Submission to the WHO consultation on the global action plan for the prevention and control of NCDs 2013-2030

The George Institute appreciated the opportunity to provide feedback on the updated Appendix 3 of WHO’s Global action plan for the prevention and control of noncommunicable diseases (NCDs) 2013–2030 and commends WHO for its efforts to revise it in light of advancing scientific knowledge.

The George Institute for Global Health contributed two submissions to the call:

• The first was developed with researchers across The George Institute in response to the first web-based consultation;
• The second was a joint submission with the NCD Alliance, and members of its network.

We strongly support the overall approach and the intention to assist countries selecting a combination of these interventions to define locally tailored packages of interventions to accelerate ongoing national NCD responses. The George Institute, however, believes there are several ways Appendix 3 could be improved to achieve NCD Targets by 2025, as well as facilitate the realisation of Sustainable Development Goals (SDG) Target 3.4.

To ensure its objectives and ambitions are realised, we have made several comments and reflections as summarised below:

• Appendix 3 should highlight the importance of equity considerations, and the need to consider the impacts of interventions on communities experiencing marginalisation because of historic power imbalances.
• A sex and gender lens should be applied to the updated Appendix 3, reflecting the latest scientific evidence on the differential impact of NCD risk factors for women and men.
• Appendix 3 would be strengthened with further guidance on how to combine packages of interventions where there are synergies in cost and outcomes.
• It is important to name Appendix 3 and retain the concept of NCD ‘best buys’.
• More information on the methodology of this update, the use of healthy-life year (HLY) unit, how cost-effectiveness was measured for interventions that include several components, and clarification on methodological limitations.
• Appendix 3 should be more consistent across sections, especially in detailing the overarching/enabling actions and outlining non-financial considerations across risk factor sections.
• Appendix 3 should be as clear and precise as possible with the description of interventions.
• The consultation and updating processes need to be strengthened.
• Appendix 3 needs to reflect the evolving NCD agenda.