Bumpy ride for UN conference on non-communicative diseases

It should surprise nobody that a global conference on non-communicative diseases fails to get to the top of most people's priorities. Former editor of the British Medical Journal Richard Smith discusses the forthcoming UN summit on non-communicable diseases (September in New York) – admits to no little surprise that there seems to be limited enthusiasm for it and contemplates the merits of a global resolution on this issue that is unsupported by any funding.

The summit focuses on four risk factors: tobacco use, alcohol misuse, physical inactivity and inadequate diet. These are leading factors in cancers, cardiovascular disease, COPD and diabetes.

Lancet editor Richard Horton observed earlier this year that the non-communicable disease agenda lacks the urgency of other issues.

Although 80% of NCD deaths take place in low and middle-income countries, the fact is that for the 50 or so poorest countries in the world an unfinished litany of problems remains—infectious diseases, maternal and childhood illnesses, and unchecked population growth. NCDs come bottom of this list.

Richard Smith still seems to feel it is worth while keeping on the table as an issue for the NCD Alliance. But the NCD Alliance seems to be losing patience with the rest of the world:

A particular problem for the NCD Alliance, a quickly formed global body of organisations concerned about NCDs, is that the outcome document lacks clear targets, meaning that member states can easily slide away from doing anything. There are also disagreements over follow up and the need for partnerships. The alliance says that its time to “stop being polite.” They want outrage.

The issues that concern the NCD Alliance seem far too important to leave at the table of a hastily formed group of non-governmental organisations, that appears to think it should be an authority on global health issues ... an authority with teeth, that can enforce its will on member states. What can such an alliance actually do? Adequate food cannot be guaranteed by a non-governmental body without the willing cooperation of many other actors. Such a body can recommend good diet, but where malnutrition is a recognised issue it won't necessarily help matters to have yet another body declare that everyone needs a balanced diet.

All an international body can do is demand policy changes. Any other kind of intervention costs money.

What kind of policy changes will be advocated? Is this kind of scenario in less developed countries really going to be helpful or relevant?

Mr Smith seems a little surprised that NCDs don't get the attention from the general public that was given to AIDS. The global health agenda seems to have turned upside down since then.