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Increasing engagement with government sectors, civil society and local communities. Key messages from the 2023 Multistakeholder Gathering on NCDs

On Thursday, 14th September 2023, the World Health Organization, NCD Alliance and the Word Diabetes Foundation co-hosted the second Multistakeholder Gathering to Accelerate Progress on the Sustainable Development Goal (SDG) target 3.4 and Universal Health Coverage (UHC). The event took place in the lead up to the second annual Gathering of the Global Group of Heads of State and Government for NCDs for the Global NCD Compact, held in the margins of the UN High-level Meetings on Universal Health Coverage in New York.

More than 500 participants dialeld into this second Multistakeholder Gathering on NCDs, bearing the slogan “Breaking boundaries, building bridges through sustainable multisectoral and multistakeholder collaboration”. The event also marked the official launch of the 2023 Global Week of Action on NCDs, and featured the global release of a landmark WHO report on multisectoral actions to strengthen the prevention and control of noncommunicable diseases and mental health conditions.

Representatives from countries featured in the global mapping report were among the key speakers of the Gathering, sharing their experiences and lessons in sustaining government collaboration for the prevention and control of NCDs and mental health conditions.

This article summarizes key lessons and priority areas in advancing whole-of-government (multisectoral) and whole-of-society (multistakeholder) approaches to tackling NCDs along the three main themes of the gathering: governance and leadership, role of civil society and effective involvement of non-health sectors.

Governance and leadership for multisectoral and multistakeholder collaboration

Effective multisectoral collaboration builds on active cooperation and policy coherence from the very onset of new government initiatives. This often requires direct support from actors with sufficient decision-making and convening power.  “A strong authorizing environment by the highest elected official in Tasmania, the Premier, was instrumental for enabling multisectoral action on health and wellbeing”, said Scoot McKeown, the Deputy Director of Public Health, Tasmania, Australia summarizing their work.

H.E. Dr Isaura Nyusi, First Lady of Mozambique, advocated to build cross-sectoral capacity on NCD prevention and control across all government sectors. “We should aim at implementing multisectoral actions that we already know that are effective in reducing the burden of NCDs. This includes ensuring adequate technical resources across all governmental sectors”, she observed.

 

“We should aim at implementing multisectoral actions that we already know that are effective in reducing the burden of NCDs. This includes ensuring adequate technical resources across all governmental sectors and the sustained involvement of civil society organizations and the community.”

- H.E. Dr Isaura Nyusi, First Lady of Mozambique -

Involving multiple government sectors also has the potential to strengthen health system resilience and adaptability. “Our multisectoral and multistakeholder task force on NCDs in Palau gives us a  upstream perspective on NCDs and their risk factors. Yet, we also need to look upstream in our health system and continuously realign and reorganize ourselves to ensure we remain effective in our efforts to remain one step ahead of the NCD crisis, said Gaafar Uberbelau, Hon Minister of Health and Human Services of Palau.

 

Perspectives from governments beyond health

Kickstarting multisectoral collaboration sometimes first calls for a narrative shift, reframing the NCD challenge as an issue with social, economic, cultural, or environmental factettes. “In the Philippines, we embraced promoting active public transport as a way to reduce pollution, create more inclusive and sustainable communities, and improve our health”, said Anneli R. Lontoc, Undersecretary for Road Transport and Infrastructure at the Department of Transportation of the Philippines.

Valuing inputs from different sectors, disciplines and stakeholders opens pathways to tackling complex health and health equity challenges. To develop Canada’s quality of life framework, for example, a truly multidisciplinary and data-driven strategy was crucial. “Measuring quality of life in all of its aspects becomes feasible when everyone can see themselves as instrumental to a shared goal. We know that if our partners do not trust our process, they will not trust our product, and the best way to ensure that trust is through effective collaboration”, recalled Josée Begin, Assistant Chief Statistician at Statistics Canada.

 

“We are securing continuity in our actions through the formalization of a municipal agreement whereby health will continue to be integrated in all municipal strategic planning and the fight on NCDs can be done with a long-term view.”

- Fabio Medrano, Mayor of Paipa, Colombia -

At the local level, the formal integration of NCD metrics and actions into local and national budget planning mechanisms can also help to engage non-health sector and sustain multisectoral initiatives over time. "We aim to formalize health surveillance as part of our municipal strategic planning, which allows us to fight NCDs in an integrated, long-term way”, explained Fabio Medrano, the Mayor of Paipa, a municipality in Colombia.

Partnerships for enhancing impact: governments and civil society organizations

Successful collaboration among government sectors often includes active civil society engagement, for instance involving people living with NCDs, family and community members, or health professionals. “For our school health programme, we coupled experience from the ground level with expertise from the Ministry of Education. This allowed us to develop highly effective health promotion and self-monitoring tools for young children and their families, empower both as agents for of a healthier lifestyle”, said Sumudu Seneviratne, a Consultant Paediatric Endocrinologist in Sri Lanka (read more here).

“We do not go to government with a complete programme but rather work together in conceptualizing what can be effectively done. Being reliable and transparent proved to be key to build trust and enable a nationwide expansion of diabetes and NCD clinics.”

- Kaushik Ramaiya, Hon General Secretary, Tanzania NCD Alliance -

Civils society organizations often hold key expertise and technical resources to implement NCD prevention and control measures or mental health programmes on the ground. In Tanzania, the national NCD Program includes the Tanzania Diabetes Association and the Tanzania NCD Alliance as equal implementing partners. “We do not approach the government with a complete programme, but rather conceptualize together what can be effectively done. This built trust and enabled us to expand diabetes and NCD clinics all across the country, remarked Kaushik Ramaiya, Hon General Secretary of Tanzania NCD Alliance.

In Brazil, some local community initiatives to reduce childhood obesity made it all the way to changing national policy. “While the government has the mandate to act universally, civil society organizations can work with specific groups, test methodologies, and develop social technologies to be scaled up. Collaborating with multiple stakeholders can thus leapfrog and accelerate action for a more effective response to pressing health and social issues”, said Renata Couto, Executive Director at the Instituto Desiderata.

Advancing multisectoral action and multistakeholder collaboration on NCDs

These and additional key messages, calls to action and inspirational quotes from the 2023 Multistakeholder Gathering are assembled in a briefing document and haven been shared with the second annual Gathering of the Global Group of Heads of State and Government for NCDs for the Global NCD Compact.

WHO is committed to support Member States and Civil Society partners in fostering multisectoral action and multistakeholder collaboration. Download the landmark, global mapping report on multisectoral action, explore the interactive country repository, or discover the latest country stories on multisectoral action.