WHO Regional Director’s closing remarks, stakeholders dialogue on NCDs, 20 March 2013

  • Representative of the Director General of Department of Health, Republic of South Africa
  • Distinguished Delegates, Participants
  • Dear Colleagues,
  • Ladies and Gentlemen

This has been a very fruitful three-day meeting. It served as a useful platform to exchange information, experiences and ideas in tackling the risk factors associated with NCDs in the African environment. 

I am happy that we could conduct this forum as well as hold the debates in a structured manner as planned. I recognize the quality and high participation of the experts and the different stakeholders attending this dialogue over the past three days. 

We followed very carefully the contributions during the plenaries and working groups. There is no doubt that this forum provided insights that triggered new ideas about how best to move forward in this regional undertaking – to enable us to put Health Promotion higher in the agendas of the government, Ministries of Health and health stakeholders in general. 

Allow me to share with you some of the main highlights as we perceived during the Dialogue. 

In relation to the harmful use of alcohol:

The delegates widely recognized that the majority of people in the region are not well-informed about the facts regarding the harmful effects of alcohol. And the reality is that alcohol has historically been part of cultures, attitudes and practices. 
Much of the discussion focused on the impact of alcohol marketing and promotion, particularly on youth. The industry has used aggressive advertising and promotion practices, which has increased access and consumption among individuals, families, and communities. 

Furthermore, delegates to this multi-stakeholder dialogue have mentioned that alcohol marketing is fast-globalizing, and targeting the trade opportunities in the region.

Delegates have also recognized challenges of regulating traditional brewers in local communities, as well as the sale of alcohol to minors.

It was strongly recommended that we take a more inclusive approach to involve communities and relevant stakeholders in policy development, and in relation to legislation, enforcement, and enactment. 

The participants also called for greater involvement of development agencies, in addressing risk factors. 

The second area we discussed was tobacco use. 

We heard good news from many delegations regarding their initiatives to ban smoking in public places.  Since the negotiations of the FCTC, we congratulate you on the progress that has been made. 

However, the stakeholders here have highlighted continued challenges in tobacco control.

The delegates observed that the tobacco industry is quite powerful and has had a negative influence on policy-making at the country level, which hinders the implementation of the WHO FCTC in countries. 

We also face challenges in terms of sustaining a multi-sectoral approach.  Coordination in the implementation of the FCTC is weak in some countries.  In addition, budgets for tobacco control remain insufficient for the implementation and enforcement of legislation and regulations. 

Delegates have emphasized the urgency for countries to have clear action plans for the implementation of FCTC, and monitor its implementation. 

Much was discussed in the area of taxation.  A need was felt for stronger capacity in economics across countries, so that countries can advance price and tax measures. 

The third area we focused on during this meeting was unhealthy diet and physical inactivity.

Delegates recognized that the region is faced with a double burden --- while we face food shortages in some regions, we also face the increasing consumption of refined foods rich in fat, salt and sugar.

The problem of overweight is becoming more and more serious because of urbanization and increased processing of our food. In some cases, it is cheaper and faster to eat refined and packaged foods as opposed to home-cooked meals.

This is an unfortunate trend that needs to be tackled now. This risk factor is already having harmful effects on cardiovascular diseases, and other major NCDs. However, as governments and communities are now becoming more aware of this problem, relevant legislation and regulation should be put into place to counter this trend and protect public health.

Again, we turn to the need for more evidence to inform our policies and strategies, and also to inform the public.  Educating the public on nutrition and health remains a critical element – to ensure that people are fully informed about their dietary choices.

In terms of physical inactivity –

Stakeholders at this meeting recognized the growing trends in physical inactivity – mainly due to the rise in motorized transportation and the lack of recreational space in urban and peri-urban settings. Here delegates have emphasized working in close collaboration with a wide range of stakeholders:  the private sector, NGOs, local governments, education and sports sectors among others. By working together we can improve the community environment and increase the opportunities for people to stay physically active. 
It was underscored the importance of the school as an entry point for encouraging children and youth to increase their physical activity, and strengthening physical education a part of the school curriculum.  

In all of these areas, the delegates have discussed common challenges and opportunities.

Throughout the dialogue, common themes emerged regarding the challenges and opportunities associated with addressing these risk factors in the African Region.  
These include:

  1. The need for policy, legislative and regulatory frameworks at national level to reinforce the multi-stakeholder efforts to promote and protect health;
  2. Strengthening data gathering, analysis and dissemination as well as operational research in order to inform decision making;
  3. Participation of the communities throughout the whole process, including planning, implementation, evaluation and documentation
    and
  4. Establishing sustainable resources for financing relevant interventions - including innovative financing of NCD prevention and control.


Ladies and gentlemen,

It has been a productive three days. 

I want to thank you for your attendance and active participation. You made a significant contribution to this landmark event. This is the first time we made an effort to address this matter. 

I want to especially thank the panelists, for bringing decisive ideas and expertise that was informative and innovative.  They brought country experiences from Thailand, Mauritania, Botswana, Ghana, and South Africa – that revealed current evidence, policies, models for community participation, and progress in building capacity for Health Promotion and related outcomes. 

And I personally leave the forum with more insights on the way forward. 

In relation to risk factors and chronic diseases, policy-makers have concrete options to take forward. 

Let me therefore reiterate WHO’s commitment to bringing diverse constituencies together to build consensus around complex, multifaceted and in some cases, divisive issues regarding risk factors for non-communicable diseases.  

As far as WHO is concerned, we already restructured the regional office for Africa, creating a major cluster dedicated to health promotion; we revisited the African Health promotion regional strategy that was recently adopted by 62nd Regional Committee, that took place in Luanda, Angola in 2012. As you know, the ongoing WHO reform is debating the 12th General Program of Work 2014-2019, and health promotion is one of the six priority categories that will provide the orientations for global health action over the coming six years. 

So, we are moving in the right direction. But we have to accelerate the pace towards concrete actions, so that we provide relevant information to people, reliable evidence to institutions, and interdisciplinary and multi-sectoral platforms that bring together all of the resources required for implementation of Health Promotion policies.  

Also, I believe that the forthcoming Global Program of Work of WHO and the post-2015 development agenda will provide a global reference framework that Africa should fully engage with.  

Only with healthier populations can we succeed in socioeconomic development. 

We will elaborate the final proceedings of this dialogue that will reflect in detail the outcomes of the discussions on thematic areas: harmful use of alcohol, tobacco use, and unhealthy diet and physical inactivity. This should provide insights to build or strengthen national platforms for action that articulate the evidence, the policy and the people’s participation. 

Finally, I want to reiterate my profound gratitude to the Honorable Minister of Health of the Republic of South Africa, and his team for the substantive contributions to make this meeting a success. I also express my thanks to the management of the Birchwood Hotel and the staff, for the accommodation and working conditions. A word of thanks also to the translators and all of the support staff, and also a special recognition to my colleagues from the WHO HQ, regional office, and country office in South Africa for all of the efforts in the preparation and performance of the meeting and dialogue. 

I wish you a safe and happy return to your respective countries. 

Thank you!