The country package identifies 15 interventions related to prevention and control of NCDs. While not all interventions will be implemented in all target countries, an effort will be made to focus on concrete policy change and other deliverables that can be completed by the end of 2016. By the end of 2016, a stepwise approach is expected to be adopted and all countries involved will have completed a national assessment, adopted a national plan, invested a national budget, adopted national targets, and made objectively verifiable improvements in compliance with global and regional mandates on tobacco, alcohol, nutrition, physical activity, and the management of NCDs.
A country that has fully complied with the entire package would meet the following criteria.
- A national intersectoral plan for the prevention and control of NCDs consistent with Health 2020 has been adopted at the highest level of government.
- Where appropriate the national United Nations Development Assistance Framework has been completed and specific NCD results are included in the results matrix.
- The national budget includes specific line items that demonstrate a national commitment to investment in a sustainable NCD prevention and control programme; such a budget uses domestic funds and human resources and is not merely a reliance on aid.
- National targets have been adopted that are directly based on the Global Monitoring Framework for NCDs.
- A national health system assessment has been conducted, its results published, and clear recommendations adopted.
- At least one national survey on risk factors (ideally based on WHO STEPwise approach to surveillance (STEPS)) has been conducted and the results published.
- A population-based cancer registry is operating to standards approved by the International Agency for Research on Cancer.
- Other more specialized risk factor surveys are considered including global youth and adult tobacco surveys (GYTS and GATS), the WHO European Childhood Obesity Surveillance Initiative (COSI) and the Health Behaviour of School-aged Children (HBSC) study.
- A clear assessment of the inequalities in the risk and burden of NCDs has been conducted and all interventions are designed to minimize inequalities and promote the health of vulnerable groups.
- A high level of compliance with the WHO Framework Convention on Tobacco Control is demonstrated including both measures to reduce demand and to control the supply of tobacco.
- Specific improvements in the compliance with the global and regional mandates on alcohol are made, in particular controlling the marketing, accessibility and affordability of alcohol, as well as addressing alcohol-related harms and injuries.
- Specific improvements are demonstrated in compliance with global and regional action plans on nutrition and physical activity particularly on the control of salt in at least one major food product, the control of marketing, and demonstrable reductions in the supply or consumption of fats (including elimination of trans fatty acids and overall reduction in saturated fats) and sugar. Environmental policies including urban design, public transport and pricing strategies are adopted to improve physical activity.
- An essential package of interventions in primary care for the prevention and control of NCDs has been adopted and incorporated in the national health system, and is universally accessible. This package includes cardio-metabolic risk assessment and management. Cancer screening is only included in the package after the country has developed the capacity to provide high-quality treatment services at scale for cancers that are already recognized.
- A system for monitoring and evaluation of the above has been established and the country publishes a transparent report on strengths and weaknesses, advances and setbacks at least every two years.
- A comprehensive approach to NCDs is applied across the life-course (from conception to old age) and in appropriate linkages with mental health and injury prevention.