What gets measured can get managed ... and measurement is the minimum demonstration of commitment

Dr Tom Frieden Director Centers for Disease Control and Prevention USA Criteria for targets • Measurable (baseline and status over time) •Ambitious interim and final targets •Achievable •Important Process for global NCD targets •WHO established technical Taskforce on NCD targets with international experts and WHO staff •Intensive work resulted in preliminary proposal which was shared with Member States in web‐based consultation •WHO will expand Taskforce and present new proposal for global NCD targets to WHO governing bodies •Key is monitoring and accountability –even more than with communicable diseases, control of NCDs depends primarily on good governance and political rather than financial capital WHO preliminary proposal for discussion

Premature mortality 25% relative reduction in mortality from cardiovascular from NCDs disease, cancer, chronic respiratory disease, and Diabetes 10% relative reduction in prevalence of diabetes Tobacco 40% relative reduction in prevalence of current daily tobacco smoking Alcohol 10% relative reduction in per capita consumption of alcohol; 10% relative reduction in prevalence of heavy episodic drinking Dietary salt intake Reduction of mean population intake of salt to <5 grams/day Obesity Halt the rise in prevalence Blood pressure 25% relative reduction in raised blood pressure WHO preliminary proposal for discussion (continued) Prevention of heart attack 80% coverage of multidrug therapy for people aged and stroke in primary care 30+ years with a 10‐year risk of heart attack or stroke ≥ 30% or existing Cancer prevention in primary • 70% of women age 30‐49 screened for cervical care cancer at least once • 25% increase in proportion of breast cancer diagnosed early •<1 % prevalence of HBsAg carriers among children aged ≤5 years Policy approaches to dietary • Elimination of partially hydrogenated vegetable risk reduction oil from the food supply •No marketing of foods high in saturated , trans‐fatty acids, free sugars, or salt to children Surveillance systems are key • Invest and support development of accurate, timely systems • Essential NCD surveillance includes •Vital statistics (with reliable cause of death) •Risk factors (e.g., GATS for tobacco; examination surveys) •Environmental exposures (e.g., nutrition, air quality) • Policy and implementation status • Investment in capacity building (e.g., practical epidemiology) and public health institutions Tobacco use can be controlled: Uruguay •Had one of highest smoking rates Adult smoking smoking in world prevalence •MPOWER policies led to one of fastest reductions ever measured 1 in 4 smokers • P: 100% smoke‐free quit • O: Support for cessation • W: Pack warnings (80% front/ back) • E: Ad ban including deceptive terms • R: Tobacco taxes (66% retail price)

Data: 2006: WHO STEPS survey; 2009: Global Adult Tobacco Survey Thank you