Reflections from the latest WHO Global Coordination Mechanism on the Prevention and Control of NCDs dialogues in Geneva, Switzerland

Last week marked the latest WHO GCM/NCD dialogue on how to strengthen international cooperation on the prevention and control of noncommunicable diseases (NCDs) within the framework of North–South, South–South and triangular cooperation. The scope and purpose of the WHO GCM/NCD is to enhance the coordination of activities, multi-stakeholder engagement and action across sectors in order to contribute to the implementation of the WHO Global NCD Action Plan 2013–2020.

The two days of presentations and discussions resembled a room full of toddlers at a birthday party, each throwing their crayons in the air and in some cases, throwing them at each other. Some not willing to play with others, while others having shared the same playground and having been friends for years.

As you listened across the room you could map out the foreseeable tribal feuds between delegations and sadly enough, a script that could have been written before the dialogue even began:

  • “We must leverage what we have learnt from HIV” vs. “You can’t compare HIV to NCDs, they are not the same”,
  • “We must engage the private sector” vs. “The private sector must not be able to direct the conversation”,
  • “We must focus on primary health care strengthening rather than focusing on vertical programs” vs. “Look at the successful vertical program we just ran in country X”.
  • “Food is the key” “Actually essential medicines are the key”
  • Director General “Improve efficiency, reduce waste”
  • “What about mental health?” “What the hell constitutes a NCD?”

-All the classics

Now that the party is over, the GCM/NCD secretariat must pick up the pieces, and figure out what crayons go in what box. Not an easy task. A task, that has yet to be successfully accomplished in the global public health arena although it has been tried in the past.

As an initial step, the GCM/NCD must take a page out of the private sector playbook and “segment the market” when it comes to private sector engagement. There is currently a misguided notion as to what and who constitutes the private sector. A self-owned food cart owner pedaling his way through the Mekong Valley is technically private sector. Small and Medium enterprises hold a diverse range of implications, many times distinct to those involving multinationals.

Furthermore, the error of continuing to just think of the ‘familiar five’ (private sector) within the global NCD arena must be corrected.

Familiar Five: 1) FBT (food, beverage, and tobacco), 2) pharmaceutical, 3) private philanthropic, 4) medical insurance providers, and 5) medical service providers/medical devices.

Other market sectors, or Non-Traditional Private Sectors (NTPS), such as the IT, apparel, consulting, aerospace and engineering, banking, automotive, coal and mining, exploration and production, metals and mining, and oil and gas service industries have arguably more to lose in terms of NCD-related medical costs and loss of productivity, given their large employment numbers and high levels of associated occupational NCD risk. As such, engaging these NTPS players holds special promise for effective action on NCDs.

It must however be acknowledged, that the GCM/NCD is trying to change the way it does business. The third GCM/NCD dialogue marked with it the launch of the first Global Virtual Discussion Forum that will be the starting point of a Community of Practice on the new GCM/NCD Web Portal. The portal can be found online and is open to all. This marks an effort to further create an added layer of transparency through the process of engaging with a broader range of stakeholders.

It will be interesting to see how the new rules of engagement within the global NCD arena play out. In the meantime, we are sharpening our crayons for the next one.

Originally trained as a medical physician, Dr. Rodriguez-Fernandez serves as the Global Medical Director of Non-communicable Diseases (NCDs) for International SOS. He also currently serves as the Executive Director and Founder of the NCD Asia Pacific Alliance.