By Thomas Alexander
Principal Deputy Director for Global Affairs
U.S. Department of Health and human Services
Mr. Thomas Alexander is the Head of the U.S. delegation at the WHO Global Conference on Noncommunicable Diseases (NCDs).
United States Government Statement on the Montevideo Roadmap
The United States thanks Uruguay for convening and leading the WHO Global Conference on Noncommunicable Diseases (NCDs) and the many hours spent in developing the Montevideo Roadmap with co-chairs Finland and Russia. We consider the Roadmap to be a “snapshot” of the current state of discussion on NCDs.
The United States strongly supports efforts to combat non-communicable diseases. We believe that the best approach to addressing the global rise in incidence of NCDs requires identifying and pursuing comprehensive, cost-effective, evidence-based, and multi-sectoral strategies. Strategies should be appropriate to each national context, and consistent with Member States’ domestic and international obligations, including trade obligations. We applaud efforts to encourage universal health access, understanding that each country will develop a system within their own contexts and priorities and that efforts to expand access do not imply primarily government-centric solutions or mandates which we do not support.
The Montevideo Roadmap does note the benefits of broad engagement across sectors, including the need to leverage the strengths of the private and public sectors to tackle the complex challenge of NCDs. However, we emphasize that it is not the role of UN agencies or other multilateral bodies to advocate for a particular outcome in legal challenges, whether local or international disputes, to which they are not a party.
In addition, any work to evaluate the impact of policies on health outcomes should be inclusive, evidence-based, and take a holistic approach that considers all economic factors. We urge the WHO Global Coordination Mechanism to take an interdisciplinary approach that includes diverse experts as well as entities with equities in this dialogue.
We note the particular focus on tobacco taxation as a tool for promoting public health. The consumption of tobacco is addictive, inherently unhealthy, and therefore distinct from other risk factors for NCDs. Therefore, given the distinct nature of tobacco, we cannot effectively advance public health goals by attempting to base national strategies to control NCDs primarily on experience with tobacco.
A better approach is to work together to find common ground on a set of principles to prevent and control NCDs. We look forward to working with WHO and other nations in achieving this end, including close examination at the upcoming Executive Board and World Health Assembly meetings on how to incorporate cooperation among all sectors.