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CHMM lookback: Experts discuss key health priorities for Commonwealth

4 June 2018

This year’s Commonwealth Health Ministers Meeting (CHMM) provided a key platform for decision-makers to discuss priorities for citizens of the 53 member countries.

Areas for consensus and collaboration included a 20 per cent sugar tax on sweetened beverages, 100 per cent smoke-free zones and one-stop crisis centres for victims of gender-based violence.

At the heart of the summit was non-communicable diseases, which account for around 10 million deaths every year in Commonwealth countries, seven million of which are due to causes such as cardiovascular diseases, cancers, respiratory disease and diabetes.

The Minister of Health for Ghana, who chaired the summit in Geneva ahead of the 71st World Health Assembly, was positive about how the discussions had gone and the collaborative road ahead for Commonwealth countries to tackle some of the most pressing issues.

Minister Kwaku Agyemang-Manu said, “From the engagement we had with countries at the Commonwealth Health Ministers Meeting, non-communicable diseases are becoming a very serious concern.

“We have to submit what we think the World Health Organization and the rest of the world, including the Commonwealth, can do to support nation states to combat non-communicable diseases in the context of the WHO and UN Declaration for Universal Health Coverage by 2030. So we have had our own discussions (at CHMM) and agreed on setting basic things that we can put in front of the WHO and World Health Assembly for consideration.”

Focusing on his own country of Ghana, Mr Agyemang-Manu added, “In the context of non-communicable diseases we are seeing more cardiovascular challenges (such as) hypertension, kidney challenges (including dialysis), renal problems, and obesity, which lead to other diseases which need to be looked at.”

Co-founder of The Elders, Graça Machel, addressed health ministers during the meeting and praised the achievements of the Commonwealth and in the efforts of many countries to work towards Universal Health Coverage.

Ms Machel said, “The Commonwealth represents a huge range of experiences and lessons in moving towards Universal Health Coverage. Of course, no country in the world has achieved perfection in UHC yet, where everybody has immediate access to every top-quality health service they need without any financial hardship. However, there are countries in the Commonwealth that are nearer that goal than most and this does not just include the richer Commonwealth members. At all income levels there are shining examples of Commonwealth countries outperforming their peers in increasing coverage of essential health services and protecting their people from the costs of these services.”

Dr Olive Shisana from the University of Cape Town, who was commissioned by the Commonwealth to write a report on gender-based violence, spoke about the widespread nature of the problem:

“In all of our Commonwealth countries there is a big problem with regard to gender-based violence and we see so many programmes coming in but no coordinated effort by the Commonwealth to end gender-based violence. There is not an agreed target amongst the Commonwealth countries to say ‘by this particular year we must have done the following things in order to eradicate gender-based violence.’ And yet it’s something that’s so crucial because it really disadvantages women, children and young boys also. So that’s something that I think the Commonwealth needs to be addressing,” she stated.

Dr Shisana expanded on one of the key recommendations for countries to provide support to victims: “The Commonwealth has identified some very [effective] gender-based violence one-stop centres in some of the Commonwealth countries and we are hoping that there will be some lesson-learning and eventually they will be able to come up with a strategy of implementing some because we need to implement evidence-based intervention to deal with gender-based violence. We cannot just simply say ‘I believe in gender-based violence and this is what I think must be done’. It must be looked at in scientific evidence. And I think the Commonwealth is in a very good position to be able to take up this issue. Because they are committed indeed to the whole issue of the right to care for those people who are affected by gender-based violence,” she said.

Professor Alafia Samuels from the University of the West Indies, and Director of the George Alleyne Chronic Disease Research Centre, discussed non-communicable diseases.

She said, “One of the main issues we need to recognise is that death from NCD’s, as such, is not the major problem; the problem is premature death from NCDs. That will be deaths before the age of 69. And you will find that, in all but the high-income countries, almost half of all NCD deaths take place in people who are less than 70 years old. So you find people are in their productive years; they’re in the workforce, and they’re getting sick and dying from NCDs way earlier than they need to. This is related to risk factors, higher incidences of NCDs as well as the question of management; screening and control.”

Professor Samuels went on to warn that many countries need to do far more to ensure they are prepared to tackle the problem. She said, “It’s interesting to note that, among the countries with the highest [prevalence] of non-communicable diseases, many are simply not equipped to deal with the scale of the problem. This means that many people under the age of 70, including those who are both active and a working age, are vulnerable and will remain so for the foreseeable future.”

The positive words of the health ministers from across the 53 countries of the Commonwealth symbolised the unique role that the organisation can play, such as consensus and collaboration around major issues such as health.

As the Secretary-General told ministers in her opening address, “It is by identifying gaps in provision or mobilisation which the Commonwealth is able to fill, by virtue of our distinctive range of membership, trust and engagement, that we will add to our admirable record of solid pioneering progress and solid achievement.”