How are countries dealing with their current cardio-vascular disease burden? A snapshot from the WHO Eastern Mediterranean Region (EMR)

In recent years, a number of global commitments have been made in the area of noncommunicable diseases (NCD). These include the UN NCD Political Declaration in 2011, and the UN Comprehensive Review on NCDs and Outcome Document in 2014. Nine global targets have been agreed in the area of NCDs, and NCDs have been addressed in the Sustainable Development Goals (SDG). Another UN high-level meeting will take place in September 2018 to assess country progress across the globe. At the regional level, a number of initiates have taken place to deliver on these global commitments. One of the guiding documents is the Regional Framework for Action on Noncommunicable Diseases. This framework was endorsed at the WHO EM Regional Committee in 2012, and includes 17 strategic interventions and 10 monitoring indicators, covering the areas of NCD governance, prevention, surveillance and healthcare. Progress is being monitored on an annual basis through the development of country progress factsheets and biennial WHO Country Capacity Survey on NCDs. To date however, progress has been insufficient and uneven. Moreover, is has been slowest in the areas of planning and surveillance, and tobacco control. No uniform approach or model exists for all EMR countries, but a number of countries have advanced their national NCD agenda through original and innovative initiatives. Perceived challenges include the uneven progress and needs across the WHO EM region, humanitarian emergencies and political instability, vertical approaches, a lack of human and financial resources and other health systems weaknesses. Opportunities however exist through the global SDG and universal health coverage (UHC) agendas offering an opportunity to revisit essential health services package until 2030. Overall, there has been political commitment to NCD governance, as evidenced by the EM Regional Committee’s endorsement of the regional framework for action. However, despite the clear roadmap, progress has been slow and scattered, differing vastly by country and by topic. We recommend that countries urgently scale up their efforts in all four areas of the EM Regional Framework of Action to be able to achieve their national and international targets.