No Partner is an Island – The Case of NCDs
06/15/2011
Addressing the challenges and discussing potential solutions to the problem of NCDs
A redefinition of "you", "I" and "we" also makes it necessary to understand both the challenges and trends of global health. States - nations - who were the masters of international society since the 17th century, now share the global arena with a number of actors of different natures, be them private companies, non-governmental organizations, charitable funds, religious institutions and - more importantly - ordinary individuals. Even among States, the North-South divide should be reconsidered.
The magnitude of the global health perspectives gets clearer when it comes to non-communicable diseases. As stated by speakers in the plenary session, more vocally by Liberia's Health Minister Walter Gwenigale, NCDs are not only an issue of developed countries. Rather, developing nations have required greater resources and capacity to tackle this mounting task in their jurisdictions. Likewise, during the debates of the last World Health Assembly, mid-May in Geneva, delegates of several developing nations, including small-island states and the least wealthy in Africa, have in choir claimed that NCDs pose them double burden, since they have still the task of eradicating contagious diseases that are still rampant in some of the poorest nations. On the other hand, generous funding does not fight alone the negative effects of NCDs in societies, as the related diseases are the main causes of death in wealthy nations. It is likely in the near future that developed nations, instead of only teaching, learn with developing counterparts innovative solutions and practices bred in the latter ones. Therefore, rich and poor nations need to dialogue on equal footing and exchange good practices in order to find solutions together. Is it still about charity?
States alone do not have the necessary tools and skills to tackle NCDs. Lack of resources, expertise, outreach and other means necessarily invite private sector, foundations, intergovernmental organizations, individuals and the victims themselves for the accomplishment of this common task. Taking the private sector, put by Herb Riband, speaking for the private sector during the noon session on NCDs, there is a clear and legitimate interest of enterprises to seek healthy labor force and consumers for the sake of adding value and ensuring the sustainability of business itself. Although the pace of this trend might be contested, it is growth is exponential and might somewhere in the near future determine the survival of companies in the marketplace. At home, States are not the givers to their nationals, but rely on a range of community actions at all levels for outreaching, reflection and guidance in the implementation of their NCDs policies. It is not about blaming the victims anymore, calling NCDs "diseases of lifestyles" but about finding solutions and implementing together, as Dr. Bongani Mayosi said. Again, not charity, but a convergence of interests. That is why Dr. Srinath called for a better cooperation at all levels, using the term PPPP to mean it now "Public, Private and People Partnership." It is a task of making passion and pragmatism working together.
One would conclude that all these challenges and trends require better coordination. However, the very nature of coordination here transcends a mere Cartesian formula or matrix. Knowing each player's role and timing would suffice for an environment of great predictability, which is excluded in this case. To the contrary, coordination on NCDs requires further mutual respect, a generous amount of listening to different partners, confidence building among them, tolerance, ownership and, more importantly, innovation. Creative solutions that do not come only from cutting edge research, but from grassroots communities. Good practices not only from the wealth, but budget-wise policies from the least developed ones.
In fact, no partner is an island.
Paulo Arantes is from the Global Health Programme at the Graduate Institute Geneva.
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