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Tackling the dual burden - Commonwealth Health Ministers Meeting

21 May 2012
Health ministers examine approaches for dealing with the dual burden of communicable and non-communicable diseases in the Commonwealth

Commonwealth health ministers discussed how lessons learned from tackling communicable diseases - such as HIV and AIDS - can be applied to the growing threat of non-communicable diseases (NCDs), at their annual meeting on Sunday, 20 May 2012.

Ministers met in Geneva, Switzerland, on the eve of the 65th World Health Assembly under the theme ‘Linking Non-communicable and Communicable Diseases’.

The main risk factors that contribute to the development of NCDs are tobacco use, unhealthy diets, harmful use of alcohol and physical inactivity.

Many Commonwealth low and middle-income countries (LMICs) are particularly affected by the dual burden of dealing with communicable diseases and the growing challenge of non-communicable diseases, due to levels of poverty, lack of education and other social factors.

LMICs account for approximately 80 per cent of reported deaths by NCDs globally. NCDs, which include cardiovascular disease, cancers and diabetes among others, kill 35 million people worldwide each year.

Opening the meeting Commonwealth Deputy Secretary-General Ransford Smith said: “Many health systems in the Commonwealth operate under enormous constraints. In many instances they are structured only to deal with communicable diseases generally, and thus are not optimally equipped to deal with non-communicable diseases.

“To better respond to both communicable and non-communicable diseases will require improved understanding of these diseases as well as improved reporting and surveillance so as to direct healthcare resources to priorities where they are most needed.

“The Commonwealth Secretariat, together with its partners, is prepared to assist member states in ensuring improvement in this area.”

Both the 2009 Commonwealth Heads of Government Meeting Statement on Non-communicable diseases and the 2011 United Nations High-Level Meeting Political Declaration on the Prevention and Control of Non-communicable Diseases acknowledged that NCDs constitute a major challenge to development in the twenty-first century, undermining social and economic advances, increasing inequalities within and between countries, and threatening the attainment of the Millennium Development Goals.

Ministers were optimistic that many countries can build on lessons learned from dealing with communicable diseases when integrating NCDs treatment into existing health services.

They heard from Professor Sir Michael Marmot, Director of the International Institute for Society and Health, UK, and delegates from Australia, Nigeria, Pakistan and Tanzania, who shared their countries’ experiences of managing communicable and non-communicable diseases.

They presented on the role of culture in affecting people’s behaviour and attitudes towards their health and the common causal factors of both communicable and non-communicable diseases, rooted in social factors such as income, education, social status and living conditions. For example, poor housing conditions can lead to poor ventilation and the development of tuberculosis – a communicable disease. At the same time, those living conditions can mean fewer open spaces for exercise, resulting in obesity and potentially diabetes – an NCD.

They also discussed how various programmes currently used to treat communicable diseases could also be used for tackling NCDs, such as mobile counselling and treating facilities to deliver messages, and monitoring for NCD risk factors during treatment for communicable diseases.

Dr Mwele Ntuli Malecela, Director-General of the National Institute for Medical Research, Tanzania, said the Millennium Development Goals for 2015 could not be reached without addressing NCDs.

Ministers discussed approaches for the integration of health systems to address both communicable and non-communicable diseases and to respond to the growing prevalence of the latter. These include: national leadership of country-owned and country-managed strategies and programmes; high-level advocacy; community and resource mobilisation; addressing the continued shortages of healthcare providers in LMICs; training existing staff; and partnerships between organisations, among others.

The meeting was chaired by Donville Inniss, Minister of Health for Barbados.