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Talks Bog Down Ahead of U.N. Health Meet

Elizabeth Whitman

UNITED NATIONS, Aug 19 2011 (IPS) - The first High Level Meeting on Non-Communicable Diseases is scheduled to take place one month from now, but U.N. member states are lagging in preparing for it, an alliance of civil society organisations says.

The draft of the political declaration that will be the outcome of the meeting contains “no overarching goal” or mechanism for following up on member states’ commitments, the Non-Communicable Disease Alliance wrote in a letter to U.N. Secretary-General Ban Ki-moon.

Instead, “sound proposals” for the draft “are being systematically deleted, diluted and downgraded” and replaced with “vague intentions”, the letter said. “Efforts by some member states to postpone and weaken United Nations negotiations” threatened international progress on managing non-communicable diseases, NCDA warned in a press release.

Ann Keeling, chair of the NCDA and CEO of the International Diabetes Federation and a former U.N. employee, said she was “surprised” that member states took so long to take positions on the issue and that preparations had gotten off to a “slow start”.

The four most common non-communicable diseases are cancer, diabetes, cardiovascular disease and chronic respiratory disease. Non- communicable diseases are responsible for 63 percent of global deaths, according to NCDA. The organisation projects 52 million NCD deaths annually by the year 2030.

The NCDA is a coalition of over 2,000 organisations that focus on non-communicable diseases. With members hailing from over 170 countries, the Alliance works at “putting non-communicable diseases on the global agenda”, according to its website.

The World Health Organisation (WHO) said in a response to the NCDA’s letter that non-communicable diseases represent “an enormous burden worldwide that requires global commitment… That is why the United Nations High-level Meeting on NCDs is being held.”

Although the NCDA’s work on the issue was “appreciated”, WHO said it “cannot pre-empt the discussions of Member States” on the upcoming meeting.

Causes of inaction

Preparations for the meeting have fallen by the wayside for several reasons, suggested Keeling, not the least of which is that with the current economic climate, states hesitate to commit any money to any cause at the moment.

Confusion and misunderstanding have also contributed to the inaction- not many are familiar with the label of non-communicable diseases, so some people aren’t sure what kinds of diseases or how many they are dealing with, Keeling told IPS. They also questioned whether the summit would focus primarily on low-income or developing countries.

Keeling stressed, however, that non-communicable diseases are not confined to the developing world, calling them “a truly global issue” that is “not under control in any country in the world”.

Nor are these diseases purely a health issue. Dealing with non- communicable diseases falls into the realm of transport systems, food marketing and human rights, to name a few, Keeling added.

The uncertainty surrounding the dynamics of non-communicable diseases – what they entail, for instance, or where they are to be found – indicates a need for clarification, Keeling pointed out. Otherwise, the summit will be even less productive than lagging preparations have already made it.

“The longer the negotiations have gone on,” Keeling said, the weaker the draft document has grown, a direction that is “entirely unacceptable”. At one point, she said, the document contained proposed targets and measures to deal with non-communicable diseases. Now they’ve been removed.

A global issue

The U.S., Canada and the European Union sought to block proposals to include the goal of cutting preventable non-communicable disease deaths by 25 percent by 2025, said the NCDA’s press release.

Low-income countries that have been guiding the preparations process and pressing for a strong measurable outcome of the meeting have encountered some “pushback” from high income countries like the U.S. and Canada, Keeling said.

Although non-communicable diseases, particularly ones that affect the elderly, have long been associated with high-income countries, now four out of five cases are in low-income countries. This shift could be one reason for more developed countries are investing less time and showing less commitment to the High Level Meeting.

The split between high and low-income countries on the issue of non- communicable diseases is reminiscent of the High Level Meeting on AIDS held last month at the United Nations in New York.

In discussions over the outcome document, divisions over the role of intellectual property rights and level of financial commitment to fighting AIDS emerged along the lines of developed and developing countries with different priorities and vastly different resources.

Similarly, in negotiating a document for the upcoming meeting, “member states are coming from very different positions”, Keeling noted.

The NCDA called on member states to agree on the overarching goal of reducing preventable deaths from NCDS by 25 percent by 2025, a clear timeline for dealing with the four major non-communicable diseases, specific targets and a high-level collaborative initiative that would assess progress.