Informal meeting of stakeholders on scaling up CVD management

5-6 April 2018, New Delhi, India

Dr Tom Frieden, distinguished partners and participants,

A very good afternoon to you.

It is my immense privilege to address this meeting. I am particularly pleased it is being held as our office celebrates World Health Day which, as you know, is focused on the quest to achieve universal health coverage.

Tackling noncommunicable diseases – or NCDs – is a major part of the South-East Asia Region’s quest to achieve that goal. The numbers illustrate why. Region-wide, NCDs are responsible for 8.9 million – or 64% – of all deaths annually. Tragically, 4.4 million of those deaths are premature.

Among NCDs, cardiovascular diseases, or, to use another acronym – CVDs – are the number one killer. CVDs account for around 3.8 million deaths in our Region annually. That equates to 43% of NCD-related deaths and 28% of all deaths. That is a staggering burden – a burden that weighs heavily on individuals, families, communities and countries.

It follows that our quest to achieve the Sustainable Development Goal target of reducing NCD mortality by one-third by 2030 is incumbent on our ability to reduce CVD mortality, and to do so with decisive efficiency.

Indeed, the deadline for meeting the global ‘25 by 25’ target – which requires reducing premature NCD-related deaths by one-fourth by 2025 – is just around the corner. Rapid and sustained progress is needed to meet that target. Thereafter we have just five more years to achieve the one-third reduction in premature NCD deaths demanded by the SDG target.

Distinguished partners and participants,

Time is moving fast. Our work is cut-out for us. But we know what needs to be done.

First and foremost, we need to take a systems approach to tackling CVDs alongside other NCDs. That means bringing services to diagnose, manage and treat these common conditions to the primary health care level. To do that, primary health care must be reinvigorated Region-wide, with special attention paid to the skills and training of primary health care workers, updating the diagnostic tools and essential medicines they have access to, and strengthening referral pathways. Importantly, it does not mean creating new programmatic silos.

A key part of detecting and managing CVDs and other NCDs at the primary level is inspiring trust in primary health care services. That begins with creating positive health care experiences, whether by instilling confidence through competent staffing or ensuring patients have ready access to essential medicines. More than that, however, it requires reducing out-of-pocket spending, particularly on medicines and basic medical devices such as those to measure blood-sugar. Region-wide, out-of-pocket spending remains a major deterrent to health-seeking behavior, as well as effective disease management.

Though systemic reform is dependent on Member States’ political will and commitment, both internal and external partners have a critical role to play. Through their advocacy among government and health sector personnel they can amplify the critical need for system-wide reform to enhance CVD and NCD detection and management. Through their vast grassroots networks they can raise the public profile of CVDs and other NCDs and draw attention to the behaviors that cause them. And through their resources and funding they can ensure that basic tools to detect and treat CVDs and other NCDs are available and fit for purpose at the primary health care level.

Given the potential for the non-government sector to have real, life-changing impact, it is inspiring to see so many partners represented here today.

Nevertheless, in making these points, we must bear in mind that no two countries are the same. No two health systems have identical strengths and weaknesses – identical quality and reach. To complicate matters, no two NCD epidemics are the same. It therefore follows that each country needs to adapt its services according to its specific needs, with partners supporting as best they can, as and where they can.

Distinguished partners and participants,

I wish you an immensely successful, informative and engaging meeting. Let the discussion be rich, and let it be readily translated into on-the-ground initiatives able to fast-track progress towards our time-bound CVD and NCD targets.

Thank you very much.