Building MultiStakeholder Partnerships for NCDs: Ideas, Steps and Actions A Meeting Report of the Global Health Council NCD Roundtable
July 2011
Acknowledgements T he G lo ba l He a lt h Co u n cil i s t ha n k fu l t o th e membe rs o f it s NC D R ou n dta b le , a nd sp e c i fi ca l l y, t he pri n ci pa l c o- sp o ns or s o f t he ev e nt “M ob ili zi ng A cti o n t o A ddre ss No n -C omm u ni c a ble D isea se s : A M ul ti sta ke ho lde r Dia lo gu e , ” i nc l udi n g t he U n ited Na t io n s Gl oba l C om pa ct , the W orl d E c on om i c F or um , P eps iC o, Me dtr o ni c , P fi zer , a n d Ma n a ge m e n t S cie n ce s fo r Hea l th . We a ls o th a n k t he s pea ker s w h o se t th e s ta ge fo r a n e nga gi ng dia lo g ue, i n cl ud in g H.E . R a y mo nd Wol f e , Amb a s sa d or o f Ja ma i ca , a nd H .E . S y lv ie L uca s , A mba ssa do r of L uxe mb o urg . T hi s d o c ume nt w a s p r epa re d b y Cra ig M os ce tti, co - cha ir o f th e Gl oba l He a l th C o un c il‟ s NC D R o u ndta ble .
F or f ur t h er i nf or ma t io n a b ou t t h e N CD R ou n d ta b le or t his re p or t , co n ta c t Cra i g Mo sc e tti , MP H Pol ic y Ma na ge r Gl oba l He a l th C o un c il cm os ce t ti @ glo ba l hea lt h. or g 2 02 . 8 3 3. 5 9 00 e xt. 32 4 0
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Contents I.
Introduction
II.
The Case for Multi-Stakeholder Partnerships
III.
Innovative Partnerships for NCD prevention and control
IV.
Lessons Learned
Appendix A : Meeting Agenda Appendix B: Private Sector Perspective on the Global NonCommunicable Disease Challenge
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Introduction NC D s, o r no n c omm u ni ca b le di sea s es , a r e c h a lle ng in g t he tra dit io n a l me a n s b y w hi c h a ct or s en ga ge i n gl oba l hea l th is s ues . N ow th e le a di n g ca use s o f de a t h w or ldw ide , rep rese n tin g 3 6 mil li on dea t hs or 6 3 p e r ce nt o f t he t ota l , NC D s a r e a si g ni fi ca nt b urd en o n h ea lt h sy ste ms . Mo re o ve r, t hi s b ur de n is o nl y pr o je cte d t o w or se n, a nd pa rti c ula rl y i n l ow - a n d mi dd le - i nc om e co u nt ries , wh i ch i s a lrea dy w he re 8 0 pe r ce nt o f a l l NC D -re la ted dea th s o c cu r. Th e c urr en t sta t us of NC D s a nd t he i r f ut u re t ra j ec to ry i n ma ny co u nt rie s i s cl o sel y tie d to t he ir a bi lit y to m odi f y f ou r p ri n ci ple ri s k f a ct or s – t oba c c o use , ha r mf u l us e of a l c oh ol , u nh ea lt h y diet s , a nd p h y si ca l i na cti vi ty . In cr e a s in g pre va l e n ce a nd ex po s ure t o t he se ri sk fa cto rs i s d ri ve n by sig ni f i ca n t c ha n ge s i n the gl oba li zed la nd s ca pe, i n cl udi n g p op u la ti on a gi ng , e xpa n si on o f m a rke ts , a ltera ti on o f pr od u cti o n a nd co n s umpt io n pa tt e r ns , a n d ur ba n iza tio n . NC D s a re re c og n ize d a s a si gn i fi ca nt b urd en on hea lt h s y stem s , e c on om ie s , a n d a s ou r ce o f ca ta str op h ic e xp end it ure fo r ma n y in di vi dua ls . H ow e ve r , the pr es si ng c ha lle ng e s l ies i n th e fa t th a t ma n y o f t he ir u n de r ly i ng det erm in a n ts lie o u tsi de t he h ea lt h se ct or . Mi ni str ie s o f h e a lt h a l on e a r e no t a b le to m odi f y f oo d pr od u cti o n a nd a va i la b ili ty ; a d ve r ti si n g a nd ma r ket i ng ; t he l oca ti on o f sa fe re c re a t io n a re a s; t he wor kp la ce e n vi ro n me n t; a n d sc h oo l - ba s ed he a l th p ro mot io n , t o n a me a f ew. A s s u c h, “ a cti o n t o pre ve nt a nd co nt ro l NC D s re q ui re s su pp ort a nd c oll a b ora t io n fr om g ov er nme nt , ci vi l so ci e t y a nd t he p ri va te se ct or ” a n d “m u st f oll ow s u cc es s fu l a ppr oa c he s to e nga ge no n - hea lt h se ct or s, ” a s W HO pr io rit ize d i n it s re c e n t Gl oba l stat us re por t on no nco mm uni ca ble di seas es , 2010 . 1 T he ne e d to pr e v e n t c a usa ti ve , up str ea m fa c tor s r ela te d t o N C Ds h a s be e n co nt i nu o us l y s tre sse d b y W HO 2 a n d wa s a ls o s tr on gl y e mp ha s ize d i n t he Se c reta r y - Ge nera l‟ s rep or t o n th e p re ve nti o n a n d co nt ro l o f NC D s, i ss ue d i n J u ne i n pre pa ra t io n f or th e Hig h L ev el Me e t in g. 3 W HO D ire ct o r - Ge ne ra l Ma r ga re t C h a n ha s a ls o a tt emp ted to fa ci lita te m u lti -s ta k eh old er c oll a b or a t io n t hr o ug h c on ve n in g a di ve r se gr ou p o f a ct or s a t t he Mo s cow Gl oba l Fo ru m a nd t hr ou g h in sti tu tio na l r e fo rms b y WH O t o e na ble a m o re i n cl u si ve del ibe ra ti o n pla t f orm . 4 A nu mbe r o f c iv il s oc iet y c oa l iti o ns a re a ls o a d vo ca t i ng f or a st ro ng m ult i - se ct ora l a n d m u lti -st a k eh ol der a pp roa c h, i n cl ud i ng t he 1
World Health Organization. 2011. Global status report on noncommunicable diseases, 2010. Geneva, Switzerland. 2 Yach D & Hawkes C. 2004. Towards a WHO long-term strategy for prevention and control of leading chronic disease. World Health Organization, Geneva, Switzerland. 3 United Nations. Prevention and control of non-communicable diseases: Report of the Secretary-General. A/66/83, 19 May 2011. 4 See 64th World Health Assembly Resolution WHA64.2, “WHO reform,” May 20, 2011, available from: apps.who.int/gb/ebwha/pdf_files/WHA64/A64_R2-en.pdf; and World Health Organization. 2010. The future of financing for WHO. Report of an informal consultation convened by the Director-General. Geneva, Switzerland.
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Gl oba l He a l th C o un c il‟ s NC D R o u ndta ble , 5 th e N C D A llia n ce , 6 a n d it s su pp orte rs g ro up . 7 T ho u gh a mu lti -s ta ke h old er a pp roa c h is re co gn ize d a s a n e ss en tia l me a n s to s us ta i na b l y pre ve nt a n d co nt ro l N CD s o ver tim e a nd a me a s ur e t o e na ble a s u cc es s fu l U N Hi g h Le v el Meeti n g on NC D s. 8 De spi te t h is st ro ng co ns en s us t here re ma i ns lit tle c la r it y a b o ut h o w to de fi ne m utli - sta ke h old er a n d m ul ti -se ct or a l; w ha t spe c if i c r ol es co u ld a n d sh o uld be ; a nd w ha t t he s pe ci fi c el eme nts a re t ha t wo ul d e na b le s u cc e s s. As s u c h, t he G lo ba l Hea lt h C ou n ci l, t he Wo rld E co n om ic For u m a nd t he U N Gl oba l C om pa c t c o nv en ed a d ia l og ue on J u ne 1 , 2 01 1 a t th e U nit ed Na ti on s to di s cu ss h ow a m ul ti sta ke ho lde r a p pr oa ch co u ld ca ta l yze a cti o n t o a d dre ss NC D s. Th e pri n ci ple ob je ct i ve s o f th e me eti ng w her e t h ree - f ol d: (1) T o e xp lor e a nd de f in e a c omm o n de fi nit io n a nd f ra me wo rk fo r mu lti -st a k e h ol der c ol la bora ti on fo r NC D a c ti o n ; (2) T o s ha re e xa mpl es o f su c ce ss f ul pa r tn er sh ip s us in g mu lti sta ke ho lde r co lla bo ra ti on ; a n d (3) T o hi gh li gh t a nd f u rt h er e xp lor e t he u n iq ue po siti o n o f t he pri va te s e c to r t o i mp r ov e hea l th , sp ec i fi ca l l y rela t ed to NC Ds . 9
Meeting Methodology
T he str u ct ur e of t he m eeti ng c o ns ist ed o f t w o m ode ra te d pa n el dis c us si o ns a nd a n i nt era c ti ve brea k o ut se ss io n w it h a f a c ili ta t or ( see Ap pe ndi x 1 for co mple te a ge nda ) . T he f irst pa ne l e xp lo red t he u nde rl yi ng ra t io na le f o r w h y a m ult i - sta ke ho l der a pp roa c h is e sse nt ia l fo r NC D pre v ent io n a n d co nt ro l. Th e se c on d pa nel co nt i nu e d b y of fe ri ng ta ng ib le e xa m ple s o f c ur re n t m u lti -s ta k e hol d er pa rt ne r s hi ps a ro u nd N CD s, a nd th e s pe ci f ic r ole t he y ca n ser ve . T h e int e ra cti ve b re a ko ut g ro up s a llo wed pa r ti ci p a nt s t o e n ga ge d m or e de e p ly i nt o t he me e ti n g‟ s pri ma r y ob je ct i ves , di sc u ss i ng is s ues o f de f i ni ng r ole s; co n str u cti n g a f ra me w or k ; ma jo r ba rr ier s ; a nd po ssi ble ne x t s te p s. 5
Global Health Council. 2011. Global Leadership, Local Solutions: Mobilizing for NCDs, A statement of the Global Health Council NCD Roundtable. Washington, DC. 6 Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, et al. 2011. “Priority actions for the non-communicable disease crisis. Lancet, vol. 377, pp. 1438-47. 7 Statement of the NCD Alliance Supporters Group in Relation to the September 2011 UN High-Level Meeting on Non-Communicable Diseases (NCDs). 27 April 2011. Available from: http://ncdalliance.org/sites/default/files/NCD%20Alliance%20Supporters%20Gr oup%20Statement.pdf. 8 Kirton J, Guebert J. 2011. “Ten measures to help ensure a successful UN Summit on NCDs.” Global Health Diplomacy Program, University of Toronto. 9 For the purposes of the meeting and this document, the phrase „private sector‟ does not include the tobacco industry, and principally includes the following types of industry: pharmaceutical, medical technology, food and beverage, and sport.
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T he me e t i ng w a s a tte n ded b y r o ug hl y 1 0 0 de lega te s f ro m M emb er Sta te U N Mi ss io ns , N G Os, a ca de mia , a nd t he pr iva te se ct or.
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The Case for Multi-stakeholder Partnerships Be for e d is c us si n g t he ra ti on a le f or m ult i - se c tora l a nd m ult i sta ke ho lde r a cti o n f or NC D s, b ot h te rm s r eq u ire a s o u nd de fi ni tio n a nd a de q ua te c o nte xt. O fte n us ed i nter c ha n gea bl y , t he tw o t erm s a re q u ite di sti n ct a n d of f er di f fer i ng c on n ota tio n s fo r t he a rra nge me nt a nd d y na mic o f a cto rs . M ult i - se ct ora l , wh i ch i s a l s o dis ti nc t fr om i nte r - se c tora l, e nc om pa s se s t h e n u mer ou s p ubl i c se cto rs t ha t in f lu e nce or rela te t o N C Ds , i n cl ud in g hea lt h, ed u ca ti o n, tra de , a gri c ul tu re , tr a ns po rta t io n , e ner g y, u rba n p la nn i ng , a nd s p ort . Acr o ss th e se m ul tip le se cto rs , t h e re a re a va riet y o f sta ke ho lde rs w it h i nt e re st a n d i n fl u en ce , i n cl ud i ng go ve r n men ts (n a ti o na l , s ta te a nd l oca l) , ci vi l so ci et y ( i nc l udi n g fa i th -ba se d a nd c omm u ni t y - ba se d orga n iza t io n s), a ca de mia a nd re sea rc h i nst i tut io n s, a n d t he pr i va t e se cto r ( Figur e 1 ). Th ese se ct or s a nd sta ke h old ers o ve rla p a nd in fl ue n ce e a ch o th e r i n c omp lex wa ys a nd u l tima te l y i n fl ue n ce s t he pre va le n ce a nd s us ce p tibi lit y to NC D ri sk fa c tor s, i n cl ud in g t oba c c o us e , a l co h ol a b use , po or die t, a n d ph y si ca l i na cti vi t y. Fi g ur e 1 . Th e i n t er p l ay of s ec t o rs i m pac t in g o n N C D r isk fac to rs 10
T he r e a r e t hr e e t he or e tica l c ha l le nge s t o imp leme nt in g a m ult i sta ke ho lde r a p pr oa ch to a ddr es si ng NC Ds . Fi rst , r ele va nt go v er nme nt mi nis tri e s or de pa rt me nt s nee d t o co or di na te th eir e f fo rts . A s o ca l le d “ w h ol e - o f- go ve r nme nt � a pp roa c h is o f ten c o ns tra i ne d by t he 10
Alleyne G. 2011. The multisectoral aspects of non-communicable diseases. Commonwealth Health Ministersâ€&#x; Update 2011.
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size a nd c om ple xit y o f mi ni str ies t ha t i n fl ue n ce N C D ou tc ome s . I n the or y , s u c h c omp le xit y a cr o ss th e g o ver n me nt c o uld be ma na g ed thr o ug h a ca bi ne t - le ve l co ord i na t or, how ev er th ere a re f ew su c ce ss f ul ca se st u die s t o r e fere n ce . N on et h eles s, Sir Geo rge Al le y ne ha s a rt i cu la te d a se t o f t h ree pr in c iple s to e f fe cti ve l y co or di na te w it hi n go ve rn me nt, i n cl ud i ng (a ) mu tua lit y of i nte re st ; ( b) spe ci f i cit y of p ur po se ; a n d ( c) c l ea r a l lo ca tio n o f re so u rce s. Se co nd , to ca p ita l ize o n th e p l ura list i c na t ur e o f s o ciet y a n d t he ri se o f di ver s e a ct or s, a b roa de r “w h ole -o f -s o cie ty ” a pp roa c h m u st e na ble co lla bo ra ti o n a nd c o or di na ti o n t o ta k e p la ce a cr os s t he se a c to rs . How e v e r , t he i n he re nt c ha l le nge re ma i ns t ha t n o o ne a ct or ca n o r sh o ul d le a d a lo ne . Co o rdi na t io n m ust ta ke pl a ce o n a va ri et y of fr o nts , a ll c o ntr ib uti n g to a b roa der a i m. Th i rd, t he U N s y stem i s c ha ll e n ge d t o a d e q ua t ely co or di na te t he m a n y U N spe c ia li zed a ge n c ie s a nd pr og ra m s wi th ma nd a tes re la te d t o NC D s, i n cl ud in g WHO , U N ICE F , W FP , F AO, I LO , U NW om en , a nd ot he rs . F urt he r, a “w ho le -o f - U N” a p pr oa c h is ne ce s sa r y t o c lea r ly de fi ne r ole s a n d co nt ri bu ti on s t o th e Gl oba l NC D Ac ti on P la n , a st ra teg y t ha t p uts WHO i n a le a de r s hi p r ole .
The business case for NCDs Bu si ne sse s a n d e mpl o yer s mo re br oa dl y ha v e a str o ng sel f -i nte re s t to in ve st i n NC D s. Fir s t, a s e mpl o yer s , b u si n esse s ha ve a hea v y in ve stme n t it s h uma n ca p ita l a nd th is i n cl ud es Principles for Effective e mpl o ye e ‟ s he a l th (b ot h ph y si ca l a nd me nta l ) a n d w e ll be i ng . Ne a rl y 6 0 p erc en t o f a l l i n di vi dua l s Multi-Sectoral glo ba l ly a re e m pl o ye d , wh i ch pr o vi des t he ca ta l yst Coordination fo r e c o nom i c g ro w t h . How ev er , w he n emp lo yee s Mutuality of Interest su f fe r fr om N C D - re la te d hea lt h c o nd iti o ns , Specificity of purpose pro d uc ti vit y de cr e a se s , a b se nte eis m in c rea s e s, a n d bu si ne ss l ose s t he o ri gi na l i nv est me nt in it s Clear allocation of w or k fo r ce . T ur ni ng t hi s a r o u nd , w he n e mp lo yer s resources in ve st i n t he h e a lt h a n d we llb ei ng o f its w or k fo r ce, in cl u di ng li mit in g e xp o su re t o N C D - rela t ed ri sk fa ct ors , th e r e t ur ns a r e si g ni fi ca nt . By s ome in di ca ti o ns , t h is ret u rn on i n ve stme nt c a n be a s hi gh a s $5 fo r e ve r y $ 1 in ve ste d. W he n 5 0 of t he la r ge s t 1 00 e co no mie s a re a ct ua ll y bu si nes s en tit ies , co mba t i ng N C Ds a n d e ns u ri ng a hea l th y wo r k fo rc e a nd e n vir o nme n t, bu si ne ss ca n s pu r hea l th po p ula t io n s a nd h e a lth y e co n omi es .
Leveraging Private Sector Comparative Adva ntages T he pr iva te se ct or is u ni qu el y po sit io ne d t o c a ta l yze a n d e n ha n ce mu lti -st a k e h ol de r e f fo rts to a d dre ss N C Ds a t th e g lo ba l , na t io na l a nd lo ca l le ve l . A va r ie t y o f in di vi d ua l a n d c olle ct ive p ri va te se ct or a cto rs ha ve a s ig ni fi ca nt his t or y e n ga gi n g on g lo ba l hea lt h i ss ue s, f ro m pha rma ce uti ca l d r ug d ona ti on p ro gra m s t o tr ea t neg le cted tr op i ca l dis e a se s t o i nn o va ti n g f or n ew va c ci ne s a nd medi ca l te c h no lo gie s. T he c ha l le nge i s t o cr ea te t he e na b li ng en v i ro nme nt a nd i nc en ti ve str u ct ure t ha t a ll ow s b us i nes s t o le vera ge its f ul l y i n n ov a ti ve a n d re s ou r ce ca p a c it y.
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R e ce nt ly , pr iva te se ct or ha s beg u n t o mo bil i ze a s a c ol le cti ve u n it, to e xp lo re co mm o n g ro u n d, a n d fo rge pa rt ner s h ips t ha t c ut a c ro ss se cto rs . A g ro up i ng o f 1 1 pr iva te se ct or c om pa n ies , rep res en ti ng a va r ie t y o f se cto rs , in c l ud in g BD , E del ma n, H uma na , J oh n so n & J oh n so n , Me dt ro n ic , M erc k , N o vo N or di s k, N i ke , P f izer , Pep si Co a n d Sa no fi , ca me t og e t her to pr od u ce a c om mo n fra mew or k by w hi c h t o e nga ge i n m u lti -st a k e ho lde r pa rt ne rs hi ps . T he se co mpa ni es ha v e co mmi tte d t o ta ki n g a cti o n in fo ur wa ys , in c lu di ng ( 1) t o pr om ote a he a l th y w o r k for ce a nd fa mil ie s; ( 2) to wo r k wit h s ta ke ho lde rs to e n su re a c ce ss to e f fe c tiv e d ia g n ost i cs , t rea t men ts a n d hea lt h co n s ume r p ro du ct s ; ( 3 ) to crea t e hea l th y e n vi ro nm en ts , b ot h wit hi n a nd o ut si de t he w or kp la ce ; a nd (4 ) t o e n su r e a str o ng ed u ca ti o n, tra i ni ng a nd re se a r c h ca pa c it y ( see Ap pe ndi x B fo r full fram ewo r k) .
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Innovative Partnerships for NCD Prevention and Control Ma n y s u c ce s s fu l mo del s o f m ult i - sta ke h old er pa rt ner s hi ps f or NC D pre ve nti o n a nd co nt ro l a re a lre a d y bei ng im p leme nte d. Th is se ct io n pro v ide s a se rie s o f e x a mple s o f su c h mo del s , hi gh lig h ti ng c ur re nt su c ce sse s, co n stra in ts a n d t he pr i va te se ct o r co ntr ib ut io n s.
Workplace Wellness Alliance R e ce nt ly , th e Wor ld E c on om ic Fo ru m C o n ve n ed b y t he Wo rld E co n om ic For u m, t he Wor k pla ce We ll nes s Al lia nc e i s c omp ri sed o f 4 5 me mbe rs – m os t of w h ic h a re pr iva te se ct or, b ut a ls o i n cl u des se ve ra l g o ve r nm e nt a g en cie s – c om mitt ed t o a da pt in g t he wo r kpl a c e e n vi ro nm e n t t o i n ce nt i vi ze hea lt hie r c ho ic es a nd a pro mo te a he a l th ie r e n vir o nme nt . 11 T he w or kp la c e r epr es ent s a n idea l e nt r y poi nt fo r he a l th p rom o tio n i nter ve nt io n s b a s ed on t he tota l t ime e mpl o ye e s spe nd i n th e wo r kpla ce a n d th e r ela ti ve l y la rge pr op or t io n of t he po p ula t io n w h o a re c urr en tl y e mpl o ye d. As emp lo ye rs , co mpa ni e s ha ve a n e c on om ic i n ce nti ve t o m a xim ize t he pr od u cti vi ty of w or ke r s b y s u sta i n i ng o r i mpr o vi ng hea lt h a n d we ll ne ss , in c lu di n g thr o ug h w e ll n e s s p ro g ra ms , f oo d a nd be ve ra ge c ho ic es , a nd s mo ke fre e e n vi ro nm e n ts . 12 Fo r exa mpl e, b y ta rge ti ng th ree mo di fi a bl e NC D ris k fa ct or s, U . S . co mp a nie s ca n sa ve ro u gh l y U S $ 7 00 pe r yea r p er e mpl o ye e . How e ve r , t he ne xt ma jo r step fo r wo rk pla ce wel l nes s is to sy ste ma ti ca ll y t ra ns iti on p il ot i n itia ti ves i nt o a new di s cip li ne , a ppl yi n g t he sa me sta nda rd s of m on it ori n g a nd e va l ua t io n see n i n ot he r p ub li c he a lt h a n d s ci en ti fi c f iel ds . 13
International Food and Beverage Alliance E sta b li sh e d i n M a y 20 0 8, t he In ter na t io na l F oo d a nd Be ve ra ge Alli a n ce (I F BA) is a gr ou p o f te n m ult in a ti o n a l co mpa nie s, i n cl ud i n g Fe r re r o, Ge ne ra l Mil ls , G r upo B imb o , Ke ll og g ‟ s, Kra ft F o ods , Ma r s , Ne stle , Pe p si Co , T he C oca C ola C ompa n y , a n d U nil ev er, t ha t ha ve sig ne d a se rie s o f fi ve v ol u nta r y c om mit me n ts r es po nd i ng to t he Wor ld He a lt h Orga n iza tio n‟ s Gl oba l Stra teg y on Diet , Physi cal A cti vity & H ealt h . 14 T he se fi v e c omm itme nt s in c lu de : (1) R e f orm u la te pr od u ct s a nd de ve lo p new pr od u cts t ha t s up por t the g oa l s of im pr o vi ng die ts ;
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For a full list of Workplace Wellness Alliance members, see http://www3.weforum.org/docs/WEF_HE_WorkplaceWellnessAlliance_Members _2011.pdf. 12 Sturchio J. “A chance for business to become more proactive.” G8 Deauville Magazine. May 2011. 13 World Economic Forum & the Boston Consulting Group. 2010. The new discipline of workplace wellness: Enhancing corporate performance by tackling chronic diseases. Geneva, Switzerland. 14 For more information about the International Food and Beverage Alliance, see https://www.ifballiance.org/.
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(2) Pro vi de e a s il y - u nd er st a nda ble nu trit io n i n fo r ma ti on t o a l l co n s ume r s ; (3) E xte nd re sp o nsi ble a d ver ti si ng a n d m a r ket in g t o c hil dre n in itia t i ve s g lo ba ll y ; (4) R a ise a w a r e n es s on ba la n ce d d iet s a nd i n cre a sed le ve ls o f ph y si ca l a c ti vit y ; a n d (5) Act i ve l y s upp or t p u bli c -pr i va te pa r tn ers h ip s t ha t s up po rt t he WHOâ€&#x; s Glo bal St rate gy . Co ntr ib ut in g t o t he s p eci f ic I FB A c omm itme n ts, s ome m ult i na ti o na l fo od a nd be ve r a ge c o mpa nie s ha ve o utl i ned sp ec i fi c g lo ba l g oa l s a nd co mmi tme nt s. Ma n y o f th ese a re i n t h e a r ea s o f pr od u ct re f or m ula t io n , m od if i c a tio n s i n ma r ke ti ng pr a ct i ce s a n d stra t e gi es to impr o ve pr od u ct a f f or da bi lit y a n d a c ces si bi li ty i n u nde rse r ved co mm u nit ie s . 15
NCD Prevention for Improved Maternal Health E ve r y ye a r a lm os t 1 5 per ce nt o f a ll pre g na n t wo me n – or , 1 0 mil li on w ome n - de ve l op ge st a tio na l d ia be tes c om pl ica t i ng pre g na n c ies a n d co mpr om is in g he a lt h o ut co mes fo r b ot h th e mot her a nd f et us . In fa ct , s om e s tu die s i ndi ca te d t ha t ch ild re n bo rn to m ot her s w it h ge sta ti ona l dia b e te s a re fo u r t o e ig ht tim es more l ik el y t o de vel op dia be te s . Ou tc om e s f o r m ot her s a re a l s o co mpr omi se d. Pre gn a n t w ome n w it h ge sta ti o n a l d ia be tes a re r ou g hl y se ve n t ime s mor e l i k ely to de ve l op t ype 2 d ia b etes la te r in li f e. T he r ef ore , m a n y ha v e ide nti f ie d t he cr iti ca l r ole t ha t dia b ete s sc re eni n g a nd ma na g eme n t mu st pla y d uri ng a nte na ta l ca re . I n fa ct, a r ece nt La ncet a r ti cle re c om me nde d t he s cre eni n g a nd ma na g eme n t o f dia bete s mell it us du ri ng pre g na nc y a s p a rt of a pa ck a ge o f in t erv en ti on s to red u ce t he pre va le n ce o f st ill bir th s. 16 T o he l p a ddr e s s t hi s g row in g c ha l le nge , N ov o N ord is k A/ S e sta b li s he d th e C ha n gi ng D ia be tes i n Pre gn a n cy Pr og ra m i n co lla bo ra ti o n w it h t he Wor ld D ia b etes Fo u nd a tio n , t he I nte rna ti on a l Dia be te s Fe de ra t io n a nd W HO to im pr ov e e x isti n g a nte na t a l ca re se r vi ce s a nd a d dre ss t he c y cle o f dia bete s a mo ng wo me n a nd c hil dre n . 17 Bu ild i ng o n t hi s p ro gra m, No v o No r dis k ha s la un c he d t he E a rl y O ri gi ns o f He a lt h i nit ia ti ve , t o en ga ge t he br oa de r gl oba l he a l th co mm un it y to d esi gn i nte rv en ti on s th a t re du ce r is k e a rl y i n 15
Yach D, Khan M, Bradley D, Hargrove R, Kehoe S, & Mensah G. 2010. The role and challenges of the food industry in addressing chronic disease. Globalization and Health, vol. 6, no. 10. 16 Pattinson R, Kerber K, Buchmann E, Friberg I, Belizan M, et. al. 2011. Stillbirths: how can health systems deliver for mothers and babies? Lancet, vol. 377, no. 9777, pp. 1610-23. 17 For more information on the Novo Nordisk Changing Diabetes in Pregnancy Program, see http://www.changingdiabetesaccess.com/Changing_diabetes_in_pregnancy.asp x.
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the li fe co ur se . 18 T he i ni tia ti ve i s e nga gi ng pa r tne rs s u ch a s Jo h n so n & J o h n so n , Pe ps iC o, S ten o Dia bet es Ce nte r, the W orl d Di a bet es Fe d e ra t io n a n d t he Un ited Na ti o ns F o un da t io n t h ro ug h a m u lti sta ke ho lde r p la t fo rm t o a d dre ss t he c rit ica l l in k s b etwee n N C Ds , ma te r na l a nd c h i ld h e a lth , a n d a c hie v in g t h e M ille n ni u m De ve l op me nt G oa l s (M D Gs ).
Preventing Cervical Cancer through Public -Private Partnerships Ce r vi ca l ca n ce r is t he se co nd lea di ng c a u se of de a t h a m o ng wo me n li vi ng i n de ve l op in g co u ntr ies . Mo re tha n 5 0 0 ,0 0 0 wo me n d ev el op ce r v ica l ca n ce r e a ch y ea r, ca u sed , i n pa rt , b y c hr o ni c i n fe ct io n o f ce r ta i n t y pe s o f huma n papi ll oma vi r us . C a u s in g r o ug hl y 2 7 5 ,0 0 0 de a t hs e a ch ye a r , t he bu rde n o f ce rv i ca l ca n cer i s e xpe ct ed to a lmo st do u ble b y 2 0 3 0 , w it h o v er 9 5 % of t he se dea t hs e xpe cte d t o oc c ur i n low - a n d m id dle -i n com e co u nt rie s. 19 How e v e r , t he u n iq ue n ess o f ce r vi ca l c a n ce r‟ s et io lo gy re q uir es a n e qua ll y i nn o va t iv e pa r tne rs hi p. W it h i n fe ct io us o rig i ns , cer v ic a l ca nc e r ca n be pre ve nt ed t hr o ug h ea rl y det ec tio n , p ri n cip a ll y t hro u gh pa p sme a r t e st in g, o r thr o ug h va c ci na t io n . H owe ver , wit h hea lt h sy ste m co n stra i nts a n d t he rela ti vel y ex pe ns ive un it c ost o f H PV va cc i ne , ce r vi ca l ca nc er ha s be c ome o ne o f the lea di ng ca n ce rs a mo ng w o me n i n de ve lop i ng c o un trie s . 20 T hr o ug h a n i nn o va ti v e pa rt ne rs h ip betwe en E nge n der Hea lt h, t he Int e r na ti o na l At om ic E ner g y A ge nc y , t he I nt erna ti on a l Age n c y fo r R e se a r c h o n Ca n ce r, J hp ieg o, t he Pa n Am eri ca n Hea l th Or ga niza ti o n, Pa rt ne r s in H e a lt h , P A T H, a n d t he U ni on fo r Int er na ti o na l Ca n cer Co ntr ol , t he A llia n ce f or Cer v ica l Ca n ce r P re ve nti o n is wo rk i ng to “ cla r i fy , pr om ote , a nd impl eme nt st ra te gie s f or pre ve nt i ng ce r vi ca l ca nc e r i n d e v e l opi n g c ou nt rie s. ” 21 Th e A lli a n ce is de ve lo pi ng in n ova ti ve a pp roa c he s o n se vera l fr o nts , i nc l ud in g m od el s fo r a ppr op ria te , a f f or da b l e, a nd e f fi ca ci o us s cre eni n g a nd trea tme nt , se r vi ce de li ve r y , e n ga geme nt wit h c om mu ni t ies , a nd t o ga r ner broa d - ba s e d po li c y a n d p ro gra m ma ti c c omm i tme nt t o a dd res si ng ce r v ica l ca n ce r .
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Matzen P & Lohse N. “NCD Prevention begins in the womb.” GLOBALHEALTH Magazine, issue 11, summer 2011. 19 American Cancer Society, AVAC, Cancer Research UK, PATH, IPPF, UICC, Pan American Health Organization, FIGO. 2011. Progress in cervical cancer prevention: The CCA Report Card. Cervical Cancer Action. 20 World Health Organization. 2011. Global status report on noncommunicable diseases, 2010. Geneva, Switzerland. 21 For more information about the Alliance for Cervical Cancer Prevention, see http://www.alliance-cxca.org/index.html.
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Lessons Learned T hi s m e e ti n g on m ult i - sta ke ho lde r e nga gem e nt to a dd re ss N C Ds b u ilt on a n um be r o f ot he r dia l og ue s a ddr es si ng t he sa m e f un da me nta l que st io ns : w ha t do m u lti -sta ke h ol der pa r tn er sh ip s l o ok l ik e; w ha t a re t he s pe ci fi c ro le s va r io u s a ct or s ca n p la y ; w ha t t ype o f a n e n vi ro nm e n t d o t he se typ es o f pa rt ne rs h ips r equ ire ; a n d h ow ca n the se pa rt ne rs hi ps le v era ge pa r tn er re so ur c es a nd e xpe rti se t o m ov e in itia t i ve s t o a la r ge r sca le ? 22, 23 T he f oll ow in g a re ma j or po i nts o f co n se ns u s t o bu ild fr o m a s st a k eh ol der be gi n or c o nti n ue to de ve l op mu lti -st a k e h ol de r pa rt ner s hip s .
A variety of stakeholders, including the private sector, have unique resources to leverage and contribute to forming strategic partnerships. Wi th a c lea r u n der sta nd in g of rol e s , r e sp o ns ib ili tie s, int ere sts a nd i nc en ti ve s, pa r tn ers h ip s t ha t a r e in cl u si ve o f pri va te se ct or a ct or s ha ve t he o ppo rt u nit y to u se ma n y of t he i r c ompa ra ti ve a dva nta ge s i n gl oba l su ppl y c ha i n , t ra i ni n g a n d re se a r ch ca pa cit y , a n d i nf or ma ti o n dis se mi na tio n to c rea te e f fe cti v e pa rt ne r s hi ps f or NC Ds . T he H ig h -L ev el Mee ti ng o n N C Ds pre se nt s a n opp or tu n it y t o m a k e t hi s ca s e a nd co nti n ue sha pi ng a n e na bli ng e n vi ro nm e n t fo r p ri va t e se ct or to e nga ge in pa rt ner s hi ps .
Many companies have already taken steps to coordinate efforts and state commitments; however engagement across the various dimensions of individual companies and the private se ctor at large can be increased. Be fo re pa rt ne r i ng e xt e r na l ly , la rge r, m ult i na ti o na l c ompa n ies o ft en fa c e t he fi rst cha lle n ge o f u nde rsta nd i ng th e s c ope o f wo rk a nd po i nts o f co nta ct i nte r na ll y . A c ompa n y ma y b e e ng a g in g on se v era l fr on ts f or a n y gi ve n i s su e , a n d d eve lo pi ng a co mp lete u nde rsta n di ng o f th e poi nt s o f i n te ra ct io ns i s o f te n co mpl ex . T h us , a n i nte rna l ma pp i ng o f a c om pa n yâ€&#x; s e xte rn a l poi nt s o f e n ga ge me nt rela te d t o N C Ds c o uld be us e f u l.
Sustained multi -stakeholder partnerships require an appropriate mix of resources, leadership, learning and adaptation to “counter the natur al te ndency to entropy.� Pa rt ne r s hip s a re d yna mic e nti tie s in need o f c riti ca l t h in k in g a nd stra t e gi c di re cti o n. C o mmit me nt by a l l pa rt n ers is ke y, w hi c h in cl u de s c le a r a nd s us ta in ed c o ntr ib uti o ns to th e pa rt ner s hi p. At th e sa me tim e , t hr ou g h a p pro pri a te f e edb a c k c h a n nel s, pa rt ner s ca n
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The McGill World Platform for Health and Economic Convergence. Harnessing the power of business of global health diplomacy. Meeting Summary Report, March 2011. 23 Global Social Observatory. Mobilizing multi-stakeholder action to address noncommunicable diseases. GSO Roundtable Report. 8 April 2011.
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e va lua te pr ogre s s a nd rel eva n ce , a nd w he n ne ce ssa r y , a com ple ti o n time ta ble .
Health systems will increasingly require a chronic care model to address NCDs and chronic infectious diseases, such as HIV/AIDS, with a role for multi-stakeholder collaboration through all components of the system (i.e. governance, supply chain, workforce , service delivery, financing, and information systems). Communities should remain the central stakeholder in any partnership. A n y g lo ba l , na t io na l o r l oca l stra teg y u lti ma tel y de pe nd s o n t he e x te nt to w hi c h co mm u niti es a re i nc l ude d i n t he pro ce ss . Co mm u nit ie s pro v ide t he c on tex t, a c ces s po in ts , a nd fe e dba c k m e c ha n ism t ha t a pp ro pri a tel y ta i lo r a nd s ust a i n pu bli c he a l th i nte r ve nti o ns , i n cl ud in g t h o se fo r NC Ds . Po li cie s a n d p ro gr a ms re la te d t o N C Ds s ho u l d be i n cl us i ve o f co m mu ni tie s, i n cl ud in g t h ose a f fe cte d b y NC Ds , t o i den ti f y t he m ost e f fi ci ent , e f fe ct i ve a nd c ult ura l a ppr op ria t e p r eve nt io n , t rea tm en t, c a re a nd re ha bil ita t io n int e r ve nti o ns .
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Appendix A. Meeting Agenda 1:30 – 2:00pm: Welcome Remarks Dr. Jeffrey L. Sturchio, President & CEO, Global Health Council H.E. Sylvie Lucas, Ambassador of Luxembourg to the United Nations H.E. Raymond Wolfe, Ambassador of Jamaica to the United Nations 2:00 – 3:00pm: The Critical Role of Multi-sectoral Engagement Sir George Alleyne, Director Emeritus, Pan American Health Organization Ms. Sarita Nayyar, Sr. Director, Health of Consumer Industries, World Economic Forum USA Mr. Herb Riband, Vice President, External Affairs, International, Medtronic Inc. Dr. Jacqueline Sherris, Vice President for Global Programs, PATH
Moderator: Dr. Jeffrey L. Sturchio 3:00 – 4:00pm: Innovative Partnerships and the Role of the Private Sector Dr. Derek Yach, Sr. Vice President, Global Health and Agriculture Policy, PepsiCo Ms. Charlotte Ersbol, Corporate Vice President, Corporate Branding & Responsibility, Novo Nordisk A/S Mr. Christopher Gray, Sr. Director, International Public Affairs, Pfizer Dr. Jonothan Quick, President and CEO, Management Sciences for Health Dr. Laurette Dube, James McGill Professor of Consumer Psychology and Services, Marketing and Management, McGill University
Moderator: Dr. Jeffrey L. Sturchio 4:00 – 4:30pm: Coffee Break 4:30 – 5:30pm: Interactive Breakout Discussions
Group Facilitators: Loyce Pace Bass, LIVESTRONG & Jorge Casimiro, The Coca Cola Company 5:30 – 6:00pm: Summary and Closing Remarks Dr. Jeffrey L. Sturchio, President and CEO, Global Health Council
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Appendix B. Private Sector Perspective on the Global Non-Communicable Disease Challenge Healthy workforces and families
Implement smoke-free workplaces and smoking cessation support within our companies and seek to extend them a cross our networks of suppliers; Provide opportunities for physical activity within our workplaces; and Ensure that employees have access to effective age appropriate screening and referral for major NCDs.
Access to effective diagnostics, treatments and health consumer products
Support efforts to expand and improve access to essential quality care by working in partnership with governments, international organizations and local partners to combat barriers exacerbated by weak health systems; Advance the goals of the WHO Global Strategy on Diet, Physical Activity, and Health; Invest in programs that contribute to the creation of well functioning health systems, thereby creating the conditions required for equitable access to medical products, vaccines and technologies of appropriate quality, safety, and efficacy; and Continue to invest in research and development to launch new and innovative technologies to address public health needs in both developed and developing countries.
Health environments
Actively work with city and town planners to increase mobility as an easy daily option for communities where they live, play and recreate; Invest in model community-based activity programs that link to environmental conservation and urban renewal; and Partner with academics, civil society, and the public sector to design and deliver innovative approaches to physical activity that effectively enable levels of exercise necessary for risk reduction.
Strong education, training and research capacity
Work together with major public and private funders to strengthen human and institutional capacity aimed at building the future cadre of NCD leaders; and Collaborate with each sector to achieve a shared goal of NCD reduction, but to also improve the overall health, vitality and wellness of worldwide populations through community education, outreach and program and policy initiation.
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