Whole of Society Whole of Government The ca

Slide1Whole of  Society;  Whole  of Government;  The  case  of NCDs Whole  of  Society;  Whole  of Government;  The  case  of NCDs By By George  Alleyne George  Alleyne Kingston,  Jamaica Kingston,  Jamaica 29  May,  2012 29  May,  2012

Slide2Responding to the challenge: a whole-of-government and a whole-of-society effort :  Recognize  that  the  rising prevalence,  morbidity  and  mortality  of non-communicable  diseases worldwide  can  be  largely  prevented and  controlled  through  collective  and multisectoral  action  by  all  Member States  and  other  relevant  stakeholders at  the  local,  national,  regional  and global  levels,…….. Para 33 :  Recognize  that  the  rising prevalence,  morbidity  and  mortality  of non-communicable  diseases worldwide  can  be  largely  prevented and  controlled  through  collective  and multisectoral  action  by  all  Member States  and  other  relevant  stakeholders at  the  local,  national,  regional  and global  levels,……..

Slide3Develop options  for  multisectoral Develop  options  for  multisectoral   action  for  effective  partnerships   action  for  effective  partnerships Political Declaration Para 64

Slide4Times “multisectorial  “  mentioned  in  UN “health”  documents Times  “multisectorial  “  mentioned  in  UN “health”  documents Political  Declaration  NCDs  2011………..15 Political  Declaration  NCDs  2011………..15 Political  commitment  HIV/AIDS  2001……2 Political  commitment  HIV/AIDS  2001……2 Agenda  21.  Chapter  6  1992.....……………0 Agenda  21.  Chapter  6  1992.....……………0 Multisectoriality Multisectoriality ? Significance and policy implications of new emphasis

Slide5MultilateralActions Efforts Responses Public policies Nat.Policies Interventions Approaches Engagenment

Slide6Whole  of  society Whole  of  society      I  equate  with  the  bodies  of  the  STATE      I  equate  with  the  bodies  of  the  STATE       government,  private  sector  (business),       government,  private  sector  (business),       civil  society       civil  society Whole  of  government Whole  of  government      I  equate  with  all  the  administrative      I  equate  with  all  the  administrative      divisions  and  institutions  of      divisions  and  institutions  of      government      government

Slide7Government Private sector Civil Society Agr. Fin. Hlth Trade Etc PM Divisions STATE GOVERNMENT

Slide8Government—Well  defined Government —Well  defined Business --Polymorphic-Businesses  touch  every Business --Polymorphic-Businesses  touch  every                   risk  factor  for  NCDs                   risk  factor  for  NCDs Civil  society- -Polymorphic Civil  society- -Polymorphic                                 NGOs-Thematic  and  non-thematic                                 NGOs-Thematic  and  non-thematic                                 Faith-based  organizations                                 Faith-based  organizations                                 Professional  organizations                                 Professional  organizations                                 Media                                 Media                                 Organized  labor                                 Organized  labor                                 Etc                                 Etc        

Slide9Sectoral responsibilities Sectoral  responsibilities Government Government       Produce  public  goods       Produce  public  goods       Public  order       Public  order Business Business       Produce  goods  and  services  efficiently       Produce  goods  and  services  efficiently        Make  a  profit        Make  a  profit Civil  society Civil  society        Guardian  of  community  values        Guardian  of  community  values        Serve  as  a  broker        Serve  as  a  broker

Slide10Tools availableGovernment Civil  society Business Business Legislation Regulation Taxation Agitate Inform Philanthropy Product power Shared value

Slide11Sectoral continuum Sectoral  continuum A B C A B C ?D Interests Sectors

Slide12Multisectoral cooperationHealth A B C Services Services Services Services Individual and population health status Government Divisions

Slide13Intersectoral cooperationGovernment Business Civil Society Health Health

Slide14Strategies to  address  NCDs Strategies  to  address  NCDs Population based interventions; Primary prevention Clinical interventions Secondary prevention Healthy NCD Society/environment Individual

Slide15Managing the interactionWhole of government ( Multisectoral) Primacy of Health Ministry        -Data on NCDs and Risk factors Imprimatur of Head of Government Health Impact Assessment

Slide16Health Impact Assessment (HIA)    is a means of assessing the health impacts of policies, plans and projects in diverse economic (sic) sectors using quantitative, qualitative and participatory techniques. ( WHO)

Slide17The major steps in conducting an HIA include Screening (identify projects or policies for which an HIA would be useful), Scoping (identify which health effects to consider), Assessing risks and benefits (identify which people may be affected and how they may be affected), Developing recommendations (suggest changes to proposals to promote positive or mitigate adverse health effects), Reporting (present the results to decision-makers), and Evaluating (determine the effect of the HIA on the decision).                                       (CDC)

Slide18 An outline scheme for health impact assessment, showing the place of “evidence” in the process. Mindell J et al. J Epidemiol Community Health 2004;58:546-551 © 2004 by BMJ Publishing Group Ltd Health Impact Assessment

Slide19Intersectoral involvement in addressingNCD risk factors Risk factor Government Private sector Civil society Tobacco ++++ - ++ Physical activity ++ + + Harmful use of alcohol ++++ ? ++ Unhealthy diet ++ +++ ?

Slide20Conclusions Whole of society and whole of government shaped as intersectoral and multisectoral approaches The differences between the two set out  The multisectoral theoretically easier, given our forms of government and tools available The intersectoral more difficult, given the polymorphic nature and interests of the private sector and civil society