United Nations task force on NCDs finds cause for concern and optimism in Belarus
A Joint Mission of the United Nations Inter-Agency Task Force on the Prevention and Control of Noncommunicable Diseases (NCDs) visited Belarus for the first time on 14–18 July 2014. The mission made several recommendations for further strengthening of Government action, but also reported that by seizing this opportunity Belarus has the potential to become an exemplary case in multisectoral action for the prevention of NCDs in Eurasia.
The 2011 Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of NCDs called upon United Nations agencies and key international organizations to work together in a coordinated manner to support national efforts to prevent and control NCDs and mitigate their impacts. The WHO Global Action Plan for the Prevention and Control of NCDs, 2013–2020 also highlights the role of the United Nations system in supporting Member States and highlights interventions for the prevention and control of NCDs in 4 key areas: tobacco control, harmful use of alcohol, unhealthy diet and physical inactivity.
The NCD Task Force mission was spearheaded by WHO and included specialists from the United Nations Development Programme (UNDP), United Nations Population Fund, United Nations Children’s Fund and the World Bank. The mission conducted a stakeholder forum and meetings with representatives of ministries, United Nations agencies, civil society and donors.
NCDs in Belarus of grave concern
NCDs are estimated to account for 89% of all deaths in Belarus (cardiovascular diseases, 63%; cancers, 14%). Premature mortality from NCDs in this upper middle income country with a population of 9.4 million is 26%. As a result, average life expectancy at birth in men is less than 65 years. In some rural areas male life expectancy is as low as 61.3 years. This premature mortality, primarily among men of working age, has significant socioeconomic consequences and is a drain on the national economy.
Smoking among men has shown a minimal decline in recent years (from 55% in 1998 to 51% in 2011). Even more concerning is that smoking has increased nearly threefold among women (3.6% in 1995 to 11% in 2011). Alcohol consumption is also a significant public health issue with per capita adult consumption estimates of 17.5 litres of pure alcohol per annum. Unless emergency action is taken, the economic and social impacts of premature deaths and illness will continue.
The health care system cannot cope with the epidemic of NCDs. All Government ministries have acknowledged NCDs as a major concern, but regard their prevention and control overwhelmingly as a Ministry of Health agenda. They have expressed willingness to participate in cross-government dialogue to better understand their roles and responsibilities in tackling NCDs, but current mechanisms for dialogue between the Ministry of Health and other line ministries are unstructured and ad hoc.
The mission welcomed the projected finalization by the Ministry of Health of a draft multisectoral NCD programme by the end of July 2014, and suggested that a national NCD coordination mechanism also be established at a technical level.
A WHO STEPwise approach to surveillance survey is expected to be carried out by June 2015. The mission advised the Government to strengthen implementation of the Framework Convention on Tobacco Control and recommended that the United Nations Country Team (UNCT) work with the Government to finalize the United Nations Development Assistance Framework (UNDAF) with NCDs as a core element.
UNDP, World Bank and WHO are committed to ensure that the newly established European Inter-Agency Task Team on NCDs visits Belarus to support the UNCT and the Government in implementing the mission’s recommendations.
A report of the mission’s findings and recommendations is being prepared and subsequent activities will be determined on the basis of this report in close consultation with the Government.