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A new vision for tackling the global noncommunicable diseases (NCDs) crisis has failed to reach consensus at the UN after the US refused to give its support, forcing member states to a vote.
After months of negotiations, the fourth political declaration on NCDs and mental health received overwhelming backing from governments at the UN general assembly on Thursday, but was rejected by the US during a speech by Robert F Kennedy Jr, the health secretary.
Addressing the assembly, he said: “We cannot accept language that pushes destructive gender ideology. Neither can we accept claims of a constitutional or international right to abortion.
“[The declaration] exceeds the UN’s proper role while ignoring the most pressing health issues, and that’s why the United States will reject it.”
There is no mention of reproductive rights or gender in the declaration except in reference to specific challenges facing women.
Despite the US’s stance, the declaration is expected to be agreed in the coming weeks. “The unity we saw today proves that most governments are ready to take the baton on NCDs,” said Katie Dain, chief executive of the NCD Alliance.
The declaration includes new targets to track and accelerate responses to NCDs such as heart disease, cancer, diabetes and chronic respiratory diseases, which cause 43 million deaths a year – 75% of all deaths worldwide. The majority (80%) are preventable.
It also strongly urges access to affordable medicines and integrates mental health and diseases such as oral and renal conditions.
But health experts criticised the failure to recommend harsher taxes on alcohol, tobacco and sugary drinks.
Commitments to such levies were included in an earlier draft but were absent from the final declaration after intense lobbying by tobacco, alcohol, and food and drink companies. Sugary drinks are not mentioned at all.
Alison Cox, policy and advocacy director of the NCD Alliance, said the watered-down declaration had missed an opportunity to reduce consumption of harmful products and raise much-needed funds for health care. Only 19 countries are on track to meet the UN goal (SDG 3.4) to reduce by one third premature mortality from NCDs by 2030, through prevention and treatment.
She said: “We thought the moment had come. All the agreement [by governments] about investing in health protection is being lost to the interests of a few industries who are externalising the effects of their products onto economies.”
Alcohol, tobacco and ultra-processed food and drink are key drivers of obesity, a major cause of NCDs.
By 2035, 4 billion people will be living with overweight and obesity. A Unicef report published earlier this month found that, for the first time, more children around the world are obese than underweight, with low and middle income countries seeing the fastest rise.
“These countries, where health systems, food systems, social protection systems are fragile, can least afford the problems that arise [from obesity],” Dr Joan Matji, director of child nutrition and development at Unicef told the World Obesity Forum in New York this week, ahead of the NCD meeting.
“Everywhere children go, shops, restaurants, schools, sports event, while watching TV or scrolling social media children are surrounded by ultra-processed foods (UPFs) that are cheap and aggressively marketed. We know UPFs are highly profitable, giving the food industry amazing power and influence.”
Mexico, which first introduced a sugar tax in 2014, is planning to increase the levy by 40%, bringing $3.2bn a year in revenue that will go towards a health fund.
The country is one of the world’s highest consumers of sugary drinks, with devastating consequences for public health: one in three Mexican children are overweight or obese, while diabetes, at 100,000 deaths a year, is the nation’s second-leading cause of death.
Speaking at the obesity forum, Ramiro López Elizalde, Mexico’s vice-minister of health, said: “Obesity is the silent epidemic of our time. While [drinks company] executives make decisions on golf courses, millions are connected to a dialysis machine. The defenders of the soda industry say [the soda tax] is only about revenue – they are wrong – we seek to reduce consumption.
“This is not just a health crisis but about social and environmental justice; the same industry that makes our children sick pollutes our rivers. Human life is not a market; it is a right we must defend.”
