Borrowing a Revolution

Congratulations to Daniel J. Barker, winner of the second CSIS Blog Contest on NCDs!  In the upcoming weeks, we will post some of the other great entries that were finalists for the contest.  Thank you for your submissions.

Question: Do you think it's possible to create a unified social movement for NCDs, akin to the movements that already exist for individual chronic diseases? If so, why? If not, what initiatives can we implement in the place of an effective social movement to move an NCD agenda forward?

Daniel J. Barker
Fellow, Institute for International Public Policy, and Managing Editor, the Global Health Governance Journal

A unified social movement for NCDs isn’t in the cards.

Building a movement around a diverse set of diseases with broad and varying constituencies just won’t work.

What we need evolution and revolution in the way we think about combating chronic disease.

In 2009, Michel Sidibé, the Executive Director of UNAIDS, announced that it was time for a “prevention revolution” in the fight against HIV/AIDS. He articulated what we learned in epidemiology 101—treating those who are sick is absolutely essential, but the only way we can actually beat an epidemic is to prevent it from growing.

Those hoping to build a movement for NCDs have focused on the lessons that can be garnered from the early days of the fight against HIV/AIDS. But we can’t forget that we are in very different situation from the AIDS activists of the 1980s and early 1990s, who were fighting a mysterious illness with unknown origins and no treatment options.

Instead, we are at an incredibly unique moment and vantage point in time, with knowledge and tools that those early HIV/AIDS activists could not have dreamed of. We know our epidemic. We know how it is caused, we know what the risk factors are, and we have even estimated how and when it will hit us and how much it will cost.

What we need is “prevention revolution” for NCDs that will use the information we have to change the way we think about combating illness. This revolution would shift the focus from what currently divides the NCD community—specific diseases and conditions—to what unites it—the need to address shared risk factors.

Many will lament, correctly, that changing lifestyles—eating, drinking, and smoking habits—is incredibly difficult.

But we have examples of real success, from the change in attitudes in the United States around tobacco use, to growing awareness in India and China about the dangers of diabetes and unbalanced diets.

Currently, initiatives like President Clinton’s Alliance for the Healthier Generation and First Lady Michelle Obama’s “Let’s Move” campaign are demonstrating how top-down approaches can bring diverse constituencies together to focus on healthy lifestyles (here’s to hoping that they will be equally successful in encouraging their spouses to attend the UN NCDs Summit!).

This kind of broad based coalition building, with government educating and regulating, civil society advocating, and industry becoming a responsible stakeholder, is what will lead to a prevention revolution and real success in the fight against NCDs.

The movement will be more diffuse, less focused, and perhaps more chaotic than past initiatives. But it will also be more flexible and adaptable. It will bring advocates together, rather than separate them over a competition for resources. It will allow cash strapped governments to take the most cost-effective and sustainable path toward preventing economic catastrophe. Even industry will be able to realize benefit in a healthier population ready and able to consume more nutritious products.

Rather than searching for the next viral video or social media campaign to launch the NCDs movement, we must get down to the much harder work of revolutionizing the way we think about how to combat chronic disease.

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