omprehensive global monitoring framework and prepare recommendations for voluntary global targets before the end of 2012.
To that end, the Secretary-General made five recommendations with a view toward further progress. First, to implement a comprehensive government approach to adopting population-wide interventions that address risk factors. Second, to undertake sustained primary healthcare measures, including prioritized modules describing essential interventions, along with palliative and long-term care, for those who already have NCDs or are at high risk of contracting them. Third, to strengthen the capacity of member states to monitor these diseases, as well as their risk factors and determinants, especially in lower-income countries. Social data disaggregated by gender was also encouraged. Fourth, to harness lessons learned from national HIV/AIDS, tuberculosis, and malaria programs in low and middle-income countries for effective integration of communicable diseases and NCDs into all health initiatives. Finally, prioritize the prevention and control of NCDs through commitments by governments, the private sector, civil society, the UN and other international organizations.
Tobacco control efforts
The tobacco control ‘wins’ in the summit’s Political Declaration include accelerated implementation of the WHO Framework Convention on Tobacco Control (see boxhead-bottom right), although without mention of the treaty’s guidelines; recognition of the “fundamental conflict of interest” between the tobacco industry and public health; reference to tobacco taxation as an effective and important means of reducing tobacco consumption; a tie-in to the development agenda recognizing the key role of prevention; multiple mentions of the impact of NCDs on development; and acknowledgement of insufficient resources.
“Including reference to the FCTC in the Political Declaration will help lay down the terms of how governments will allocate their resources. The same is true for private organizations,” said Rob Cunningham, who was in New York on behalf of the Canadian Cancer Society. “The FCTC has been a revolutionary driving force behind tobacco control in the developing world,” he continued, adding that tobacco control is a “best buy” as it affects all four major chronic diseases, with tobacco control the cheapest and most successful route in combating these diseases due to the ability to increase revenue by raising taxes on cigarettes and other tobacco products. While there is no commitment of resources, the Political Declaration mentions the need to “promote all possible means to identify and mobilize adequate, predictable and sustained financial resources... and to consider support for voluntary, cost-effective, innovative approaches for long-term financing of NCD prevention and control.” It also made reference to the “continued inclusion of NCDs in development cooperation agendas and initiatives” and mention of national ownership of aid priorities.
Smoking prevention attracted much attention in many countries, including strategies for reducing tobacco use, describing action taken on the taxation, advertising and regulation fronts and the banning of smoking in public spaces.
Some of the efforts by developing countries were quite innovative. New Zealand’s Justice Minister, Simon Power, said the country aimed to be smoke-free by 2025. Australia’s Minister for Health and Ageing, Nicola Roxon, displayed a prototype for its plain packaging legislation, which later received Royal Assent on December 1, to a round of applause. She told the Assembly that Big Tobacco was fighting desperately to put a stop to their efforts, but that the government was resolved to move forward.
However, some of the efforts in the developing world were, for them, quite cutting edge as representatives from these countries outlined their plans to control tobacco use. Delano Bouterse, President of Suriname, speaking on behalf of the Caribbean Community (CARICOM), noted that they developed a strategic plan of action including minimum health standards for tobacco. Agnès