Do words speak louder than actions? Reflections after the summit.
I deliberately resisted blogging about it for a whole month, partly because I wanted to see the build-up and the aftermath of it, and partly because I wanted to see what everybody else said about it. I am, of course, talking about the UN High Level Meeting for non-communicable diseases (NCDs) on 19th and 20th September. The only other occasion that the UN has met like this on a health issue is for HIV/AIDS. The stakes were and are undoubtedly high and momentum has gathered and continues to gather. Yet there is definitely a sense of anti-climax after the summit. The organisation and run-up to the meeting seems to have been dogged by logistical but more importantly, by blocks through governments and multinational companies concerned about hard outcomes from the meeting.
I followed ex-BMJ editor, Richard Smith’s blog keenly throughout the meeting. It does not seem like the key stakeholders were invited or asked for opinions in time. As he said, probably the best thing to come out of the meeting and the pre-meeting is the NCD Alliance, a robust organisation of all the important stakeholders joined for the common purpose of raising awareness.
There is no question that awareness has been raised, and the summit was covered by medical journals, including the Lancet and the BMJ. Interestingly, the major American journals were notable by their silence on the first NCD summit of its kind. Yet, these same journals are the first to publish trials of expensive therapies for cardiovascular diseases, often with major conflicts of interest. On the subject of conflicts of interest, there are particular concerns about NCDs and the way big company interests are still able to play a major role in the UN.
The newspapers and other press gave coverage, but not as much as one would hope. Some of the loudest calls for actions came from celebrities such as Jamie Oliver. Looking around the WHO website, I did not find much in the way of concrete outcomes.
During my clinical cardiology practice, I have asked doctors and patients in the last few months if they knew that the meeting was happening. Almost without exception the answer was “no”.
On the second day of the summit, Richard Smith depressingly concluded:
“The big failures for me have been the failure to raise understanding of NCDs among the wider population and—as discussed at this morning’s meeting—the failure to recognise the need for a system that has at its centre patients not professionals.” It does not come much more damning than that.
What is the point of global health and health policy if it is not engaging at all with end-users? At the BMA Global Health event last week, I could not help feeling that this is an issue across global health and health policy-makers. Words are important but so are actions, particularly if the global fight against NCDs is to succeed.