I have been attending the World Health Assembly (WHA)—the decision-making body of the World Health Organization (WHO)—religiously for the past five years, and this year was different. Different because WHO reiterated that going forward, all their work will be evaluated in light of their new “triple billion” targets.
By 2023 the targets aim to achieve:
- 1 billion more people benefiting from universal health coverage;
- 1 billion more people that are protected from health emergencies; and
- 1 billion more people enjoying better health and well-being.
There was a new sense of urgency by participants that more needs to be done to improve health through a multi-sectoral approach. This was the first time that WHO made a global call for action towards the elimination of cervical cancer and by so doing brought together the community of non-communicable diseases (NCDs), communicable diseases and family, women, children and adolescent health communities to deliberate on the implementation strategy. For example, people with HIV are five times more likely to get cervical cancer, and cervical cancer affects girls in particular.
Furthermore, the WHA passed resolutions on new initiatives for the elimination of malaria, polio and tuberculosis. The resolutions require an integrated healthcare approach, health systems strengthening and improved health financing models to implement and sustain these initiatives.
And, the effort to address NCDs and mental health gained momentum, starting with WHO’s impactful report, Time to Deliver, and its creation of a new Family, Maternal, Children and Adolescent division, with a focus on adolescent health.
Lynchpin to Success: Strong, Integrated Approaches
These efforts were reinforced at a recent UN hearing I attended July 5, as part of the preparatory process for the upcoming high-level meeting of the UN General Assembly on NCDs and Mental Health. The focus of the hearing was on sharing best practices and discussing the way forward through a multi-sectoral approach, and offering recommendations to heads of states and governments for supporting the UN resolution on NCDs and Mental Health.
The hearing’s closing statement reiterated that the Sustainable Development Goal (SDG) target 3.4 on NCDs aims to “by 2030 reduce by one third premature mortality from NCDs through prevention and treatment and promote mental health and well-being.”
By focusing on adolescents, WHO and the UN have acknowledged that more children and adolescents are susceptible to the risk factors of NCDs and mental health. Tackling these risk factors in children and adolescents is critical in reducing related disabilities that occur in adults.
The emotional well-being of young children is directly tied to the functioning of their caregivers and the families in which they live. “As early experiences shape the architecture of the developing brain, they also lay the foundations of sound mental health. By improving children’s environments of relationships and experiences early in life, society can address many costly problems, including incarceration, homelessness, and the failure to complete high school”.
Further, we know that suicide and depression are major issues for both younger and older adolescents. Suicide is the second leading cause of death among 15-29 year olds globally  and depression--the leading cause of disability worldwide--affects 350 million people.
WHO’s Time to Deliver report on NCDs and Mental Health states, “The challenge is not only to gain political support, but also to guarantee implementation, whether through legislation, norms and standards setting, or investment.”
Multi-sectoral action is evident throughout this report as an enabling factor for health. Investments are required to understand how to apply multi-sectoral approaches effectively in different settings. It is time for a focus on action plans and interventions to address mental health at its roots in childhood; to prevent disabilities and address chronic diseases that are crippling society and reducing people’s quality of life.
How Do We Move Forward?
To enable a multi-sectoral approach to NCDs and mental health, there needs to be different fora that bring stakeholders from other sectors together to discuss health as one of the key drivers of any given economy. After all, every employer wants healthy employees!
Health insurance providers need to be engaged and understand the importance of the provision for NCDs and mental health. We need to also determine ways to achieve domestic resource mobilisation for health system strengthening which includes NCDs and mental health.
As part of the UN high-level meeting on NCDs and Mental Health in September, I suggest that Heads of States and governments task Ministries of Finance to lead the initiative of determining how NCDs and mental health can be funded. The Ministries of Finance should set targets and develop impact measurement in conjunction with the health sector. This is critical as NCDs and mental health have a huge impact on the workforce and economic development of any given country.
And, to promote greater awareness of the need for more, and earlier, mental health interventions, the UN should appoint more celebrity champions and ambassadors for adolescent health, NCDs and mental health.
I cannot overemphasize that a whole-of-government approach to this challenge in every country is an urgent need. I believe we finally have the right policies and framework in place, and now is the “Time to Deliver” results.
1. Time to Deliver: Report of the WHO Independent High-level Commission on Noncommunicable Diseases, 2018
2. “Establishing a Level Foundation for Life: Mental Health Begins in Early Childhood” and the Working Paper series from the Center on the Developing Child at Harvard University. 2015
4. WHO Independent High-Level Commission on NCDs : “Think piece: Why is 2018 a strategically important year for NCD’s?”