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Holding governments to account essential for progress in NCDs say experts

Sir Alleyne “Goals of WHO’s 25 x 25 entirely possible if we hold governments to account”

Sharjah, 15 November 2015

The final plenary session of the joint FoCP NCD Alliance Global Forum on Non-Communicable Diseases (NCD) took place today with Sir George Alleyne, Director Emeritus, PAHO, USA, giving a keynote address about the role of civil society in holding governments to account, in a session that was chaired by Professor Rachel Nugent, Clinical Associate Professor, called “Achieving “25 by 25”: Accountability as a Force for Change”.

Alleyne said the goals of 25 x 25, which seeks to achieve a 25% reduction in preventable deaths by 2025 was technically feasible according to the data but it can only be done if proper attention is paid to the accountability process. The goals were set by the World Health Authority’s (WHO) Global Action Plan.

Alleyne said, “These are the imperatives of accountability that civil society follows to ensure the commitments made by governments are actionable and produce results. Very importantly there must be independent variation of results. We must insist on it, very seldom is there independent verification of results of government policy and if civil society is going to monitor this, then they need to insist on independent verification. There must also be presentation and correction of results and importantly, transparency. This should not be done behind closed doors. These are the imperatives of accountability. If governments say they are going to do this, or do that, then they should be held accountable to that.”
Alleyne also said there are regulatory bodies in almost every one of our countries and civil society can report back to them on what was, and was not, done, and that litigation is also an option.

Douglas Webb, Senior Advisor, United Nations Development Programme said that when looking at accountability of government departments such as the department of health, accountability can depend on them knowing what they are supposed to be doing and ensuring they have the capacity to do it as this is not always the case, the resources, he said, are not there.

Webb added, “In holding governments to account, we need to think about what good governance is. We all have a right to health and one of the things we do as an organisation is to negotiate with other parts of society whose priorities are not public health. What governments need to do is put a firewall between public health and those whose priorities are not public health – that is what good governance is.”

Mrs. Maisha Hutton, Executive Director, Healthy Caribbean Coalition (HCC), Barbados said the focus of their organisation was on strengthening alliances and capacity building in order to have a targeted approach to ensuring accountability. “We have already had some successes,” she said, “and we have quite a methodological approach in this. We build capacity around information generation, ensuring we capture relevant information. And secondly once we have the information we hold workshops specifically tailored around identifying needs and priorities as a result of the data. We have produced reports that are under consideration by the government on alcohol policy, tobacco regulation and now we are working on childhood obesity recommendations, so we are very pleased with those successes.”

Dr Mary Assunta, Senior Policy Development Advisor, Southeast Asia Tobacco Control Alliance (SEATCA), Australia, said the organisation worked across eight countries and organised regional workshops to ensure they get firsthand information on where governments are. “We issue guidelines with recommendations for parties in our region who have difficulty in implementation and we also provide a status report on what the government is implementing with comparative score rankings,” she said. “The government doesn’t like this as they don’t want to be compared with others who may be doing better but it is important to show where progress has been made and what needs to be strengthened. We lobby for illustrative warnings about tobacco on packaging, insisting on prominent pictorial warnings. We also monitor the food and beverage industry to see what it is saying to governments.”

Session three was followed by the workshop stream  “Equipping the NCD Movement to Ensure Accountability in NCD Prevention and Control” with four concurrent workshops and had Mr Marc Wortmann, Alzheimer’s Disease International, UK and Sir Trevor Hassell, Healthy Caribbean Coalition, Barbados, as co-chairs. The first workshop was titled “Official Monitoring on NCDs and Civil Society Engagement” and was led by the WHO and NCD Alliance. The second concurrent workshop was “The Civil Society Monitoring of the Private Sector for NCD Prevention” led by Healthy Latin America Coalition; Southeast Asia Tobacco Control Alliance and World Cancer Research Fund International. A third workshop was “The Power of the People: Communication Strategies to Mobilise Public Opinion on NCDs” while the fourth was “Engaging Patients in NCD Policy, Practice and Monitoring”.

On Saturday afternoon the forum’s second plenary session was titled “The NCD Civil Society Movement: Strengthening Unity, Building Momentum” and was moderated by Dr Karen Sealey, International Health Consultant, Trinidad and Tobago and began with a presentation of a situational analysis of National and Regional NCD Alliances by Ms Katie Dain, Executive Director, NCD Alliance, UK.

Sealey explained the analysis comprised an online survey, in depth interviews and reports from regional alliances in order to get a better idea of the “why and the how” of regional and national alliances; what their priorities and activities were, challenges and capacities were and what were the relationships between global and regional alliances. She said, “We also wanted to understand most importantly how we could learn from each other. What we learnt was there was a domino effect, once one alliance was formed you started to see a lot more developing. With a shared goal and shared vision we can achieve a lot more together. We’ve seen some early wins from alliances, but in terms of challenges or capacity needs, financial resources was cited as an in issue and in terms of capacity, lack of technical expertise and good practice in strategy and planning was needed.”

Sealey added that a range of recommendations were produced for both the national and global level as a result of the analysis, among them was the need to prioritise support for the alliances in low and middle income countries. She finished her presentation with a proverb: “If you want to go fast go alone; if want to go far, go together.”

HRH Princess Dina Mired, Director General, King Hussein Cancer Foundation, Honorary Chairperson of the Jordan Breast Cancer Program, Jordan said, “As we have heard, our work is not done, there is much to do. In Jordan we work on prevention and awareness building and we would like to work more on alliances with other federations but we don’t have as many counterparts as other countries, but the Jordan Breast Cancer Program actively works on collaborations.”
Princess Mired added that very often patients are passive receivers of care and don’t know what their rights are. She said what she has learnt as a mother and wife of a cancer survivor that it was very important to hear from patients themselves when setting priorities.
Ms Jennifer Bushee, Knowledge Management Manager and Deputy Director, Global Network of People Living with HIV (GNP+), The Netherlands said there were three important elements in galvanizing support. “She said in the HIV sector, the first is visibility. There are those who have come forward and disclosed their HIV status which helps create a sense of tolerance and normalization. Secondly a sense of urgency must be added and people have campaigned with coffins outside government buildings to get this message across. Thirdly there has been an active grass roots movement with people who couldn’t get their needs met but who joined together and became global.”

Ms Veronica Schoj, Executive Director, InterAmerican Heart Foundation & Advocacy Committee member, Healthy Latin America Coalition, Argentina said that they had developed their alliance initially through the tobacco control movement and the nutrition movement and that they had had some successes in mitigating industry interference. “We work on this from a human rights perspective in terms of protection of public health and from conflicts of interest,” she said.

Professor Gerald Yonga, Chair, Kenya NCD Alliance and Co-Chair East Africa NCD Alliance Initiative, Kenya also had good experience of partnering with other alliances and spoke about twinning initiatives with Dutch and other African countries.

The second workshop stream followed under the heading “Effective NCD Alliances for Advocacy Impact”, chaired by Ms Suzanne Volqvartz, Danish NCD Alliance, Denmark and Mr Olivier Raynaud, Management Sciences for Heath, USA, with the first workshop being called “How to Work Effectively as an Alliance” led by NCD Alliance, South Africa; NCD Alliance, UK Richmond Group of Charities and the European Chronic Disease Alliance. The second workshop was called “Resource Mobilisation: Collaboration for Impact” and was led by Medtronic Philanthropy, ACT+, Rabin Martin.

The third workshop was led by American Cancer Society and Mexico Salud-Hable (NCD Alliance Mexico) and was called “Campaign Planning: Step by Step Guide to Successful Campaigns”, While the final workshop on Saturday was called “Twining: North-South and South-South Cooperation for NCDs” led by regional NCD Alliances, and American College of Cardiology.

The NCD Alliance Forum is being held under the patronage of Her Highness Sheikha Jawaher bint Mohammed Al Qasimi, Wife of His Highness the Ruler of Sharjah, Founder and Royal Patron of the Friends of Cancer Patients (FoCP) and International Ambassador for the World Cancer Declaration of the Union for International Cancer Control (UICC) and International Ambassador for Childhood Cancer for UICC on 14 - 15 November 2015, at Al Jawaher Reception and Convention Centre.

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