{"id":8608,"date":"2011-05-05T15:22:41","date_gmt":"2011-05-05T14:22:41","guid":{"rendered":"https:\/\/stg-blogs.bmj.com\/bmj\/?p=8608"},"modified":"2011-05-05T15:22:41","modified_gmt":"2011-05-05T14:22:41","slug":"richard-smith-lunch-with-90-health-ministers-in-moscow","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmj\/2011\/05\/05\/richard-smith-lunch-with-90-health-ministers-in-moscow\/","title":{"rendered":"Richard Smith: Lunch with 90 health ministers in Moscow"},"content":{"rendered":"

\"RichardLast week I enjoyed myself facilitating a lunchtime meeting of 90 health ministers at a meeting in Moscow on non-communicable disease. The meeting, like all global meetings, was something of a trial\u2014see previous blog<\/a>\u2014but the lunch was fun.<\/p>\n

I wasn’t clear exactly who was there, but the meeting included ministers from China, India, Russia, US, Kenya, Uganda, Egypt, Greece, Chile, and Britain\u2014so much of the world’s population was represented. Margaret Chan, director general of WHO, was also there\u2014so the whole world was represented in some way.<\/p>\n

We had two questions to try and answer (see below), and my job had three parts\u2014get as many ministers as possible to speak, not let anybody speak for too long, and oblige them to stick to the question. (I was warned before that \u201cministers like to speak a lot and often not on the point.\u201d)\u00a0 I think that I did not too badly, and I was pleased that we heard from several ministers from smaller countries, particularly those from islands in the Western Pacific, which have some of the world’s highest rates of NCDs. The same ministers, mostly those from big countries, dominated the conference set pieces.<\/p>\n

One disappointment was that there weren’t more jokes, but the Italian minister quipped that Berlusconi would certainly come to the UN’s September meeting because his friend Putin was coming. (\u201cA fairly distasteful couple,\u201d I thought to myself.) I tried pinning down Kathleen Sebelius, the US minister, on whether Obama would come. Understandably she didn’t make any commitment but did say that even if Obama didn’t come his wife might because she has such an interest in obesity. She then added that if Will and Kate were to come everybody would come.<\/p>\n

About 25 ministers spoke, but sadly nobody wrote down what they said. I couldn’t as I was skipping from table to table with the microphone, but after the meeting I tried to remember as many answers as I could, and here they are:<\/p>\n

Question one: How to get heads of state or government to attend the UN High Level Meeting on NCDs in New York in September?<\/strong><\/p>\n

1.\u00a0Send a personal invitation from Ban Ki-Moon, Barack Obama, and Margaret Chan
\n2.\u00a0Let it be known as heads of state or government declare that they will go. (Did Prime Minister Putin accept? It wasn\u2019t quite clear.)
\n3.\u00a0Make an economic case for high level action on NCDs
\n4.\u00a0Convince them that it\u2019s a development issue
\n5.\u00a0Convince them that the meeting will lead to practical, affordable steps that will make a difference
\n6.\u00a0Show them how the issue of NCDs relates to climate change and food security, other issues they worry about
\n7.\u00a0Pay their fare
\n8.\u00a0Reassure them that the meeting won\u2019t be just talk
\n9.\u00a0Recognise how little time the heads of state and government have and structure the meeting accordingly
\n10.\u00a0Convince them that this is a public health emergency, worse even than HIV\/AIDS
\n11.\u00a0Generally messages must be shaped around the major concerns of leaders\u2014hence perhaps the emphasis on economics<\/p>\n

Question two: What outcomes do ministers hope for from the UN meeting?<\/strong><\/p>\n

1.\u00a0Action on tobacco, energetic implementation of the Framework Convention on Tobacco Control. But recognition of the problem of poor countries that have substantial income from growing tobacco.
\n2.\u00a0Action on other risk factors
\n3.\u00a0Access to essential drugs and technology
\n4.\u00a0Training of health workers
\n5.\u00a0Strengthening of health systems, particularly primary care
\n6.\u00a0No diminution in efforts on communicable disease, recognition of the importance of both
\n7.\u00a0Support for low and middle income countries to implement changes
\n8.\u00a0Something practical that makes a difference
\n9.\u00a0Generally there were many issues and no clear agreement on priorities (but little time was available and the emphasis was on hearing from many rather than nailing down priorities)<\/p>\n

Competing interest<\/strong>: RS is the director of the UnitedHealth Chronic Disease Initiative. UnitedHealth Group is a for-profit organisation, but its chronic disease initiative is a philanthropic programme. UnitedHealth paid RS\u2019s expenses for attending the meeting, but he facilitated the meeting of ministers on behalf of WHO.<\/em><\/p>\n

See also:<\/strong><\/p>\n