This year may have well been one of the most important years for those of us committed to fighting cancer globally. The UN High-level Meeting on Non-communicable Diseases (NCDs), which took place in New York on 19-20 September, represented the climax of two years of intense advocacy and diplomacy to establish cancer and the other NCDs as a global political imperative. Before then, cancer and other NCDs were side issues during a decade fixated with HIV/AIDS (the only other disease to ever be the subject of a UN High-level meeting that took place in 2001), TB and malaria, which in combination take centre stage in the Millennium Development Goals. But now wisdom is beginning to prevail as the UN recognises the devastating effects cancer and other NCDs have in every country–not just developed countries where one in two people are likely to develop cancer during their lifetime, but also in low- and middle-income countries where NCDs are rapidly becoming an epidemic debilitating a whole generation.
We can draw comfort from the headlines contained in the UN Political Declaration on NCDs (document A/66/L.1) signed by 193 Member States; NCDs are "a challenge of epidemic proportions and its socio-economic and developmental impacts" and are devastating countries around the world. The challenge we face has to be coordinated through a "whole-of-government" and a "whole-of-society" approach, because none of us has the capacity or resources to control this epidemic alone. Fundamentally, we have to change the way seven billion people live their lives because in a large part our health is determined by exposure to risk factors and inadequate access to health-promoting environments, collectively constructed by our society. Tobacco will kill one billion people in this century alone if we stand on the sidelines. It is proposed in the UN Political Declaration on NCDs that the solution is to "strengthen national policies and health systems," encourage "international cooperation, including collaborative partnership," invest in greater "research and development" and build "monitoring and evaluation" systems to ensure that we "follow-up" in due course.
All this to achieve what? The unanswered question. The gaping hole in the Political Declaration is an overall target (or set of targets), which shows genuine commitment to address our generation's epidemic. Or, are we asking too much from a generation which is becoming too cosy with just 'noting' the problems that we will leave behind for future generations--the climate change issue; the growing disparity between rich and poor; worrying population growth; rapidly decreasing oil reserves? Where are the political leaders required to make our generation the resolvers rather than the observers of global problems? Who is stepping forward and placing a target in front of us that will inspire millions of people to take action and in so doing, protect our children and grandchildren?
In 2020, if we continue as we are, 44 million people will die unnecessarily. I may be one of them. Hopefully not, as I do my best to avoid NCD risk factors, I live in a country with an excellent health infrastructure and I can afford good health care. Nevertheless, for every one of me there are millions of people not in the same privileged position. Tobacco companies will encourage them to smoke; they will not have access to nutritious food or opportunities for regular exercise and consequently will become overweight or even obese. Controllable infections will expose women to cervical cancer. Cancer will be diagnosed too late, and in most countries, treatment and care will be woefully inadequate. The result? Countless families devastated by the loss of a father, a mother, a child or other family members and potentially immediate poverty and financial ruin.
So, our call to all Member States is to build on the UN Political Declaration on NCDs and to be even more ambitious. Let us be bold and tell our children today that we will not let cancer and other NCDs ravage their generation as it has our own. Let us aim high and set ourselves the extraordinary target of reducing the number of avoidable premature deaths from NCDs by 25% by 2025.
The Union for International Cancer Control (UICC) and its NCD Alliance partners, the International Diabetes Federation, the World Heart Federation and International Union Against Tuberculosis and Lung Disease (The Union) are not waiting for targets to be set by the political process. Every day we work together with our members to reach people affected by NCDs, helping them and their families survive and live with these debilitating diseases. This we will not stop, but to be more effective in our work, we require the engagement of governments and the private sector, governments to allocate priority and resources to intersectoral NCD interventions and the private sector to support joint action at country level and continue to invest in innovative ways to prevent and treat these diseases. The potential for collaboration is great and we welcome the UN High-level Meeting's commitment to make partnership work at every level.
NCDs affect us all. They do not label someone as a government official, an employee of a company or an NGO volunteer and treat him or her differently. We face a common enemy.