The United Nations Interagency Task Force on the Prevention and Control of Noncommunicable Diseases (NCDs) visited Mozambique from 2-6 November to support the African country’s efforts to tackle these diseases - principally cardiovascular diseases, diabetes, cancers, and chronic respiratory diseases.
In Mozambique, NCDs cause 23% of all deaths, and nearly 1 in 5 people die prematurely from these conditions, which are having an increasing adverse socioeconomic impact on the country.
Mozambique is the third country in the WHO African Region to host a Joint Mission of the Task Force. The mission included representatives from the Joint United Nations Programme on HIV/AIDS (UNAIDS), United Nations Development Programme (UNDP), and the World Health Organization (WHO), which led the mission.
During the visit, the Task Force also met with parliamentarians, high-level officials from government, development partners, representatives of the civil society, academia and professional associations in addition to the heads of resident UN agencies.
NCDs in the Sustainable Development Agenda
The prevention and control of NCDS is now a core part of the Sustainable Development Agenda 2016-2030 which was adopted in September 2015 by all governments around the world at the UN General Assembly.
The Sustainable Development Goals are the successor to the Millennium Development Goals. “This means that NCDs now need to be an issue that the whole of the UN system need to be supporting as one in Mozambique,” said Dr Mouzinho Saide, the Deputy Minister of Health.
“With all the other challenges that Mozambique faces, we have not yet been able to focus sufficiently on NCDs. We now need that to change,” the Deputy Minister added. “Too many people die too young from NCDs in Mozambique and unless we do something about it now, the picture is only going to get worse,” Dr Saide added.
“The Ministry of Health cannot tackle NCDs on its own, its needs all government ministries to work together to reduce the exposure to the major risk factors for NCDs: tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity” he concluded.
WHO Framework Convention on Tobacco Control
The mission reviewed NCD policies and actions in place across government and the UN system and made a number of recommendations.
Bettina Maas, acting UN Resident Coordinator and UNFPA Resident Representative in Mozambique, said: “A priority for government is to ratify the WHO Framework Convention on Tobacco Control (WHO FCTC). The UN system will do whatever it can to encourage Parliament to ratify the FCTC and then support its implementation.”
The WHO FCTC is the first international treaty negotiated under the auspices of WHO. The treaty, to which there are 180 Parties, reaffirms the right of all people to the highest standard of health and the Convention represents a milestone for the promotion of public health and provides new legal dimensions for international health cooperation.
There are a number of low-cost measures that governments can implement immediately to reduce levels of tobacco use. They are to:
- Reduce affordability of tobacco products by increasing tobacco excise taxes;
- create by law completely smoke-free environments in all indoor workplaces, public places and public transport;
- warn people of the dangers of tobacco and tobacco smoke through effective health warnings and mass media campaigns; and
- ban all forms of tobacco advertising, promotion and sponsorship.
Moving forward
The Task Force concluded that Mozambique has a long way to go in implementing a set of very cost-effective and affordable interventions for all countries (“best buys”), which Ministers of Health adopted at the World Health Assembly in 2013 as part of the WHO Global NCD Action Plan 2013-2020.
The mission also heard of the adverse socioeconomic impact of harmful use of alcohol, including violence and road traffic crashes.
Hilde de Graeve, the WHO Representative to Mozambique, said The harmful use of alcohol is a real threat to Mozambique. “The Government urgently needs to enforce existing legislation and update it in order to regulate the commercial and public availability of alcohol, to restrict or ban alcohol advertising and promotions, and use pricing policies such as excise tax increases on alcoholic beverages,” she said. “The UN is committed to scale up its support to Government in this area.”
The Joint Mission reviewed the draft UN Development Assistance Framework (UNDAF) for 2017-2021 with UN agencies in country. Dr Nick Banatvala, Senior Adviser to WHO’s Assistant Director-General for NCDs and Mental Health, said that seeing NCDs reflected in the draft UNDAF was positive, as it is the UN’s blue print for proving strategic technical assistance to the Government.
“Tackling NCDs and their main risk factors, requires the whole-of-government, whole-of-society and whole-of UN system to work together as one,” Dr Banatvala added. “But with nearly 40% of adult Mozambicans having high blood pressure and large numbers with diabetes, getting effective primary care to tackle these conditions is critical. It is important that strengthening the primary care response to NCDs is part of the UNDAF.”
“The Government of Mozambique, alongside all other countries, will report to the UN General Assembly in 2018 on progress made in developing a national NCD response.
Like many other African countries, it now needs to scale up action urgently if it is to control this latest epidemic. "The UN is committed to provide all the support it can to help Mozambique in building a national NCD response to meet the NCD-related targets in the SDGs” Bettina Maas concluded.