Proposals to include cirrhotic liver disease and haemophilia, and other inherited bleeding disorders, into the definition of non-communicable diseases (NCDs) will be tabled at the World Health Assembly in May, the World Health Organization (WHO) Executive Board (EB) resolved on Tuesday.

Egypt, which sponsored the resolution on cirrhotic liver disease, told the EB that it affects more than 1.7 billion people worldwide, “driven by metabolic risk factors, unhealthy diets and physical inactivity”.

The resolution calls for the formal recognition and systematic integration of the liver disease into the global NCD response, “including surveillance systems, prevention strategies, primary healthcare-based management and national NCD plans”.

Introducing the resolution on haemophilia and other inherited bleeding disorders, Armenia said it aimed to address “the systematic under-diagnosis and historical lack of prioritisation” afforded to these disorders and “bridge the gap in access to essential treatment and care”.

Dr Jeremy Farrar, WHO Assistant Director General, said that NCDs will be one of the “defining concerns” of the 21st century, after a mammoth session on NCDs that was addressed by almost every member state.

NCDs already account for over 80% of deaths in the Western Pacific region, the EB heard from a representative from the Solomon Islands.

Several countries appealed for support and guidance to address their growing burdens of key NCDs, including diabetes, heart disease and hypertension – driven mainly by unhealthy diets and lack of exercise.

The majority of countries have been unable to reach NCD-related targets set out in the Sustainable Development Goals (SDGs), and Farrar warned that the world’s ageing population would make matters worse.

Farrar also cautioned against an “over-reliance in many parts of the world on treatment, as opposed to prevention and promotion of health”.

During the WHO’s reforms, it has combined into one division health promotion, disease prevention and care, and this would encourage a “holistic approach to treatment beyond just drugs”. 

UN Declaration on NCDs

Much of the discussion focused on how to implement the Political Declaration on NCDs and mental health, adopted by the United Nations last December after last year’s High-Level Meeting (HLM).

The declaration was expected to be adopted by consensus at HLM last September, but the US refused at the last minute. It was then referred to the UN General Assembly for a vote, where only the US and Argentina opposed it.

Farrar said that, during the current time where there are “questions on multilateralism”, it was reassuring that “the vast, overwhelming number of countries could come together and agree on a political declaration”.

The declaration sets three global targets for 2030: 150 million fewer tobacco users; 150 million more people with hypertension under control; and 150 million more people with access to mental health care.

It also commits to at least 80% of countries with policy, legislative, regulatory and fiscal measures in place to address NCDs and mental health; at least 80% of primary health care facilities stocking essential medicines and basic technologies; and at least 60% of countries with measures to cover or limit the cost of essential NCD and mental health services.

However, the NCD Alliance told the EB it was concerned about “the significant influence of health-harming industries, which weakened the [Political Declaration], including less ambitious commitments on NCD prevention, the removal of the health tax targets [on tobacco, alcohol and sugary drinks] and the omission of any reference to fossil fuels as key drivers of NCDs”.

Meanwhile, Farrar said that while “political declarations have a critical role to play, in the end, they’re not the way that things get implemented,” pledging WHO support to countries to make a difference to people’s lives.