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Five in Five to Survive: Top 5 lists, non-communicable diseases, and global health

Posted by Mark Ryan, MD October 9, 2011 at 1:49 PM

(The following post was written by Irène Mathieu, a second-year medical student at Vanderbilt.  Irène attended the NPA’s Annual Meeting last weekend, and wrote this post in part related to the meeting’s presentations.  Irène’s blog can be read here.)

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The Occupy Wall Street movement has spread like crazy to cities across the country, including my own (now even more) beloved Nashville. Last month the United Nations held its second ever high-level meeting on a health issue – noncommunicable, chronic diseases (diabetes, cancer, cardiovascular disease, and smoking-related illnesses; referred to from now on as NCDs). And this past weekend was the sixth annual conference of npalliance.org, a small but growing national organization for doctors inclined toward activism, that unspoken part of the Hippocratic Oath.

The people camped out on Wall Street listening to Cornell West want pretty much the same thing as NPA doctors – for our national and international leaders, like the UN, to cease their unhealthy relationships with Industry. Unhealthy political relationships directly correlate to an unhealthy citizenry. Sadly, the UN meeting in September was notably devoid of the grand-scale commitments made the last time it held a high-level meeting on a health issue, which was HIV/AIDS.

This year, there were a lot of mumbles and hand-waving and broad framing of nebulous ideals. The heavy hand of industry in the fight against NCDs was predicted to be a stalling point at the New York meeting. Unfortunately, in many modern-day democracies – most obviously in our own – corporations are afforded more rights and privileges than people. We, the people, may not wield the financial power that corporations use to gain these privileges – but we do have a voice. And if HIV/AIDS was the major health justice movement of the ‘90s, then NCDs are our task.

The NCD Alliance shares this belief as its premise. Even Ban Ki-Moon observed that NCDs represent “a public health emergency in slow motion.” (Then he proceeded to lead the UN in an equally slow-motion response to the crisis.) NCDs are food issues, housing issues, environmental issues, urban planning issues, and educational issues. Every sector of society could play a role in decreasing the burden of these diseases. The only way to make sure such a complex movement makes an impact is to align our interests by setting goals we can all agree on.

Attendees of the UN meeting last month would have done well to set a series of goals like the Millennium Development Goals (unfortunately those will be largely unmet, however). World leaders could create a set of targets or indicators – say, 15 concrete items, like a target average blood pressure for a subset of the population or a percentage of people with high cholesterol on statins or hours of media time devoted to public health campaigns – and participating countries could select, for example, five indicators to work on in the next five years. Let’s call it the Five in Five to Survive: five things we, as a global community, can do in five years to increase survival of the people in our population who are most vulnerable to NCDs. And let’s hold our leaders accountable to them.

It’s clear that we cannot wait on those who attend UN high level meetings to make the commitments we need to decrease the global burden of NCDs. So what if health care workers and others who work with communities heavily affected by NCDs make up their own Five in Five? What if we create a national or global network to share best practices?

When our leaders fail on their commitments to the people, the people should bring their commitment to the leaders. Let’s bring it.

One Response to “Five in Five to Survive: Top 5 lists, non-communicable diseases, and global health”

  1. Irene (and Mark),

    When you wrote: “So what if health care workers…who work with communities heavily affected by NCDs make up their own Five in Five? What if we create a national or global network to share best practices?” it was inspiring to read, because we need to continue reminding ourselves of the failures by our leaders to protect the public interest. Their failures have resulted in the ongoing decline of our country’s health, and I think the point you make about networking is the beginning of what will get back our population’s health. We need an “Occupy Healthcare” movement. Our organizations – NPA and DFA – are finding more ways to work together. When we and others become one big strong voice, articulating and demanding change, it will happen. We can do this.

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