‘We have to live in the future you create’ – Pierre Cooke Jnr, Youth Technical Adviser, Healthy Caribbean Coalition; Barbados National Youth Parliament

Closing the accountability gap

The third and final theme of the Global Forum was accountability, the subject of the morning plenary. Brenda Killen set out the approach of the Independent Accountability Panel (IAP) of Every Women Every Child Every Adolescent: monitoring, review, remedy/action: ‘There is lots of monitoring and data – but this won’t deliver accountability on its own.’ She also urged delegates to identify and support ‘custodians of accountability’, who may be parliamentarians, policymakers, civil society, the independent media (and she welcomed their presence at the Forum), communities and individuals.

The panel discussion demonstrated accountability in theory and practice. Professor Adnan Hyder presented four guiding principles for academics: independence, including establishing a ‘firewall’ between funding of research and the interpretation of data; quality data that is of relevance to countries’ actual needs; supporting evidence-based advocacy; and producing the next generation of leaders. 

Pierre Cooke is one of these leaders, and he talked about the importance of being accountable to young people: ‘the decisions that are made today affect our future – policymakers don’t have to live through it!’ Policymakers themselves were represented by Dr Somaya Al Jowder, who is a physician living with diabetes. Her experiences during her time as one of Bahrain’s first women parliamentarians have reinforced her view that ‘If we don’t work on this as a team, we will never succeed in covering the gap’.

Ensuring accountability of the private sector is essential – including on human rights, as Beatriz Champagne noted. Rankings and scorecards can also help to embolden ‘internal changemakers’ within the companies themselves.

When speaking on measuring and monitoring the pharmaceutical industry to improve access to medicines, Dr Jayasree Iyer, Access to Medicine Foundation. ‘There is an army of investors, who are extremely powerful; this is no longer only about investing in the companies that make the highest profit’.

Sparking discussions, shaping the way ahead at workshops

NCD policies:

• Sustainable financing for NCDs is an ongoing concern, despite clear evidence that there are high returns on investment. Channelling development money into NCDs is essentially future-proofing health for all.

‘NCD interventions need to be prioritised in the international platform for increased funding as domestic finances alone will not solve it’ –Bent Nielsen, World Diabetes Federation

Access to essential medicines is key to achieving the SDG target on NCDs. This can be facilitated by integrated and accurate data, the use of digital tools – and by listening to the voices of people living with NCDs in vulnerable populations such as humanitarian settings.

Social movements and voices for change:

• Think like a broadcaster’ was run in conjunction with BBC StoryWorks, who launched the landmark new short documentary series “Turning the Tide”. Produced in conjunction with the NCD Alliance, the series contains 26 short films depicting the impact of the NCD epidemic across the globe, including: diabetes in Mexico, mental health in South Africa, stroke in Romania, hypertension in Myanmar and psoriasis in the Philippines. The workshop called on delegates to be bold in our storytelling, to know our audience and to trigger emotions, which will more strongly embed our messages and increase media attention.

‘We live in an age where people die more than live with NCDs, and it is still not striking to people!’ -Simon Shelley (BBC StoryWorks)

• Coalitions for NCD advocacy can be broadened by bringing in new sectors and voices in innovative ways. Compromise and creativity are necessary for strong coalitions and ‘We need transparency, even within the coalition’ (Labram Musah, Ghana NCD Alliance).

Accountability – shining a light on the public and private sectors:

• Conflicts of interest with the private sector is a perennial concern – a case of ‘David and Goliath’. There is a fundamental incompatibility between unhealthy commodities and public-health objectives: ‘I don’t care what you are – if you cross the line with what our principles are and what our work is, we won’t engage’ (Deborah Chen, from the Healthy Caribbean Coalition and member of the NCD Alliance Board of Directors). Standards set by civil society should go beyond industry’s own ‘pledges’, to ensure that they are held fully responsible. 
• Only about a third of NCD alliances are currently engaged in activities to hold governments to account. Government non-compliance with existing policies is a major issue across all regions, and civil society needs to strongly encourage government and donors to allocate adequate funding to NCDs.

‘If you close the accountability gap, the investment and leadership gaps will follow’ – Nina Renshaw, NCD Alliance

Interactive spaces 

There is so much value and enjoyment in the informal aspects of the Global Forum. By the end of the Forum, the ‘aspirations wall’ was covered in suggestions in many languages. ‘Community in Action’ posters provided a snapshot of insights into the diversity of the advocacy and research undertaken globally by the NCD Alliance members – including hypertension control in Kenya and the right to health in Colombia.

And to close…

The final plenary asked a panel of delegates for their main takeaways:

We are so much stronger and more credible together. Dr Ibtihal Fadhil quoted an Arabic proverb, ‘You can’t clap with one hand’: we must work across sectors.

‘We have momentum on our side; if we unleash the power of NCD alliance members and activists and patients and government, we stand a good chance of turning the tide’  –Professor Sani Malami, NCD Alliance Nigeria.

Helen Seibel suggested that we should consider alliances’ successes and translate that globally: ‘The solution is probably somewhere in this room, and that gives me a great sense of hope!’

De Marie Hauerslev of NCD Child welcomed the way in which the voice of young people had been reflected not only in the Global Forum itself, but also in the planning process. When Jyotsna Govil asked the youth delegates with ‘Are you ready to pick up the baton?’, there was a chorus of ‘Yes!’ in response.

Katie Dain, CEO NCDA, summarised the Forum as being about inspiration (stories and expertise), determination to close the implementation deficit gaps, and optimism. She also announced that the Global Week of Action on NCDs 2020 will focus on one of the five gaps in the NCD Compass: accountability.

To close the plenary, we were treated to a thoroughly enjoyable video: a rap by Chris Agbega, an Our Views Our Voices advocate from Ghana. You can watch it here - and we guarantee you will be joining in with ‘Enough NCDs, enough, enough!’

In the closing ceremony, Ms Cajsa Lindberg, Our Views Our Voices advocate from Sweden, encouraged delegates to consider a principled approach to their advocacy: ‘Without passion nothing happens; without compassion the wrong things happen’. HE Mrs Sawsan Jafar (Chairman of the Board of Directors, Friends of Cancer Patients, UAE) highlighted the Forum´s launch of the WHO NCD Progress Monitor 2020 which provides rich information and data on country progress; noted the NCD Civil Society Compass which helps with identifying gaps in the NCD response and proposes civil society actions to address those; mentioned collaborating with NCD Child and support of  youth advocates. In recognition of exceptional work to bridge the gaps to improve the NCD response, HE and Todd Harper, President of NCDA, presented the Sharjah Awards for Civil Society Excellence 2020 to the Vietnam NCD Prevention and Control Alliance, the Slovenian NCD Alliance and the Healthy Caribbean Coalition. 

In his closing remarks, Todd Harper highlighted the critical role of civil society to stimulate equitable progress by 2025 and 2030: “Here in Sharjah, we took critical steps as a movement to identify how we can accelerate implementation of life-saving and transformative policies; and how to strengthen our movement to deliver change”.

We have come so far, and there is still so much to be done – it is time to follow Katie Dain’s advice: ‘Let’s up the ante and get on with it!’  

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Particular thanks to the rapporteurs of the workshops, whose feedback has been invaluable in putting this blog together and in informing the final report of the Global Forum: Margianta Surahman Juhanda Dinata, Apoorva Gomber, Daniel Hunt, Nimal Mohamed, Omnia el Omrani and Stephanie Whiteman.