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– Declaration unanimously adoptedAfter ten long years of tireless and relentless advocacy in the global health arena on the part of Health Minister Dr Leslie Ramsammy for greater, national, regional and global action for the prevention and control of Non Communicable Diseases (NCDs), the global community has finally conceded that these diseases constitute an important threat in the global effort to end poverty and improving the lives of people.Against this background a historic High Level Meeting on NCDs at the United Nations was convened on September 19 and 20th 2011 in New York.It was only the second time in the entire life of the UN that a General Assembly High Level Meeting on Health was held – the first was in June 2001 at a UNGASS on HIV.Coming out of the high level caucus last weekend,Jordi Masip Jersey, a comprehensive declaration addressing NCDs was brokered with the aim of fostering better health for people in developing and developed countries, and a consequent instrument aimed at eliminating poverty should be implemented shortly.From left) President of the 61st World Health Assembly Dr Leslie Ramsammy, HRH Princess Muna Al Hussein of Jordan and Archbishop Desmond Tutu of Cape Town stand in the Assembly Hall with WHO Director-General Dr Margaret Chan and Deputy Director-General Dr Anarfi Asamoa-Baah.An action plan is being prepared and the General Assembly will meet again in 2014 to review progress in the efforts to prevent and control the NCDs with an ultimate goal of reducing preventable deaths from NCDs by 25% by 2025Noting his relentless and unrelenting battle over the last decade to have the global community consider NCDs a “priorty development issue,” Minister Ramsammy said the decision by the UN was “late but still timely,” and described it as “a significant personal achievement.”“NCDs will now rightly assume a place of prominence as a global threat that needs to be addressed as an emergency. The world now appropriately acknowledges the NCDs as comprising a new front in the fight to promote global public health and in the fight against poverty.”A GLARING OMISSIONGuyana recognized at an early stage that the efficacy of efforts pursued at the national level with regards to the NCDs needed to be complemented by regional and global consideration and action.In his opening address to the Sixty-first World Health Assembly, on 19 May 2008, Minister Ramsammy in his capacity as President of the Assembly, referred to the ‘glaring omission’ of NCDs from the Millennium Development Goals (MDGs).“It is in this light that I propose we seriously consider an MDG+, which would set goals for the NCDs,Nike Rams #99 Aaron Donald Royal Blue Alternate Mens Stitched NFL Elite Jersey, as we have done for other public health challenges. The 2015 target date for the MDGs are not far away and I am certain pressures would be mounting on countries to achieve the goals established. Unless we include goals for the NCDs now, we are likely to face circumstances which would force neglect of the NCDs as we try to ensure we achieve those goals already identified.”Minister Ramsammy had always strongly posited the view that when the MDGs Declaration was made by the UN and signed by more than 200 countries in 2000, it was a grave mistake to have left out the NCDs from consideration. His rationalization was that the MDG Declaration was, after all,DeAndre Jordan Team USA Jersey, a poverty reduction instrument, and the NCDs was at least as important a cause of poverty and a barrier for the reduction of poverty, as any other health or non-health factor.That was the genesis of his ten-year crusade advocating for an MDG+.He utilized every opportunity that came his way in the global arena to urge his cause and soon began to be referred to in the global health arena as “The crusader of the NCDs”This was his major platform as the President of Executive of the Directing Council of PAHO in 2001-2002, as the President of the World Health Assembly in 2008 and as the President of the Directing Council in 2007 and 2008.At three high-level meetings of ECOSOC held in 2009, Minister Ramsammy asserted to the distinguished gathering that “”Non-communicable diseases have transformed themselves into violent tornadoes bringing death and disability to every country. None of us come from a country that has been spared. We need to catapult our efforts and our advocacy into a more urgent and robust crusade against non-communicable diseases in developing countries.The MDGs failed to identify non-communicable diseases, in spite of the fact that these diseases account for fully 60 per cent of global mortalities… I believe that this is a serious omission and this anomaly should be corrected. I propose we seriously consider an MDG+, which would set goals for non-communicable diseases, as we have done for other public health challenges.”As could be expected, his charge to the World Health Assembly on completion of his tenure as 61st President also urged that relevant attention be placed on the NCDsOn 19 May 2009, over 150 leaders from ministries of health, civil society and the private sector met during the 62nd World Health Assembly in Geneva to discuss a major global emergency: non-communicable diseases (NCDs). This event was a world first, bringing together leaders from across the global health community with the three major NCD federations (IDF, WHF and UICC), who together represented over 700 national organizations in 170 countries.The success of the event, demonstrated by a high turnout, extensive press coverage, and a lead editorial in the Lancet, spoke to the growing movement within global health concerning the NCDs. This movement culminated in the historical convening of the High Level Meeting on NCDs at the UN general Assembly last weekend.THE CARIBBEAN LED THE WAYOver the years, Guyana also worked with the other Member States of CARICOM to ensure a regionally coordinated response to NCDs.The decision was informed to a large extent by the gravity of the development challenge that NCDs posed for all CARICOM Member States.In this regard, CARICOM was instrumental in facilitating the General Assembly’s consideration of the issue of NCDs.At last weekend’s meeting,Antoine Roussel Jersey, Minister Ramsammy lauded the role countries of CARICOM played in bringing the NCD issue to the international stage and the importance of this issue to the CARICOM Region.He highlighted ten significant steps that the Caribbean took that sealed the victory of having a meeting of the UN to discuss the NCDsAmong them are the May 2010 UN Resolution on NCDs at which the Caribbean sponsored and was able to obtain co-sponsorship from many countries around the world for the Resolution which called on the Secretary General to convene the High Level Meeting in September 2011 to address the Global NCD Crisis.Since then the Caribbean has played a pivotal role in 1st Regional Meeting of Ministers of Health of the Americas and the drafting of the Mexico Declaration on NCDs of February 2011 and in the 1st Global Meeting of Ministers of Health and in the drafting of the Moscow Resolution on NCDs of April 2011. Dr. Ramsammy was a member of the steering committee for the organization of the Moscow meeting.This determination prompted the convening of the first ever Heads of Government Summit to address the NCD crisis in September 2007 which led to the now famous Port of Spain Declaration on the NCDs: Uniting to Stop the Epidemic of Chronic Non-Communicable Diseases.This milestone event has since led to the Bridgetown Declaration of October 2008 where a civil society umbrella was established and has now formed the Healthy Caribbean Coalition to fight against the NCDs. There has also been a private sector pledge in this regard.In 2010, the second Summit of Heads to address the issue was held as Commonwealth Heads of Government met in Trinidad and declared that the NCDs represent a global crisis and must be addressed as an important threat in the global effort to end poverty and improve the lives of people.Minister Ramsammy reminded that Caribbean Governments also worked with PAHO to create the Caribbean Strategy against the NCDs. As part of this, the declaration was made that the 2nd week of every September would be observed as Caribbean Wellness Week and now advocacy is being made for it to become a Global Wellness Week.THE WAY FORWARDIn finally agreeing to a global approach to reverse the NCD Crisis, Dr. Ramsammy believes that the world is better poised to address its anti-poverty platform and its pursuit of global equity. “For me it is such approaches that will allow the pro-equity dream of ensuring that the life expectancy in every country in the world is greater than 70  to become reality….If we could prevent and control NCDs, then this goal is within our reach.”“I have spent a decade as Minister of Health, joining many of my colleague Ministers Chief Medical officers and other personnel in the Caribbean, calling for action against the global pandemic of NCDs, a severe barrier to poverty reduction and, indeed, what the evidence portrayed – a significant contributor to new poverty. Now we have a vehicle through which to pursue more aggressive National,Edwin Encarnacion Blue Jays Jersey, Regional and Global Actions.”Alluding to the need for urgent action towards the NCDs, Ramsammy urged the full implementation of the Political Declaration, including early agreement on global targets, a monitoring framework, and a substantive and collaborative partnership of global stakeholders to facilitate continued action on NCDs as well as greater access to affordable,Orlando Magic Jersey, safe,Jake Allen Jersey, effective and quality-assured medicines and improved access to palliative and rehabilitative services particularly at the community level.He also called on the caucus to reorient trade and agricultural policies to facilitate the provision of healthy local foods; and, the provision of increased and sustained human, financial and technical resources from all sources, including innovative approaches.“For this reason,Steve Larmer Jersey, we call on all Member States to work together to support the follow-up processes, such as the development of national plans by 2013, the development of global targets and indicators, including the overall goal of reducing preventable deaths from NCDs by 25% by 2025,Trevor Daley Jersey, to monitor trends and to assess progress made in the implementation of national strategies and plans.”He added that Guyana supports the appointment of an envoy or representative on NCDs to promote aggressive action and to foster national and regional collaboration.