By Victoria Watson, Research Analyst and Global Health Corps Fellow at CHANGE
This fall, I attended the United Nations General Assembly (UNGA)'s third high-level meeting on the prevention and control of non-communicable diseases (NCDs). As a first-time delegate and panelist from Canada, I was excited to see countries come together and commit to new ways of eliminating avoidable deaths from diseases, such as heart and lung diseases, cancers and diabetes, and mental health.
In some ways, I was not disappointed: By the end of the high-level meeting, the General Assembly enthusiastically adopted the NCD political declaration, including many new commitments to reduce NCD mortality by a third by 2030.
But noticeably missing from the meeting was any explicit mention of women’s health issues – sexual and reproductive health specifically. This is significant because preventing NCDs — from preconception through pregnancy, infancy, childhood, and adulthood — is a direct opportunity to prevent diseases afflicting women and girls, and improve how they access healthcare. As stated by the Pan-American Health Organization (PAHO), biological differences, gender roles, and social marginalization expose women to different NCD risks, influence risk behaviors, and the appropriateness of interventions. A woman’s health also impacts the wellbeing of her children. Simply put, one cannot extract gender from the NCD equation.
The absence of women’s health issues was not because of a lack of advocacy, however.
Prior to the meeting, civil society organizations raised their voices during UNGA to highlight the need for cross-cutting interventions that address NCDs and gendered health issues, especially for younger populations. A series of global health milestones that centered women’s needs in NCD action supported civil society voices. In 2017, the World Health Organization (WHO) designated the human papillomavirus (HPV) vaccination as one of the NDC ‘best buys,’ which are essential interventions for countries to adopt to address NCDs. In Australia, HPV is poised to be eliminated through vaccination. Hopefully, this would inspire discussion around the intersection of NCDs and women’s health.
Such discussion did happen at certain UNGA events regarding cervical cancer and HPV prevention. "We have the tools in our hands to end deaths from cervical cancer … energized by funders’ and policy-makers’ growing interest in giving every girl and woman access to those tools,” said Celina Schocken, executive director of TogetHER, at an UNGA side-event called “Accelerating the global elimination of cervical cancer” hosted by the American Cancer Society and the Union for International Cancer Control (UICC).
Her Royal Highness Princess Dina Mired of Jordan, president-elect of UICC agreed, and emphasized the need to prioritize access to health care for girls and women. “The opportunity to protect girls and women is not available to all,” she said. “Cervical cancer is treatable when found at an early stage and we can help manage the disease, but again these critical services are not available to all.”
The unmet need for health services to address NCDs for adolescent girls and women was especially clear when teenage girls from across the world advocated at UNGA through the help of NCD Child, a coalition advocating for children’s rights in healthcare.
While at UNGA I met Spoorthy Samatvam, a 13-year-old girl from India whose entire village raised the money for her to travel to UNGA and make her needs known. She expressed an urgent necessity for health education at all levels to increase awareness of health issues among Indian youth and their families in order to improve health for young girls.
She was one of five girls I met, all under the age of 20, who had traveled from across the world to attend UNGA. They were there to make sure their voices were heard by the government officials who would soon make decisions at the high-level meeting that could directly affect their healthcare.
Spoorthy’s message, together with the voices of other young women at UNGA, demonstrated the magnitude of the need for greater awareness of NCDs and related SRH issues.
The absence of any commitments directly impacting health issues experienced by women and girls in the declaration adopted at the high-level meeting showed how much more work needs to be done to make gendered health needs included in global health action.
It’s time to bring attention to all of the links between NCDs and women’s health, and in doing so improve the health of future generations. For civil society and governments, this begins today through the acknowledgement and planning of strategies to fully address the sexual and reproductive health needs of girls and young women as they relate to the prevention of NCDs.
Dr. Tedros Adhanom Ghebreyesus, WHO’s director-general, urged political action by clarifying that the 41 million people dying prematurely of NCDs every year is preventable – as long as countries act fast. Such action must also urgently prioritize women's health, or risk failing their needs entirely.