Health professions call on Member States to act against NCDs and social determinants of health

Speaking at the UN high level meeting on NCDs in New York, Wonchat Subhachaturas, World Medical Association President, and WHPA representative, called on member states to address both noncommunicable and communicable diseases in conjunction with social determinants of health, to avoid a 'silo' approach to health care.

WMA President speech for Roundtable 1 UN High Level Meeting on NCDs  

New York, 19 September 2011

Chairman, Your Excellencies, Colleagues caring for the health of the people of the world, Ladies and Gentleman… 

The World Medical Association welcomes the attention that is now being given to NCDs and the recognition that they are major contributors to the global burden of disease. Such intense activity as this gives hope that Member States will pay more attention to preventing, treating and rehabilitating NCDs, many of which have reversible causes. This is necessary.  This is effective, cost effective and right.  

Why should a child born today have an expected lifespan which is less than that of his or her parents?  Sadly this is the risk we now run if we don't all work together on strategies to reduce the burden of both noncommunicable and communicable diseases after this United Nations meeting ends. That is the unpalatable heritage that today's infants will receive.

The WMA, is the peak international body representing the doctors of the world – who have a key, daily, hands-on mandate and duty to care for patients throughout their lives. On behalf of the five World Health Professions Alliance WHPA organisations, we all have concerns about the present discussions. We fear the disease-orientated and narrow approach towards noncommunicable, among the wide field of NCDs.

With the focus mainly on cardiovascular disease, cancer, diabetes and chronic respiratory disease, we fear that governments will concentrate only on improvements in these areas, detracting from other significant needs of other major NCD threats, such as mental disorders, musculoskeletal diseases, oral diseases and accidents. The effect of this vertical or 'silo' approach will be to deprive other important areas of health care of necessary resources.

Furthermore, the burden of disease from NCDs is often multiple and chronic, and the illness and suffering of the individual numerous – only a combined, primary care based, collaborative and whole-person view can succeed.  

We welcome the inclusion now of mental disorders, oral disease and eye diseases to the political declaration of this meeting. 

We advocate a complete approach that links individual risk factors with social and economic determinants of health, conditions in which people are born, grow, live, work and age, and the influences of society. From the outset, member states must address NCDs with SDHs and communicable diseases – and not in isolation.  

The way forward is to emphasize access to effective health care as a human right. Defining health success as a mere statistical challenge deprives individuals of the health care they are entitled to. We are deeply concerned that the current discussion, especially disease targets, reduces health care to very limited technical provisions. This approach forgets the very important, person-centred care and people-centred public health care approaches. These are vital to all and currently absent from far too many health systems.

The way forward is to develop health care systems based on a core of solid primary care. These cannot be reduced to serving particular interests. Illnesses are not confined to one disease category in an individual patient. We know that a patient may have a mental disorder, diabetes, and high blood pressure – all at the same time. 

The WMA and the World Health Professions Alliance that we form a part of – speaking for 26 million health professionals – urge Member States to take immediate and sustained action, from now, to beat this serious threat to human health and development. In particular the world's health professions highlight the following core requirements: 

  • Adopt a holistic approach based on common risk factors.  
  • Extend the scope from a limited number of diseases to the broad field of NCDs 
  • Ensure equitable access to health care as a human right so as to address the dramatic disparities within and between countries. 
  • Promote a common approach that addresses and pays due attention to the link between non-communicable diseases and the social determinants of health, with a particular focus on the broader factors that influence behaviour and associated health risks.  
  • Emphasize primary health care as the way to strengthen health care systems through a comprehensive approach that integrates prevention, specialised treatment and rehabilitation supported by the enhancement of collaborative practice between healthcare professionals (integrated care). 

I thank you sincerely for this opportunity to speak today and undertake that my organisation, the WMA, will work collaboratively with the UN and with our Member Associations to improve the recognition and care of noncommunicable diseases amongst the people of our world.


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