It is a timely moment for the WHO to appoint an Independent Global High-level Commission on Non-Communicable Diseases (NCDs)just when the formal preparatory process for the third High-Level Meeting on NCDs is about to begin. Dr Tedros has announced back in October 2017, during the Montevideo Conference on NCDs, that such a Commission would be established. So now it has happened at highest political level: five current and former Heads of States, 10 government ministers, and 12 renowned global health leaders have been appointed to this Commission.
The chairs of the Commission have been carefully selected:
- Sauli Niinistö, President of Finland, is representing a member state that successfully tackled NCDs through a Health in All Policies approach;
- Maithripala Sirisena, President of Sri Lanka and a former Minister of Health, has put alcohol and tobacco control on the top of the national agenda;
- Tabaré Vazquez, President of Uruguay, is known for his fight against tobacco and promotion of public health as a priority for governments;
- Veronika Skvortsova, Minister of HealthCare of the Russian Federation, worked before her political career as a medical doctor and civil society leader in stroke and heart disease prevention and treatment; Russia has also played a leadership role in promoting the international NCD agenda; and
- Sania Nishtar, President of Heartfile and a former Minister of Health of Pakistan, known for her lifelong commitment to development of health and health services in Pakistan.
Africa and the Middle East and North African (MENA) Region are not represented as chairs, however, three high-level personalities from Africa, two Ministers of Health from the MENA region and other Ministers have been appointed as Commissioners to ensure geographical representation. Well-known global health leaders complement this set of political statespersons and Prof Ilona Kickbusch, Director of the Global Health Centre, is one of the Commissioners to recommend action to tackle NCDs. She sees the task of the Commission to make “courageous recommendations that will foster political will and address the commercial determinants of health”.
The composition of the Commission is therefore interesting in two aspects:
First, it shows that the WHO is well aware of the need to leverage political commitment. Only member states have the power to and can affect real change. Political leadership is needed in the fight against NCDs. The Second High-Level Meeting had no heads of state and hardly any high-level representative attending and this should change in the upcoming Third High-Level Meeting (HLM) to be convened in September 2018. The first report of the Commission is due to be published in July 2018, right in time to be considered by the inter-governmental HLM preparatory process.
Second, the inclusion of individuals from outside the health sector reflects the need to frame NCDs beyond the health silo and urge collective action. Government, international organizations, civil society, academica, philanthropies, the private sector and public-private partnerships, all have to come together to agreements on how best to reduce risk factors. “The NCDs are a tsunami, destroying the health, social and economic development potential of many countries”, says Prof Kickbusch. The commercial determinants of health play a pivotal role here, even if it is a complex issue with no easy solutions at hand because economic and health interests meet nationally in opposite playgrounds. Yet, a common understanding need to be found at global and national level.
Therefore, this High-Level Commission does not have an easy task ahead. It should identify, among others, options for governance, finance, science and technology, as well as mechanisms for cooperation and accountability. This is a challenging list of tasks, many of which are complex and multidimensional, but taken up in a suitable manner, they may be able to trigger further progress. A progress urgently needed and we all want to see to happen.
Michaela Told, Deputy Director & Executive Director, Global Health Centre
The first draft of the Commission’s report should be publicly available for consultation in April 2018, with the first report to be published in July 2018 and the Commission to run until October 2019.