPMENT (AusAID) Dr Praveena GUNARATNAM, Program Manager, Health and HIV Section, Australian Agency for International Development, P.O. Box 887, Canberra, ACT 2601, Australia. Telephone: +612 6206 4490. Facsimile: +612 6206 4720. E-mail: Praveena.Gunaratnam@ausaid.gov.au CHINESE CENTER FOR DISEASE CONTROL AND PREVENTION Dr SHI Xiaoming, Vice Director, Noncommunicable Diseases and Community Division, Chinese Centre for Disease Control and Prevention, 27 Nan Wei Road, Beijing 100050, People's Republic of China. DEPARTMENT OF HEALTH (HONG KONG SPECIAL ADMINISTRATIVE REGION) Dr Jacqueline CHOI, Principal Health and Medical Officer, Noncommunicable Disease Division, Surveillance and Epidemiology Branch, Department of Health, Government of Hong Kong Special Administrative Region, 21st Floor, Wu Chung House, 213 Queen’s Road East, Wan Chai, Hong Kong (SAR) China. Telephone: (852) 2961 8888. Facsimile: (852) 2893 9613. E-mail: choij@dh.gov.hk DEPARTMENT OF INTERNATIONAL COOPERATION, MINISTRY OF HEALTH Dr Xing JUN, Division Director, Department of International Cooperation, Ministry of Health, Beijing, People's Republic of China. Telephone: 68792277. Facsimile: 68792279. E-mail: xingj@moh.gov.cn EMBASSY OF JAPAN Ms Yuko OGINO, Second Secretary, Economic Section Embassy of Japan, 18-11, Junghak-dong, Jongno-gu, Seoul, Republic of Korea. Telephone: +82-2-2170-5244. Facsimile: +82-2-738-9748. E-mail: yuko.ogino@mofa.go.jp /oggynonmiu@yahoo.co.jp HEALTH PROMOTION BOARD (SINGAPORE) Dr CHEW Ling, Director, Research and Strategic Planning Division, Health Promotion Board, 3 Second Hospital Avenue Singapore 168937. Telephone: 6435 3819. Facsimile: 6436 8532. E-mail: CHEW_Ling@hpb.gov.sg Mr Alan PUI, Deputy Director, Strategic Planning and Collaborations, Health Promotion Board, 3 Second Hospital Avenue, Singapore 168937. Telephone: 6435 3035. Facsimile: 6438 9757. E-mail: Alan_PUI@hpb.gov.sg INTERNATIONAL DIABETES FEDERATION Professor Ruth COLAGIURI, Vice President, International Diabetes Federation, 166 Chaussee de la Hulpe, B-1170 Brussels Belgium. Telephone: +32-2-5385511. Facsimile: +32-2-5385114. E-mail: Ruth.Colagiuri@idf.org KOREA CENTERS FOR DISEASE CONTROL AND PREVENTION Dr Young Taek KIM, Director , Chronic Disease Surveillance Division, Korea Centers for Disease Control and Prevention, Osong Health Technology Administration Complex, 187 Osongsaengmyeong2(i)-ro, Gangoe-myeon, Cheongwon-gun Chungcheongbuk-do, 363-951 Republic of Korea. Telephone: +82-43-719-7380. Facsimile: +82-43-719-7527. E-mail: ruyoung@korea.kr Dr Duk Hyoung LEE, Director, Center of Disease Prevention Osong Health Technology Administration Complex, 187 Osongsaengmyeong2(i)-ro, Gangoe-myeon, Cheongwon-gun, Chungcheongbuk-do, 363-951 Republic of Korea. Telephone: +82-43-719-7301. Facsimile: +82-43-719-7527. E-mail: leeduk0125@hanmail.net. MINISTRY OF HEALTH (BRUNEI DARUSSALAM) Dr Hajah Rahmah Hj Md SAID, Director General of Health Services, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam. Telephone: +6737181101. Facsimile: +6732381887. E-mail: rahmahms@gmail.com. Ms Noraini MANAP, Assistant Director of Policy and Planning, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam. Telephone: +6732380528. Facsimile: +6732380128. E-mail: noraini.manap@moh.gov.bn. Datin Haslinda HASSAN, Specialist Endocrinologist, Ministry of Health, Bandar Seri Begawan, Brunei Darussalam. Telephone: +67382382031. Facsimile: +6732380687. E-mail: haslindahassan@gmail.com. MINISTRY OF HEALTH (SINGAPORE) Dr Derrick HENG, Director, Epidemiology and Disease Control Division, Ministry of Health Singapore, College of Medicine Building, 16 College Road, Singapore 169854. Telephone: (65) 6325 9224. Facsimile: (65) 6325 9194. E-mail: Derrick_Heng@moh.gov.sg. Ms Cher Lui Stephanie SEET, Assistant Manager, Noncommunicable Diseases, Epidemiology and Disease Control Division, Ministry of Health Singapore, College of Medicine Building, 16 College Road, Singapore 169854. Telephone: (65) 6325 8602. Facsimile: (65) 6325 9194. E-mail: Stephanie_SEET@moh.gov.sg. NOSSAL INSTITUTE OF GLOBAL HEALTH Ms Helen ROBINSON, Nossal Institute for Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, L4 Alan Gilbert Building, 161 Barry Street, Carlton, Victoria 3010, Australia. Telephone: +613 8344 9299. Facsimile: +614 3873 6020. E-mail: rhm@unimelb.edu.au. OECD KOREA POLICY CENTRE Dr Sook Young KWAK, Director, Public Health and Social Policy Programme, OECD Korea Policy Centre, Seoul, Republic of Korea Telephone: 82-2-3299-1096. E-mail: ksy921@oecdkorea.org SOUTHEAST ASIA TOBACCO CONTROL ALLIANCE (SEATCA)/FRAMEWORK CONVENTION ALLIANCE (FCAP) Dr Domilyn VILLARREIZ, FCTC Programme Manager (SEATCA), Regional Coordinator WPR-ASEAN, Framework Convention Alliance (FCA), Thakolsuk Place, Room 2 AB 115 Thoddamri Road. Dusit, Bangkok, Thailand. Telephone: (66 2) 241 0082. Facsimile: (66 2) 241 0082. E-mail: domilyn@seatca.org UNION FOR INTERNATIONAL CANCER CONTROL Professor Susan HENSHALL, Advocacy Director, Union International Cancer Control and Cancer Council Australia. Level 1, 120 Chalmers Street, Surry Hills NSW 2010, Australia. Telephone: +61 2 8063 4100. Facsimile: +61 2 8063 4101. E-mail: henshall@uicc.org. WORLD BANK Mr Shiyong WANG, Senior Health Specialist, World Bank, Beijing, People's Republic of China. Telephone: 86 10 58617781. Facsimile: 86 10 58617800. E-mail: swang1@worldbank.org. WORLD ECONOMIC FORUM Dr Eva Jane-LLOPIS, Head, Chronic Disease and Wellness, World Economic Forum, 91-93, route de la Capite, CH-1223 Cologny/Geneva, Switzerland. Telephone: 41228693702. Facsimile: 41228693532. E-mail: Eva.Jane-Llopis@weforum.org. 5. SECRETARIAT WHO WESTERN PACIFIC REGION Dr HAN Tieru, Director, Division of Building Healthy Communities and Populations, World Health Organization, Regional Office for the Western Pacific, United Nations Avenue, Ermita, Manila, Philippines. Telephone: 632-5288001. Facsimile: 632-5211036. E-mail: hant@wpro.who.int. Dr Hendrik BEKEDAM, Director, Division of Health Systems Development, World Health Organization, Regional Office for the Western Pacific, United Nations Avenue, Ermita, Manila, Philippines. Telephone: 632-5288001. Facsimile: 632-5211036. E-mail: bekedamh@wpro.who.int. Dr Hai-Rim SHIN, Team Leader, Noncommunicable Diseases and Health Promotion, Division of Building Healthy Communities and Populations, World Health Organization, Regional Office for the Western Pacific, United Nations Avenue, Ermita, Manila, Philippines. Telephone: 632-5288001. Facsimile: 632-5211036. E-mail: shinh@wpro.who.int. Dr Cherian VARGHESE, Technical Officer, Noncommunicable Diseases and Health Promotion, Division of Building Healthy Communities and Populations, World Health Organization, Regional Office for the Western Pacific, United Nations Avenue, Ermita, Manila, Philippines. Telephone: 632-5288001. Facsimile: 632-5211036. E-mail: varghesec@wpro.who.int. Dr Geun Heag YOO, Technical Officer, Environmental Health, Division of Building Healthy Communities and Populations, World Health Organization, Regional Office for the Western Pacific, United Nations Avenue, Ermita, Manila, Philippines. Telephone: 632-5288001. Facsimile: 632-5211036. E-mail: yoog@wpro.who.int. WHO HEADQUARTERS Dr Timothy Peter ARMSTRONG, Coordinator, NMH/CHP/SPP, World Health Organization Headquarters Office in Geneva (HQ), Avenue Appia 20, CH – 1211 Geneva 27, Switzerland. Telephone: +41 22 791 12 74. Facsimile: +41 22 791 31 11. E-mail: armstrongt@who.int. ANNEX 2 PROGRAMME DAY 1: 17 March 2011 (Thursday) 08:30 – 09:00 09:00 – 09:20 09:20 – 09:35 Registration Opening session 1. Opening address 2. Welcome address Dr Shin Young-soo, RD/WHO/ WPRO Minister Dr Chin Soo-Hee, Republic of Korea 09:35 – 09:45 Election of Co-Chairs: adopt agenda 09:45 – 10:10 Keynote address (video presentation) Dr Ala Alwan, ADG/NMH/WHO/HQ 10:10 – 10:45 Coffee break and group photo 10:45 – 11:00 11:00 – 11:15 NCD prevention and control: introduction of draft Seoul declaration Presentation of "Nadi Statement on the NCD crisis in Pacific island countries" Professor Robert Beaglehole Minister Dr Kautu Tenaua, Kiribati Session 1 – Health and socioeconomic burden of NCD: challenges and opportunities 11:15 – 11:30 11:30 – 11:45 11:45 – 12:00 12:00 – 12:30 1. WHO-Western Pacific regional situation, strategic response to NCD 2. Economics of the worldwide obesity epidemic 3. Economic burden of NCD in the world Discussion Dr Han Tieru, DHP/WHO/WPRO Dr Eric Finkelstein, Duke-NUS Dr Eva Jane-Llopis, WEF 12:30 – 13:30 Lunch break Session 2 – National strategic responses to NCD: national policies and programmes 13:30 – 13:45 13:45 – 14:00 14:00 – 14:15 14:15 – 14:30 14:30 – 15:15 1. NCD prevention and control – Australia's perspectives 2. Strategic response to NCD epidemic in China 3. National policy and programme on NCD prevention and control in Mongolia 4. National policy and programme on NCD prevention and control in Viet Nam 5. Panel discussion Ms. Jenny Hefford Dr Kong Lingzhi, China Dr Jadamba Tsolmon, Mongolia Dr Truong Dinh Bac, Viet Nam Moderator: Dr Mark Jacobs, New Zealand Discussants: Cambodia, Lao People's Democratic Republic, Malaysia and Philippines 15:15 – 15:30 Coffee break Session 3 – Multisectoral actions: comprehensive and integrated approaches to reduce major risk factors and social determinants 15:30 – 15:45 15:45 – 16:00 16:00 – 16:15 16:15 – 17:15 1. Multisectoral action for behaviour change and Health Promotion Foundations 2. Promoting healthy lifestyle – The Singapore experience 3. Healthy diet and physical exercise – Hong Kong (China) experience Panel discussion Professor Rob Moodie, Australia Mr Ang Hak Seng, Singapore Dr Lam Ping-yan, Hong Kong (China) Moderator: Professor Rob Moodie Discussants: China, Malaysia, New Zealand and Republic of Korea 19:00 WELCOME RECEPTION DAY 2: 18 March 2011 (Friday) Session 4 – Health systems strengthening to address NCD prevention, treatment and care 09:00 – 09:15 09:15 – 09:30 09:30 – 09:45 09:45 – 10:00 10:00 – 10:15 1. Health systems and NCD 2. Strengthening primary health care for NCD prevention and control 3. Sustainable financing for NCD 4. Health systems strengthening and NCD – Malaysia's experiences 5. Improving NCD service delivery: quality, access and coverage-Experience from New Zealand Dr Hendrik Bekedam, DHS/WHO/WPRO Professor Li Liming, PUMC Professor Soonman Kwon, SNU Dato' Dr Hasan Abdul Rahman, Malaysia Dr Mark Jacobs, New Zealand 10:15 – 10:30 Coffee break 10:30 – 12:00 6. Panel discussion: strengthening health systems for NCD Moderator: Professor Myongsei Sohn Discussants: Professor Li Liming, Brunei Darussalam, Hong Kong (China), Mongolia, Philippines and Viet Nam 12:00 – 13:00 Lunch break Session 5 – Partnerships for NCD 13:00 – 13:15 13:15 – 13:30 13:30 – 14:30 1. NCD Alliance 2. Promoting NCD in the development agenda 3. Panel discussion: Partnership for strengthening national capacity, improving service delivery and research Professor Ruth Colagiuri, IDF (NCD Alliance) Dr Mario Villaverde, Philippines Moderator: Professor Ruth Colagiuri Discussants: Professor Susan Henshall (UICC) Professor Ruth Colagiuri (IDF) Dr Duk Hyoung LEE (Korea CDC) Dr Shi Xiaoming (China CDC) Dr Eva Jane-Llopis (WEF) Mr Gerard Servais (ADB) Mr Shiyong Wang (World Bank) 14:30 – 15:00 Coffee break 15:00 – 15:45 Session 6 – Seoul declaration and next steps Discussion, finalization and adoption of the draft Seoul declaration Discuss the mechanism for communication with the United Nations General Assembly High-level Meeting on the Prevention and Control of Noncommunicable Diseases Co-Chairs Facilitator: Professor Robert Beaglehole Closing session 15:45 – 16:00 Closing remarks Dr Shin Young-soo, RD/WHO/WPRO Dr Jong-Koo Lee Director/Deputy Minister Korea Centers for Disease Control and Prevention, Republic of Korea ANNEX 3 OPENING REMARKS OF THE DR SHIN YOUNG-SOO WHO REGIONAL DIRECTOR FOR THE WESTERN PACIFIC AT THE REGIONAL HIGH-LEVEL MEETING ON SCALING UP MULTISECTORAL ACTIONS FOR NONCOMMUNICABLE PREVENTION AND CONTROL 17 MARCH 2011 SEOUL, REPUBLIC OF KOREA HONOURABLE MINISTER DR CHIN SOO-HEE, MINISTRY OF HEALTH AND WELFARE, REPUBLIC OF KOREA, DISTINGUISHED PARTICIPANTS, REPRESENTATIVES OF PARTNER AGENCIES, AND DIPLOMATIC CORPS. Good morning, and welcome to this Regional High-level Meeting on Scaling Up Multisectoral Action on Noncommunicable Disease Prevention and Control. I would like to thank the many senior officials, including ministers and vice-ministers of health, finance and planning, who traveled here to help us consider what perhaps is the most stubborn public health challenge facing Western Pacific Regionand that's the rising tide of noncommunicable diseases. I also would like to thank the Ministry of Health and Welfare of the Republic of Korea and the Korea Centers for Disease Control and Prevention for their support in co-hosting this important meeting and for providing this wonderful venue for our discussions. First of all, I would like to take this opportunity to express my sincerest condolences to the people of Japan, who lost their families, relatives and friends, and those who are suffering so much from unimaginable scale of disasters. I simply hope that the Japanese people can recover from these ordeal as soon as possible. Throughout history, changes in the ways we live, the foods we eat and the work we do have evolved slowly, allowing our bodies to adapt. But changes over the past few decades— particularly rising urbanization, an increasingly sedentary lifestyle, and the aggressive marketing of foods unnaturally high in fat, salt and sugar—have occurred so rapidly that the human organism has not had time to adapt. As a result, noncommunicable diseases—cancer, cardiovascular diseases, chronic respiratory conditions and diabetes—are rising rapidly and now affect every country in our Region. Today, in the Western Pacific Region—home to nearly 1.8 billion people, a quarter of global population—noncommunicable diseases are responsible for four out of every five deaths. Nearly 30 000 people in our Region die every day due to diseases that can and should be prevented. Tobacco alone claims 3000 lives in the Western Pacific Region every single day, according to WHO estimates. WHO's global data show that overweight and obesity are responsible for 44% of all diabetes cases. And physical inactivity is estimated to cause between 15% and 25% of breast and colon cancers, and is responsible for 30% of the heart disease burden worldwide. The rising tide of noncommunicable diseases is already straining our health systems. Unlike communicable diseases that tend to affect people quickly, noncommunicable diseases generally progress much more slowly, creating complex health needs that are expensive to treat and can overwhelm already stressed health systems. Developing nations do not always have the resources to facilitate extended care for chronic noncommunicable diseases, leaving the patients in the care of their families. And we are only seeing the tip of the iceberg. Globally, deaths due to cancer are projected to rise by more than 60% in the first 30 years of this century, according to the latest WHO projections. And deaths due to cardiovascular disease are expected to rise more than 70% over the same period. It's usually the poorest people in our Region who have the highest burden of noncommunicable disease, as they often have greater exposure to risk factors and less access to preventive and therapeutic services. Noncommunicable diseases are claiming victims at increasingly younger ages, even during childhood, depriving many of our citizens of their most productive years. These premature deaths not only devastate families by claiming the lives of primary wage-earners, but they weaken communities and national economies, making it more difficult to achieve equitable and sustainable development. To the uninitiated, noncommunicable disease sounds like a "health issue" that can only be solved by the health sector. But as medical doctors, public health specialists, and government and community leaders, we know that by the time people enter the health system with noncommunicable diseases, it's often too late to offer much help. The battle really needs to begin at a much earlier stage. If we want to win the battle against noncommunicable diseases, the health sector must join hands with other sectors—agriculture, education, the environment, the food industry, trade, transportation and others. And that's why we were very careful in choosing the title for this meeting, making sure the words "Multisectoral Action" were included. We need a "whole-of-government" approach that engages all sectors. The private sector— those involved in producing, marketing and trading food—can take important steps to make our food healthier, while still enjoying healthy profits. Actions can be taken by city planners and transportation officials to create urban environments that promote healthier and more active lifestyles. Our goal is to make it easier for all of our people to make healthier choices. We are gathered here today so that our collective voice can be heard when world leaders gather in New York in September for a High-level Meeting of the United Nations General Assembly on the Prevention and Control of Noncommunicable Diseases. Working together over these next two days, we hope to agree on a Seoul Declaration on Noncommunicable Disease Prevention and Control in the Western Pacific. This document, which many of us have worked on in draft form, lays out a road map for prevention and control in the Western Pacific and will allow us to raise our voices as one on the global stage at the NCD Summit at the United Nations in September. We should not let ourselves think the problem is too big or too complicated. In the Western Pacific Region, we have seen real progress in controlling tobacco, one of the major risk factors for noncommunicable diseases. All the countries in our Region have ratified the WHO Framework Convention on Tobacco Control and now have laws designed to reduce tobacco consumption. As a result, many countries in the Western Pacific are reporting declines in smoking prevalence. We must mount similar efforts against unhealthy diets, physical inactivity and other NCD risk factors. There is an urgent need to push these issues higher on the public health agenda of countries in the Region, where public awareness of these problems is still low. The Seoul Declaration and the United Nations high-level meeting in September are significant steps in mounting an effective, comprehensive and sustained response to noncommunicable diseases. We know what needs to be done. Now we have to do it. Thank you. ANNEX 4 NADI STATEMENT ON THE NONCOMMUNICABLE CRISIS IN PACIFIC ISLAND COUNTRIES AND AREAS