WHO, UN and Global Stroke Policies Up-date

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On behalf of the WSO Global Policy Subcommittee, I am happy to report major progress in the field of non-communicable diseases (NCDs) including stroke since the previous newsletter in April this year.

Along with several other representatives of NGOs in the NCD field, WSO was well represented at the 67th WHO General Assembly May 19-25 in Geneva. Several important decisions were made including a resolution on action plan indicators for NCDs, recommendations on terms of reference for a UN Task Force and a Global Coordinating Mechanism on NCDs, resolution of a Global Disability Action Plan 2014-2020, request to Member States to ensure that health is central to the post-2015 development agenda, and a 1st time resolution on palliative care. Furthermore, the NCD Alliance and The Lancet hosted an exciting side event to introduce a new accountability initiative for NCDs emphasizing the importance of partnerships across sectors (including UN, academia and civil society) to accomplish the 2025 global NCD targets.

The ground-breaking adoption by the United Nations (UN) declaration on non-communicable diseases in September, 2011 is well known to the members of the WSO. With this event, NCDs including stroke definitively entered the global political arena, being the 2nd time in the history of the UN that the General Assembly addressed a medical topic. As a follow up to the 2011 UN declaration, a high-level meeting took place at the United Nations on 10 and 11 July 2014 to review the progress achieved in the prevention and control of NCD’s since the political declaration of September, 2011. The meeting was preceeded by NGO hearings at the UN on June 19th. Both meetings were remarkable in spirit and highly successful, and it was a privilege for me to attend and represent the WSO at these events. The progress since 2011 in the development of common concepts and a common language among Member States, governmental organizations, and NGOs to combat NCDs was evident during sessions, during the many side events, and at personal contacts during the meeting. The civil society voice was stronger and much more unified now than in 2011, and it was even stated that one of the major progresses so far from 2011 was the collaboration and commonality of messages from the NGOs. Civil society has been, and will continue to be, a major driver for progress to occur.  NCDs are a global epidemic that cannot be tackled by an individual health-care provider, hospital, health system, country or region in isolation. Multisectorial collaboration is required, and is urgent – inactivity is not an alternative.

The outcome document of the UN review in July this year calls for scaling up the efforts towards a world free of the avoidable burden of NCD’s. Emphasis is placed on countries to integrate NCDs into health planning and national development plans, to set national NCD targets and develop national NCD multisectoral plans by 2015 and to implement policies and interventions to reduce NCD risk factors by 2016. Actions include reduction of exposure to major risk factors for stroke, anticoagulants for stroke prevention in patients with atrial fibrillation, essential diagnostic facilities, and stroke unit care. The outcome document also emphasizes the importance of monitoring the trends and determinants of NCDs including collection of data on gender differences and social determinants. United Nations will convene a third high-level meeting on NCDs in 2018 to review progress made in individual countries.

WHO has a major leading role in this work, whereas the primary responsibility to implement adequate actions lies on the different countries. However, an important role is also given to civil society (including stroke societies) and academia. The World Stroke Organization, being a NGO in official relations with WHO, has a close collaboration with WHO to promote stroke as part of the actions on NCDs. WSO has an excellent collaboration with the NCD Alliance and a large number of individual NGOs broadly related to stroke and stroke risk factors. Within the stroke field WSO is the nave in the collaboration between regional stroke societies (the American Heart/American Stroke Association (AHA/ASA), the European Stroke Organization (ESO), the Asian-Pacific Stroke Society (APSO), and other stroke societies. Our task includes a strong committment to actively support and promote the action plans recently adopted by the governmental organizations and to make them widely known among our members. Political will, global leadership, and a mobilized and united civil society in the fight agains stroke and other NCDs is essential for success.

Global stroke issues and reviews of the recent development and future plans will be well featured at the upcoming World Stroke Congress in Istanbul in October. It is my hope that very many of you will attend, actively take part, be inspired, and learn how you can serve the global stroke actions from your own position and perspective.

Bo Norrving?Chair, WSO Global Policy Subcommittee