The Kenyan government and the UN Country Team are collaborating to address the country’s rising number of premature deaths from noncommunicable diseases (NCDs), including heart diseases, cancers, diabetes, and chronic respiratory diseases, scaling up solutions based on national leadership, global perspectives and local insights.

The government and the UN Country Team are receiving support this week from the United Nations Interagency Task Force for the Prevention and Control of NCDs, comprising WHO, UNAIDS, UNDP, UNFPA, UNICEF and the World Bank, to help build and share solutions in three main areas:

• Setting national targets for NCDs.
• Finalizing the work on the development of a national action plan to reduce exposure of Kenyans to risk factors for NCDs and enable health systems in Kenya to respond to NCDs.
• Mapping the NCD epidemic to ensure that they are no longer hidden, misunderstood and underreported.

NCDs account for 27% of deaths suffered by Kenyans aged between 30 and 70 years, equivalent to almost 370 000 people per year, reducing productivity, curtailing economic growth and trapping the poorest people in chronic poverty. The probability of dying too young from an NCD in Kenya is 18%. The main risk factors for NCDs in Kenya are exposure to tobacco use, physical inactivity, unhealthy diets and harmful use of alcohol due to effects of globalization on marketing and trade, rapid urbanization and population ageing. NCDs contribute to over 50% of inpatient admissions and 40% of hospital deaths, which dominate health care budgets in Kenya.

“It is very clear that the risk factors associated with NCDs transcend the health sector and go beyond the capacities of the Ministry of Health alone to respond,” says Dr Nicholas Muraguri, Director of Medical Services at the Kenyan Ministry of Health. “It deals with tobacco use, alcohol use, sedentary lifestyles and so on. “Therefore it needs a multisectoral response to address NCDs and their risk factors.”

Dr Muraguri adds: “The action by the UN Country Team and the Joint Task Force on NCDs is significant because at this juncture we are trying to scale up our programming for NCDs and this mission will give us guidance to help develop the policies and strategies required for us to develop an appropriate programme to address NCDs prevention and management.”

The great levels of illness and death associated with NCDs has meant that the Kenyan government has prioritized NCDs prevention and control in its National Medium Term Plan (MTPII) 2014-2018; National Health Strategic Plan (KNSSP) 2014-2018; the just-launched United Nations Development Assisted Framework (UNDAF) 2014-2018 for Kenya; and the Kenya third generation WHO Country Cooperation Strategy (2014-2019).

The Joint Mission of the United Nations Interagency Task Force on the Prevention and Control of NCDs (UNIATF) is using its five-day mission to encourage Kenya to make prevention the cornerstone of the national response to NCDs. The Task Force met on 30 September with senior Kenya health officials responsible for NCDs, health promotion, community health and tobacco control. It also briefed the UN Resident Coordinator for Kenya and other members of UN Country on the mission’s objectives and the main findings and recommendations. The Task Force also met with representatives of academia and civil society.

Later this week, the mission meets officials from Kenya’s ministries of Labour and Social Security; the Treasury, Information, Communication and Technology; Transport and Industrialization; Land Housing and Urban Development; and Education; plus the Tobacco Control Board and National Authority for the Campaign Against Drug and Alcohol Abuse.

“WHO and the UN Country Team is learning from many successes in addressing NCDs,” says Dr Custodia Mandlhate, WHO Representative to Kenya. “Strong partnerships across multiple ministries of government, and between governments, communities and the private sector, are absolutely essential. Prevention must be the cornerstone of the national response to NCDs. It is a practical possibility.”

There is a set of cost-effective interventions to prevent and control of NCDs in all countries, says Dr Nicholas Banatvala, from the Geneva-based WHO Noncommunicable Diseases and Mental Health Cluster. “Some studies estimate that implementing these very cost-effective interventions will cost only 4% of current health spending in low-income countries, 2% in lower-middle-income countries and less than 1% in upper-middle-income countries,” explains Dr Banatvala.

Globally, over 14 million people die each year from NCDs between the ages of 30 and 70, of which 85% are in developing countries. The probability of dying from any of the major NCDs between the ages of 30 and 70 ranges from 10% in developed countries to 60% in low- and middle-income countries. It is estimated that up to two thirds of premature deaths are linked to exposure to risk factors (namely, tobacco use, unhealthy diet and physical inactivity, and the harmful use of alcohol) and up to half of all such deaths are linked to weak health systems that do not respond effectively and equitably to the health-care needs of people with NCDs (principally cardiovascular diseases, cancers, chronic respiratory diseases and diabetes).

World leaders agreed in 2011 on a roadmap of commitments for a world free of the avoidable burden of NCDs. The WHO Global NCD Action Plan, 2013-2020, which the World Health Assembly endorsed in 2013, put in place a global agenda, based on nine global concrete targets for 2025. The global plan comprises a set of actions that, when performed collectively by governments, international partners and WHO, will help attain a global target of a 25% reduction in premature deaths from NCDs and achieve the commitments made by world leaders in 2011. Kenya is applying latest scientific knowledge, available evidence and international experience included in the global plan in finalizing its own national plan

In July 2014, Ministers of Health adopted the Outcome Document of the High-level Meeting of the United Nations General Assembly on the Comprehensive Review and Assessment of the Progress Achieved in the Prevention and Control of NCDs. They recognized the remarkable progress achieved at the national level since 2011, including an increase in the number of countries with an operational national NCD policy and a budget for implementation, from 32% of countries in 2010 to 50% in 2013.

Recognizing that progress in implementing the roadmap of commitments included in the 2011 Political Declaration has been insufficient and highly uneven, and that continued and increased efforts are essential, Ministers committed to prioritize a set of measures which they will take between 2014 and 2018, including the development of national action plans.

The UN Interagency Task Force on the Prevention and Control of Non-communicable Diseases was established by the UN Secretary-General in June 2013 and placed under WHO’s leadership. It is coordinating the activities of the relevant UN organizations and other intergovernmental bodies to help realize the 2011 Heads of State commitments in the 2011 Political Declaration on NCDs, in particular by implementing the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020.

The Task Force will stage numerous more missions to other countries during 2014 and 2015. The responsibility for tackling NCDs lies with government, but action requires extensive collaboration across government and with a broad range of development partners. The aim is to reduce the vast number of premature deaths for NCDs in Kenya in line with WHO voluntary global target of a 25% reduction in premature mortality from NCDs by 2025.