Presentation by Mrs. Tatyana A. Golikova, the Russian Federation Minister of Health and Social Development, at the First Global Ministerial Conference

Distinguished ladies and gentlemen,

Distinguished colleagues,

1.

Let me welcome you sincerely in Moscow, where we are to work out the shared position and approaches to resolution of the critical global problem – that is, proliferation of non-communicable diseases (NCD).

Non-communicable diseases, taking the lead in the structure of mortality and morbidity, cause a huge detriment to lives of human individuals, as well as to economy in developed and developing countries. At the same time, as estimated by the World Health Organization, 9.1 million deaths per year can be prevented.

As recorded in the WHO charter, the right of every individual for the highest level of physical and psychical health cannot be realized unless active measures are taken for prophylactics, countering, and treatment of non-communicable diseases.

There is considerable disparity in prevention, countering and treatment of non-communicable diseases among and within different countries. However, so far, rather weak efforts are taken to overcome such disparity: within the global framework of international aid programs, only 3% of resources are allocated to counter non-commutable diseases.

Having gathered here today, we represent a coordinated international force, which is able to elevate the subject of non-communicable diseases to the top lines of international and national agenda, to build mechanisms of international cooperation in countering the non-commutable diseases, as well as to orient national healthcare systems to prevention and control of such diseases. 

2.

While defining the approaches to countering the non-communicable diseases, we should proceed from the proper understanding of their causes. The first factor is found in the inherited and genetic predisposition. The modern medicine does have sufficient tools to control and consider this factor by the systems of screening, applied, in particular, at the initial stages of human life. This would enable us to proceed to the paradigm of “health management” in the course of the whole life of human individuals.

The feature of non-communicable diseases is that most of the risk factors are to be found in the condition of the natural and social environment as well as in the human lifestyles as such.

Socio-economic development would cause a strong impact on proliferation of non-communicable diseases – up to 90% of deaths occur in the low- and medium-income countries. However, in these countries, too, the problems are not only connected with lack of funds, but also with organization of healthcare. In order to break the trend for growth of such diseases, it is necessary to direct political will and organizational efforts to mass prophylactic programs and to making the healthy lifestyle a habit, as well as to reorient the healthcare to working with healthy people before they get sick.

The human factor is of paramount importance for preventing proliferation of non-communicable diseases. For developed countries, this is probably the most important component in prevention of NCD. To treat people is not our only task – we as well have to talk with people, to attain their understanding of the value of health, and to help them to understand the mechanisms for health protection and the effects of the risk factors.

The role of such factor as psychic health is growing. A considerable percentage of people, turning for medical aid with symptoms of somatic disorders, in fact are in need of psychological and psychotherapeutic treatment. Psychic health and rehabilitation after the experienced diseases become a critical factor. By the WHO data, every fourth or every fifth inhabitant of the Earth suffers from psyche disorders, and by 2020 depression will rank first in terms of morbidity. The global and national systems of healthcare must respond to this challenge by providing people with psychological and psychotherapeutic aid and helping them to master the methods of self-regulation, protection of psychical equilibrium and ability to live a happy life in the new socio-cultural environment.

Notwithstanding the different social, economic and cultural conditions, we may identify several common points in organization of prophylactics and control of non-communicable diseases:

1. The cross-sectoral approach to countering the non-communicable diseases. This issue is to be addressed through cooperation of educational, labor protection, industrial, agricultural, environmental sectors, mass media, physical training, and sports under the leadership of healthcare sector.
2. Mandatory engagement of private sector, nongovernmental organizations, and wide public supported by strong governmental focus on these issues.
3. Enhancement of the prevention elements share in the health sector, introduction of the illness prevention standards in health management systems, screening and warning people before their getting ill.
4. The countering of non-communicable diseases should rely on the sound platform providing for inclusion of health in the range of today’s basic human values and ensuring the proper conditions for healthy lifestyle.

3.

It is very important that the First Global Ministerial Conference on healthy lifestyle and non-communicable diseases is held in Russia, which has declared the human health a state priority, and is implementing large-scale programs of healthcare development emphasizing the reduction of mortality from non-communicable diseases and the healthy lifestyle.

Since 2005, Russia has been implementing the Health national project having among its key components the development of primary healthcare institutions and enhancement of prophylactic measures.

Since 2008, we have been deploying target initiatives aimed to improve medical aid in cases of cardiovascular and oncology diseases. The cardiovascular program has shown the promising performance almost immediately: during the first nine months (2009), the mortality resulting from the blood system diseases was reduced by 5.4%, the mortality from cerebrovascular diseases fell by 8.5%. During the next year, 2010 the mortality figures gained 2.5% more in reduction against 2009. The oncology program also demonstrates a positive trend, with oncologic mortality having decreased in 2010 by 0.3%, and by 0.8% in those areas where the program activities are based. 

Russia continuingly develops the system of mass periodic screening and health surveys helping to identify risks of non-communicable diseases that take the lead in mortality structure.

From the last year, we have started shifting to the “physician – healthy man” interaction scheme by opening the special healthcare institutions called Health Centers. We have opened 502 Health Centers for adults and 193 pediatric and juvenile Health Centers. They focus on preventive and awareness raising efforts, examination of health people for risk factors and the development of individual recommendations as to the maintenance of healthy lifestyle. During their first year of operation, the Health Centers were visited by about 2.5 million people.

Health Centers represent both infrastructure and support for our efforts to establish healthy lifestyle and struggle against bad habits.  From 2009, we have been implementing a Healthy Russia initiative with strong focus on information and communicative elements. We succeeded in making the healthy lifestyle an item of the national mass media’s agenda. As a result, the number of people motivated to maintain the healthy lifestyle has grown up 3% over the year, and this state initiative gains broad support by nongovernmental organizations, corporations, cities, and regions.

What often impedes healthy lifestyle and contributes to non-communicable diseases is bad habits and especially tobacco, alcohol, and drug addiction. Russia is not in the favorable situation with respect to these addictions. That is why we are so scrupulous in selection of the most efficient means to counter them, by combining the medical and social aspects of the problem.

This is the logic we pursue by our Detoxication System Improvement Program, which consistently links together the extensive prevention measures, treatment, rehabilitation, and establishment of medical communities. The program provides for enhancement of relations between doctors and patients, especially during the rehabilitation process that includes medical psychological and social rehabilitation helping a patient with employment and professional training. All services under the Program are also provided free of charge.

Some positive results have been achieved already. In 2010, the number of drug addicts went down by 2% for the first time. In 2009, the alcohol consumption per capita decreased by 3 liter of pure ethanol against 2008.

In the next two years, we are going to implement the most extensive and comprehensive program of last decades aimed at the healthcare system modernization, which is supposed to be funded from federal budget in the amount of roughly RUR 460 billion (that is equal to about USD 16 billion). The program’s prior goal is also to achieve reduction of morbidity and mortality from their leading causes.

4.

I hope that the Russian experience in countering the non-communicable diseases will appear useful for and demanded by the global community. And I am sure that the Moscow Conference will enable the Russian government and healthcare system to develop proper approaches to countering the NCD and introduction of healthy lifestyle.

I wish the results of the Moscow Conference to provide a sound platform for the Top-Level Meeting in the Special Session of the United Nations General Assembly devoted to prevention of and countering the non-communicable diseases, which is to be held in New-York in September 2011.

The year 2011 may eventually leave its mark on history as the starting year in development of the new global healthcare and social organization paradigm based on the prevention of and countering the non-communicable diseases.

Let me wish you good work and fruitful discussions during the Conference.