Working Together Globally:
Canada’s World Health Organization (WHO) Collaborating Centre on Chronic Noncommunicable Disease Policy

The Public Health Agency of Canada’s World Health Organization (WHO) Collaborating Centre on chronic noncommunicable disease policy is a designated centre of excellence. A collaborating centre is an institution designated by the WHO to form part of an international collaborative network to exchange information and develop technical cooperation with other institutions. This Collaborating Centre is unique as the only collaborating centre in the world dedicated to chronic disease policy and is recognized as a global authority in chronic disease policy development, implementation and evaluation.

Collectively, chronic diseases – also referred to as noncommunicable diseases – are a growing global epidemic. Chronic diseases such as arthritis, diabetes, cancer, cardiovascular diseases, respiratory diseases, and mental illness account for the highest causes of preventable death in Canada and the world. Chronic diseases also constitute the largest avoidable burden on the public health care system.

Working together globally is essential to helping prevent and control chronic illness. Canada shares with the world the same risk factors: high fat and high sugar processed foods, sedentary lifestyle and consumption of tobacco and alcohol products.

Public health policy is the roadmap that guides how best to take action in reducing chronic disease. National health policy informed by global “best practices” leads to direct action at the community level and affects the choices made by individuals. Improving the lives of individuals through effective health policy globally is in Canada’s health interest.

This online resource is a hub to share state-of-the-art knowledge and tools to help prevent and reduce chronic disease. Here, public health policymakers and practitioners around the world can find essential information about chronic disease health policy research, training, evaluation, capacity building and partnership initiatives.

• A Vital Part of the Public Health Agency of Canada Action Plan 2007-2012
• What We Do
• Benefits to Canadians
• Building Momentum
• Policy Development in Action
• Sharing Lessons Learned
• Our Partners
• Chronic Disease Policy Resources
• Frequently Asked Questions (FAQs)

A Vital Part of the Public Health Agency of Canada Strategic Plan 2007 – 2012

Chronic diseases, sometimes referred to as noncommunicable diseases or NCDs, account for the highest causes of death in Canada and the world. NCDs include a variety of chronic diseases such as arthritis, diabetes, cancer, cardiovascular diseases, respiratory diseases, and mental illness.

The Public Health Agency of Canada (PHAC) supports the WHO Collaborating Centre on chronic noncommunicable disease policy. PHAC provides public health practitioners in Canada and worldwide with data, analysis, web tools and technical advice that support policies, programs and public health interventions for chronic disease prevention.

PHAC’s Strategic Plan 2007-2012 promotes a strong international public health infrastructure and helps to reduce the risk factors leading to chronic illnesses by sharing Canada’s leadership and expertise in NCD health policy development. Through strategic global partnerships, international cooperation and dialogue, we also learn about successful initiatives in other countries.

The WHO Collaborating Centre on chronic noncommunicable disease policy delivers on PHAC’s objectives by working in an international context to share Canada’s expertise to promote health policy planning, implementation and evaluation to combat global noncommunicable diseases. First designated in 1994 [with successful subsequent redesignation every four years by the World Health Organization (WHO) ], the Centre is recognized as a worldwide centre of excellence in the development, implementation and evaluation of NCD public health policy. The WHO Collaborating Centre reports activities annually to World Health Organization Headquarters (WHO HQ) and its regional body, the Pan American Health Organization (PAHO) to advance NCD prevention and control policies in Canada and around the world.

Through PHAC’s policy initiatives as a contributing member of WHO, public health policymakers and practitioners in Canada and worldwide can find essential information about chronic disease health policy research, training, evaluation, capacity building and partnership initiatives.

What We Do

At the Public Health Agency of Canada (PHAC), the WHO Collaborating Centre on chronic noncommunicable disease policy promotes leadership and innovation to combat noncommunicable disease (NCD) through public health policy planning, implementation and evaluation activities.

In Canada and around the world, the WHO Collaborating Centre shares leading-edge knowledge and practical tools pertaining to policy monitoring, policy research, policy training and capacity building, policy dialogue, policy partnership initiatives, policy outreach, and policy legislation development.

Policy Monitoring

Monitoring NCD public health policy strengthens the national and global roadmap that guides how best to take action in reducing chronic disease at the practical level.

Policy Research

Policy research expands the body of knowledge about best practices in reducing NCDs. Policy research may involve primary or secondary research (or a synthesis of the two), scenario development, foresight modeling, qualitative and quantitative research methods, as well as lessons learned from practical experience in developing and deploying innovative methodological approaches and technological tools.

Policy Training and Capacity Building

Policy training and capacity building enlarge the field of expertise to prevent and control NCDs through the dissemination of methodological approaches and technical tools.

Policy Dialogue

Policy dialogue is a method that allows research evidence to be considered together with the views, experiences and knowledge of those who will be involved in or affected by policy decisions. Policy dialogue promotes the continuous exchange of emerging NCD public health policy information and initiatives at the country or sub-regional level (e.g. the Caribbean, Central America) to help policymakers and practitioners to formulate effective development, implementation and evaluation of strategies to reduce NCDs.

Policy Partnership Initiatives

Policy partnership initiatives encourage the sharing of knowledge and resources between participating partners and promote cross-disciplinary, cross-sectoral and cross-cultural perspectives to stimulate action that changes risks to populations and health determinants.

Policy Outreach

Through outreach activities such as presentations and publications, the WHO Collaborating Centre disseminates recent developments in chronic disease policy research and best practices. The state-of-the-art knowledge that is shared assists policymakers in making effective and informed public health policy decisions, in Canada and around the world.

Policy Legislation Development

Legislation is the enactment of public health policy compelling specific actions for the prevention and control of chronic or noncommunicable diseases. The enforcement of supportive health measures, such as banning smoking in public places, together with consequences for failure to comply, are cornerstones in controlling the risk factors that contribute to chronic disease.

Benefits to Canadians

The Public Health Agency of Canada’s World Health Organization (WHO) Collaborating Centre on chronic noncommunicable disease policy works nationally and internationally through collaborative initiatives, partnership frameworks, grants to support research and distribution of emerging chronic disease policy knowledge.

Public health policy is the roadmap that guides how best to take concrete action in reducing chronic disease at the practical level. National health policy informed by global “best practices” promotes effective action at the community and individual level. Improving the lives of individuals through effective global health policy is in Canada’s health interest.

A Globalized World

Canadians live in an increasingly globalized world with interconnected economies and health challenges. Our partnerships provide access to breakthrough scientific research and developments in the field of chronic disease prevention and treatment. Collaborative, multilateral action is key to tackling the many components that contribute to chronic disease.

A Foreign Policy Priority

The Americas are and will remain a foreign policy priority (Government of Canada, Canada and the Americas: Priorities and Progress, 2009). Canada, as a country of the Americas, plays a special leadership role through PHAC’s WHO Collaborating Centre on chronic noncommunicable disease policy as a co-lead with the Pan American Health Organization in the CARMEN Policy Observatory. (CARMEN is a network of 32 countries in the PAHO region committed to shared solutions in reducing chronic diseases through integrated, evidence-based prevention and control programs).

Creative Solutions

Working across political and professional boundaries through intersectoral collaboration promotes a strong knowledge base and new approaches to reducing chronic disease mortality and morbidity rates.

Cost-Effectiveness

Contributing to the development and dissemination of internationally recognized best practices helps improve cost-effectiveness by promoting sound investments in high-impact interventions. Collaborating helps strengthen our approach to reducing the burden of chronic disease in Canada while ensuring good value for money.

Canada’s Reputation

Canada is known internationally for its advanced public health systems and plays a leadership role in tackling chronic diseases for Canadians and for the world. Development of advanced chronic disease policy monitoring, research, intervention and evaluation through global health networks is in Canada’s best interest.

A Fundamental Value

Canada promotes key Canadian values such as equitable access to health care through its participation in international organizations. Promoting healthy living and reducing chronic disease is a public health priority for Canada. Canada is committed to developing and sharing tools and best practices to help build capacity for all nations through its partnership with the World Health Organization (WHO) .

Building momentum to tackle the global health challenge of the 21st century

By 2015 it is projected that more than 40 million people will die annually from chronic diseases. Chronic diseases impose a much greater burden on poor countries and poor populations than on richer economies and must be tackled as a development issue.

The challenge of chronic disease worldwide requires the reduction of economic disparity between global citizens and effective access to healthy lifestyle and preventative medical care. There is a new and urgent global priority to address chronic diseases and the risk factors that impede effective reduction and control, namely poverty, hunger, social exclusion, discrimination and inequality. In order to empower populations through the promotion of positive lifestyle choices, there must be sustainable access to education, health services and availability of health food choices for consumers.

It also requires a collaborative approach between public health policymakers, non-governmental agencies and private sector entities. Recent high level policy discussions -- and subsequent commitment to multisectoral collaboration to address rising rates of chronic disease -- have stimulated significant international momentum.

Canada works at the frontlines through PHAC’s WHO Collaborating Centre on chronic noncommunicable disease policy through its participation at key junctures in the emerging rise of addressing chronic disease as a global priority.

September 2007
Uniting Against Chronic Diseases:
The CARICOM Summit on Healthy Living and Chronic Disease
Port of Spain, Trinidad and Tobago

The heads of thirteen Caribbean national governments met in Port of Spain, Trinidad and Tobago under the umbrella of the Caribbean Community (CARICOM) Secretariat in September 2007 to work together strategically by sharing knowledge and resources to combat together the effects of chronic diseases and risk factors on their respective populations.

The Summit was organized in partnership with the Pan American Health Organization’s (PAHO) Chronic Disease Unit in conjunction with the CARMEN Policy Observatory, including support from PHAC’s WHO Collaborating Centre on chronic noncommunicable disease policy. (CARMEN the Collaborative Action for Risk Faction Prevention and Effective Management of Noncommunicable Disease, is a network of 32 countries in the Americas, which form one of five major geographical areas of the World Health Organization).

The successful summit marked the convergence of several components. First, the summit was a direct consequence of the advent of a collective Caribbean Cooperation in Health approach to shared health priorities among the member states of CARICOM as a political integration framework. It was also based on the recognition that Caribbean populations are the most seriously affected by the social and economic burden of chronic diseases as a sub-region within PAHO’s CARMEN network.

The summit was also based on a model of cooperation between health, social, legislative, education, agriculture, trade and fiscal sectors, pointing the way to integrative public health policy initiatives where collaboration is the key to successful intervention.

April 2009
Fifth Summit of the Americas:
Securing Our Citizens’ Future by Promoting Human Prosperity, Energy Security and Environmental Sustainability
Port of Spain, Trinidad and Tobago

At the fifth meeting of the member countries of the Americas, a new Declaration of Commitment was drafted including two important articles addressing the commitment to reducing the burden of chronic disease.

Article 28 calls for the promotion of comprehensive and integrated preventive and control strategies at the individual, family, community, national and regional levels. It also reiterates the critical need for innovative collaboration of the public sector, private sector, media, civil society organizations, communities and relevant regional and international partners.

Article 29 specifically instructs the inter-American Ministers of Health to work with the Pan American Health Organization (PAHO) to incorporate the surveillance of chronic disease and associated risk factors into existing national health information reporting systems by 2015.

November 2009
Commonwealth Heads of Government Meeting (CHOGM)
Partnering for a More Equitable and Sustainable Future
Port of Spain, Trinidad and Tobago

The Commonwealth Heads of Government Meeting (CHOGM) is the collective body of 54 Commonwealth countries representing 2 billion people. It is convened every two years to review global, political and economic developments and to conduct a strategic overview of the Commonwealth’s work in support of the interests of member countries.

In November 2009, the theme of the meeting was “Partnering for a more Equitable and Sustainable Future”. Although the main topic of discussion was addressing climate change as a global challenge, chronic disease as a “global health tsunami, threatening the economic and social development of many Commonwealth countries” was positioned as a worldwide health priority. A special statement was issued affirming CHOGM’s commitment “to addressing the burgeoning incidence of noncommunicable diseases (NCDs), and to increasing the ability of our countries to respond to this emerging health crisis.”

May 2010
Commonwealth Health Ministers Meeting
Geneva, Switzerland

At the Commonwealth Health Ministers Meeting, it was agreed that chronic disease indicators would be tabled at the 2010 Millennium Development Goals (MDGs) Review Summit, taking place at the United Nations General Assembly in September 2010 in preparation for the 2011 high level summit on preventing chronic disease. The meeting sought to identify elements of a possible Commonwealth Programme of Action, pursuant to the call by Heads of Government for the consideration of a UN Summit on NCDs. It also provided countries with an opportunity to examine the status of the MDGs in the Commonwealth and the challenges and opportunities that face member nations.

November 2010
CARMEN Policy Observatory Meeting on Chronic Noncommunicable Disease Policy
Port of Spain, Trinidad and Tobago

In preparation for the September 2011 UN Summit on chronic disease, PAHO members, including PHAC’s WHO Collaborating Centre on chronic disease policy as a key member, met to prepare to ensure involvement of Heads of State (through Ministries of Health) by sharing examples of how PAHO/WHO contribute to chronic disease policy development and by supporting WHO in coordinating the summit. PAHO will provide leadership by showing how “whole government” and “whole society” approaches create effective multisectoral collaboration.

September 2011
United Nations General Assembly
New York, USA

The increasing visibility of chronic disease as the world’s leading cause of death, and moreover, the leading cause of preventable death has resulted in a UN resolution to discuss strategies as an urgent priority for the 2011 meeting.

The resolution builds on Objective #1 of the WHO NCD Global Strategy Action Plan 2008-2013 which calls on global development initiatives to take into account the prevention and control of chronic diseases and raise the priority accorded in development work at global and national levels.

All UN member countries are now engaged in preparing surveillance, intervention and policy evaluation activities in preparation for the global summit to address chronic disease, the first time the rising pandemic of noncommunicable disease around the world will be specifically addressed by the international body of heads of government.

2013
World Health Organization Health in All Policies Meeting
Helsinki, Finland

Health is largely determined by factors outside the health care domain. It is widely recognized that decisions made by many sectors can help to influence the conditions that shape the health of the population. Efforts to integrate health considerations into societal policy-making with the aim to improve population health and avoid risk factors of chronic diseases are being considered almost everywhere, at the community level as well as at the national, regional and local levels.

PHAC’s WHO Collaborating Centre on chronic noncommunicable disease policy has committed to work with WHO HQ in preparation of the 2013 Health in All Policies (HiAP) summit to be held in Helsinki. The collaboration will focus on case studies that promote intersectoral policies in battling chronic disease: Mobilizing Intersectoral Action to Promote Health: The Case of ActNowBC (2010) marks the first case study report and accompanying backgrounder in this series.

Policy Development in Action

The World Health Organization (WHO) has encouraged nations to work together to reduce the burden of chronic disease around the world. As the personal and national costs of living with chronic diseases continue to rise, WHO is committed to motivating transformational change and measurable improvements through innovative international and intersectoral partnerships.

By sharing challenges and solutions, emerging proven approaches to public health policy, implementation and evaluation will lead the way for all to significantly reduce disease and the impediments that produce health inequities. Two leading agencies dedicated to reducing chronic diseases have joined forces to address chronic diseases in the Americas together:

• The WHO Collaborating Centre on chronic noncommunicable disease policy is the only chronic disease policy collaborating centre in the world. A vital part of the Public Health Agency of Canada (PHAC), this WHO Collaborating Centre is recognized as a global authority in the analysis of policy development, implementation and evaluation.
• The Pan American Health Organization (PAHO) is an international public health agency working to improve health and living standards of the countries of the Americas. It serves as the specialized organization for health of the Inter-American System and as the WHO Regional Office for the Americas.

Together, PHAC and PAHO lead groundbreaking initiatives to mobilize a higher, more effective level of strategic planning and interdisciplinary critical thinking to drive national health policies.

CARMEN Policy Observatory

The Americas are and will remain a health policy priority for Canada. Canadians have much to gain by being involved in the region, and they also have much to contribute.

Canada’s government has made it clear that re-engagement in the Americas is a critical international priority for our country… Canada is committed to playing a bigger role in the Americas and to doing so for the long term.

Prime Minister Stephen Harper
July 17, 2007

The WHO Collaborating Centre on chronic noncommunicable disease policy at PHAC conducts the CARMEN Policy Observatory jointly with PAHO to promote the expansion of effective systematic chronic disease policy development and implementation using both qualitative and quantitative methodologies. (CARMEN is a network of 32 countries in the PAHO region committed to shared solutions in reducing chronic diseases through integrated, evidence-based prevention and control programs.)

The key areas of activity for the Policy Observatory are policy monitoring and analysis, policy dialogues, policy research, outreach, capacity building and training. The Policy Observatory's broad mandate includes the review of public policies affecting chronic disease prevention, risk factors and risk conditions, as well as relevant legislations and regulations. The Policy Observatory has been successful in boosting the technical capacity of policy analysis in a number of countries of the Americas, and around the world.

Two recent collaborative initiatives between PAHO and PHAC’s WHO Collaborating Centre on chronic disease have yielded groundbreaking results, harnessing strategic planning to immediate action.

The Canada-Chile Technical Cooperation on chronic disease policy

In 2006, Canadian and Chilean public health policy delegates attending the annual Pan American Health Organization (PAHO) Directing Council Meeting forged an ambitious technical cooperation initiative focusing on prevention and control of chronic diseases, a priority for both countries.

The Canada-Chile dialogue produced an innovative framework for sharing technical expertise in the prevention and control of chronic diseases. Working as member nations under the PAHO framework, they developed a three-phase project:

• PHASE 1 (DECEMBER 2007): Canadian representatives from PHAC visited counterparts in Chile to learn about Chilean strategies for chronic disease risk factors and determinants in reduction and control;
• PHASE 2 (AUGUST 2008): Chilean representatives visited counterparts in Canada to learn how chronic disease is managed through public health policy at the national and provincial levels.
• PHASE 3 (SEPTEMBER 2009): The Ministry of Health in Chile hosted an international cross-sectoral dialogue with participating experts from Chile, Canada, Paraguay and Brazil. The dialogues produced the blueprint for a new national plan of action for Chile, and a model for other countries on how international collaboration and knowledge exchange enhances the respective strategic policies of each participant.

The Uniting Against Chronic Diseases Summit

In 2007, the heads of 13 Caribbean national governments met in Port of Spain, Trinidad and Tobago under the umbrella of the Caribbean Community (CARICOM) Secretariat to work together strategically by sharing knowledge and resources to combat together the effects of chronic diseases on their respective populations.

The summit was organized in partnership with PAHO’s Chronic Disease Unit in conjunction with the CARMEN Policy Observatory with support from PHAC’s WHO Collaborating Centre on chronic noncommunicable disease policy. The successful summit established a framework for the complex intersection of several progressive vectors:

• Activation of a collective approach to shared health priorities among the member states of CARICOM as an emerging political integration framework;
• Recognition of Caribbean populations as most seriously affected by the social and economic burden of chronic diseases;
• Collaboration between chronic disease public health policymakers with non-governmental agencies and private sector entities;
• Strategically linking chronic disease prevention and control to empowering populations through the promotion of positive lifestyle choices with access to education, health services and consumer choice;
• Prioritizing national mandates through public policy, legislation and fiscal measures to reduce the negative effects of risk determinants such as tobacco, alcohol and unhealthy foods;
• Intersectoral solutions involving the integration of health, social, legislative and fiscal sectors.

Sharing Lessons Learned

One of the most persistent challenges in combating chronic disease is linking the creation of ambitious public health policies to the delivery of tangible positive effects in actual populations.

Sharing the lessons learned from international dialogue is central to the mandate of the CARMEN Policy Observatory. Through outreach initiatives, PAHO and PHAC’s WHO Collaborating Centre on chronic noncommunicable disease policy share the “best practices” of their past projects.

High level planning sessions, collaborative agreements and dialogues, shared knowledge of best practices, and resources allotted to research and case studies are only meaningful if they can be harnessed to transformational change with an accountability framework to measure causal effects.

Traditionally, public health policy has depended on a linear planning process followed by implementation and evaluation, founded on a singular methodological paradigm and supported by political commitment and a variety of resources.

Emerging cross-disciplinary perspectives and “best practices” case studies have shown that maximum efficacy comes with greater awareness and understanding of the complex and interrelated components required to produce positive change. Many components must be considered together to reduce population mortality and morbidity statistics and produce real life improvements for individuals and communities coping with chronic diseases.

Moreover, a more sophisticated understanding of achieving results must also combine improving the determinants of health that affect chronic diseases (such as individual lifestyle choices) together with the reduction of disparities between population segments (such as reducing unequal access to education, resources and health services).

Defining Project Objectives

At the outset of the project, it is necessary to define project objectives. These objectives, in turn, form a key part of the project accountability framework by providing specific performance indicators against which the effectiveness of the community intervention can be measured. Identifying the objectives also serves to promote greater dialogue among project participants about the importance and approach to measurement of effectiveness and to identify future stakeholders of the eventual performance assessment, such as funding bodies.

Project objectives should reach deeper than achieving dialogue or tabulating statistics. Action should deliver transformational change, measurably delivering individual change, community change and systemic change.

Gathering Data

Prior to launching the project, gather and prepare evidence. Undertake research, if necessary, to ensure that credible and timely information is available to support project objectives.

Defining Methodology

The realist synthesis model developed by Ray Pawson provides a new innovative perspective for evaluating community health interventions by seeking to identify the specific social mechanisms that determine outcomes. The realist synthesis model views health programs as context-dependent and evaluates transformational change by linking the intentions of intervention designers to the complex real-world contexts of how communities respond to programs.

What mechanisms drive an intervention forward successfully, for whom and under what circumstances? It is from the sometimes complicated answers to these questions that forward momentum will be found to create truly effective health programs tailored to best suit the given context. By carefully considering the variable social, political, economic and cultural environments that are proven to foster successful change, health policymakers can identify the transferability of program elements into community programs with comparable contexts.

Analyzing Context

Prior to designing an intervention or program action, it is critical to define and assess the many factors that form the total project context. These can include social, cultural, physical, environmental, economic, political, and gender factors. It is critical to undertake this analysis each time at the onset of a project, as subtle fluctuations within any single or cluster of factors will affect program effectiveness. These “drivers” determine critical decisions in defining resource allocation, target populations, methodology, timing and scope.

Defining Framework

To truly achieve transformational change by reducing chronic disease in populations, and reducing the inequities to achieve health for all, a holistic framework is required. This framework needs to link immediate, intermediate and long-term health outcomes with external contexts and with the proven process components needed for a successful community intervention.

With each community-based intervention, the framework has to be adjusted to consider the particular external contexts that will influence the project parameters. These include social, cultural, physical, environmental, economic, political and gender exigencies. As these contexts are always in flux, assessments and adjustments are critical to create an intervention that can thrive.

Implementing the Process

Moving from intervention planning to action depends on clearly defining the process components and the underlying drivers or mechanisms to power the process.

Collaborative Planning Mechanisms

Transformational change works best when the power of strategic partnerships is harnessed to expand scope, resources and reach. Collaborative planning mechanisms include:

• Meaningful participation of all stakeholders
• Engaging in critical dialogue
• Sharing power and responsibility
• Planning and evaluating project action

Community Organization and Action Mechanisms

Effective interventions depend upon strong project governance and vigilance over the process:

• Evolving leadership
• Sustained mobilization of resources
• Critical reflection and systematic monitoring
• Ongoing educational and training opportunities

Transformational Change Mechanisms

Community-based interventions should seek to achieve transformational change, that is individual change, community change and systemic change. The mechanisms for transformational change include:

• Developing and attracting champions
• Generating public awareness of evidence-based project successes
• Influencing public policy and decision-making bodies
• Working with relevant social movements, private sector organizations and advocacy groups
• Improving knowledge exchange and community-academic partnerships

Evaluating Impact

Designing and delivering interventions are only part of the equation. These have to take root in the community and improve both health indicators and reduce health disparities between communities. These impacts or outcomes are linked to the project objectives established at the outset of the project. In planning evaluation, objective and subjective indicators must be defined as well as methods for quantitative and qualitative data collection.

Evaluation is the key to measuring success. An analytical method assigning relative values to each mechanism has been developed by PHAC’s WHO Collaborating Centre on chronic noncommunicable disease policy in collaboration with the Canadian Consortium for Health Promotion Research synthesizing all intervention process mechanisms into an impact index. This impact index is correlated to an outcomes index and the final score is weighted by the local context.

The impact index looks backward as an accountability measure gauging the success of the investment in community-based interventions and also forward providing guidance on future policy and funding decisions.

Our Partners

PHAC’s WHO Collaborating Centre provides leadership in chronic or noncommunicable disease policy development, implementation and evaluation through active collaborative projects, through collaboration with strategic partnership networks and initiatives:

WHO’s The Global Noncommunicable Disease Network (NCDnet)

The World Health Organization’s 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases 2013 specifically calls upon international partners, Member States and WHO to promote partnerships for the prevention and control of noncommunicable diseases (NCDs).

NCDnet is a resource for the global health policy community providing practical tools and resources to support monitoring and evaluation in the prevention and control of chronic or noncommunicable diseases (NCDs). PHAC’s WHO Collaborating Centre is leading the evaluation of the success of NCDnet as a partnership vehicle and plays a vital role by assisting in the performance measurement of the implementation of WHO’s Global Action Plan.

Pan American Health Organization (PAHO)

PHAC’s WHO Collaborating Centre is a contributing partner in the Pan American Health Organization public policies on noncommunicable diseases (NCDs). PAHO is an international public health agency with more than 100 years of experience in working to improve health and living standards of the countries of the Americas. It serves as the specialized organization for health of the Inter-American System. It also serves as the Regional Office for the Americas of the World Health Organization and enjoys international recognition as part of the United Nations system.

PAHO has a Regional Strategy and Plan of Action on an Integrated Approach to the Prevention and Control of Chronic Diseases . One of the approaches is to create multisectoral partnerships and networks for chronic disease, creating the Partners Forum . PHAC’s WHO Collaborating Centre is a pillar of the regional NCD strategy.

Canadian Best Practices Portal for Health Promotion and Chronic Disease Prevention

A central and early component of the Canadian Best Practices System, the Portal provides relevant and accessible best practices information to enhance decision making.

Canadian Coalition for Global Health Research (CCGHR)

The Canadian Coalition for Global Health Research is a not-for-profit organization governed by a volunteer Board. The Coalition began in 2001 as an informal network and has evolved through generous support from the Canadian International Development Agency , the Canadian Institutes of Health Research , Health Canada , the International Development Research Centre and other foundations. The Coalition’s primary focus is on research to improve health in low- and middle-income countries (LMICs) in Africa, Asia and Latin America.

Canadian Institutes for Health Research

Canadian Institutes of Health Research (CIHR) is the major federal agency responsible for funding health research in Canada. It aims to excel in the creation of new health knowledge, and to translate that knowledge from the research setting into real world applications. The results are improved health for Canadians, more effective health services and products, and a strengthened Canadian health care system.

Canadian International Development Agency

Canadian International Development Agency (CIDA) is the lead player in delivering Canada’s official development assistance program. Its mission is to support sustainable development in order to reduce poverty and to contribute to a more secure, equitable and prosperous world.

Canadian Society for International Health

The Canadian Society for International Health (CSIH) is a national non-governmental organization that works domestically and internationally to reduce global health inequities and strengthen health systems.

The CARMEN Policy Observatory

The CARMEN Policy Observatory is a joint initiative between PHAC’s WHO Collaborating Centre on chronic noncommunicable disease and the Pan American Health Organization (PAHO). The purpose of the Observatory is to promote the expansion of effective systematic NCD policy development and implementation using both qualitative and quantitative methodologies. The Observatory also fosters strong international and pan-sectoral NCD-prevention collaborations and shares its findings through a variety of channels including publications, websites and international policy dialogues and conferences.

Centers for Disease Control and Prevention (USA)

CDC’s National Center for Chronic Disease Prevention and Health Promotion is at the forefront of prevention and control chronic diseases. The CDC conducts studies to better understand the causes of these diseases, supports programs to promote healthy behaviors, and monitors the health of the nation through surveys. Critical to the success of these efforts are partnerships with state health and education agencies, voluntary associations, private organizations, and other federal agencies. Together, the center and its partners are working to create a healthier nation.

Chronic Disease Prevention Alliance of Canada

The Chronic Disease Prevention Alliance of Canada (CDPAC) is a networked community of organizations and individuals who share a common vision for an integrated system of chronic disease prevention in Canada.

Chronic Diseases and Injuries in Canada Journal

Chronic Diseases and Injuries in Canada (CDIC) is a quarterly scientific journal focusing on current evidence relevant to the control and prevention of noncommunicable (chronic) diseases and injuries in Canada. The journal publishes a unique blend of peer-reviewed feature articles by authors from the public and private sectors that may include research from such fields as epidemiology, public/community health, biostatistics, behavioural sciences and health services.

Economic Burden of Illness in Canada

Health Canada first published the Economic Burden of Illness in Canada (EBIC) in 1991 and again in 1997. The overwhelming response to these original reports and continued requests for more detailed cost-of-illness information indicated the need for an up-to-date revision that would provide even more detail than the first two reports.

National Collaborating Centres for Public Health

The purpose of the Centres is to foster linkages throughout the public health system. A key function is to connect, co-operate, collaborate and communicate with all stakeholders in the public health community, including the provinces and territories, international experts, academia, non-governmental organizations, the research community and health practitioners.

World Bank

Since 1945, Canada and the World Bank have worked together, with other member governments, to create a world based on a common vision. As our knowledge and understanding of the world have changed and grown over the last sixty years, so has that vision. Today, we continue to work together to finance projects, design policies and deliver programs in an effort to eliminate poverty and create a world based on the principles of sustainable development.

World Health Organization (WHO): European Regional Strategy

In the WHO European region, 86% of deaths are caused by noncommunicable diseases – a group of conditions that includes cardiovascular disease, cancer, mental health problems, diabetes mellitus, chronic respiratory disease, and musculoskeletal conditions. This broad group of disorders are largely preventable and are linked by common risk factors, underlying determinants and opportunities for intervention. Through the Deputy Chief Public Health Officer, PHAC’s WHO Collaborating Centre coordinates an international working group on noncommunicable disease policy. It provides social science methodology support to the development of both the WHO European Regional Strategy and the Pan American Health Organization NCD action plans.

World Health Organization (European Office) – Chronic Disease and Health Promotion

WHO’s regional office for Europe encompasses a region made up of 53 countries, with over 880 million people. The sheer size of the European Region means an incredible diversity of people and health situations. The Member States share a common goal: ensuring that the European Region’s citizens enjoy better health.

World Health Organization (WHO): Headquarters

PHAC’s WHO Collaborating Centre is a contributing partner in the World Health Organization’s public policies on noncommunicable diseases (NCDs). Of the 35 million people who died from chronic disease in 2005, half were under 70 and half were women.

World Health Organization Headquarters (WHO HQ) – Chronic Disease and Health Promotion Department

Leadership and direction for urgent global, regional and national efforts to promote health and to prevent and control major chronic diseases and their risk factors.

Chronic Disease Policy Resources

World Health Organization

WHO. 2010. NCDnet [The Global Noncommunicable Disease Network]. Geneva: World Health Organization.

WHO. 2010. The WHO Global InfoBase: data for saving lives. Geneva: World Health Organization.

WHO. 2010. The WHO STEPwise approach to surveillance (STEPS). Geneva: World Health Organization.

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WHO. 2008. A Framework to Monitor and Evaluate implementation: WHO Global Strategy on Diet, Physical Activity and Health. Geneva: World Health Organization.

WHO. 2008. Preventing noncommunicable diseases in the workplace through diet and physical activity: World Health Organization/World Economic Forum report of a joint event. - Opens in a new window (614 KB – 52 pages) Geneva: World Health Organization.

WHO. 2008. Prevention and control of noncommunicable diseases: implementation of the global strategy (WHA 61.14). - Opens in a new window (91 KB – 21 pages) Geneva: World Health Organization.

WHO/Singh, Debbie. 2007. How can chronic disease management programmes operate across care settings and providers? - Opens in a new window (282 KB – 39 pages) Geneva: World Health Organization.

WHO. 2005. Fruit and vegetables for health. Report of a joint FAO/WHO workshop. - Opens in a new window (1,013 KB – 39 pages) Geneva: World Health Organization.

WHO. 2005. Preventing Chronic Diseases: A Vital Investment. Geneva: World Health Organization.

WHO. 2003. Diet, nutrition and the prevention of chronic diseases. Report of a joint WHO/FAO expert consultation. WHO Technical Report Series No. 916. Geneva: World Health Organization.

WHO. 2003 – 2008. Global school-based student health survey (GSHS). Geneva: World Health Organization.

WHO. 2002. Diet, Nutrition and the Prevention of Chronic Diseases. Report of a joint WHO/FAO Expert Consultation. WHO Technical Report Series No. 916.

WHO. 2002. WHO Global Report: Innovative care for chronic conditions: building blocks for action. - Opens in a new window (4,164 KB – 103 pages) Geneva: World Health Organization.

WHO. 2001. Secondary Prevention of Noncommunicable Diseases in Low- and Middle-Income Countries through Community-Based and Health Service Interventions. - Opens in a new window (463 KB – 29 pages)

WHO. 2000. Obesity: preventing and managing the global epidemic. - Opens in a new window (586 KB – 16 pages) Report of a WHO consultation. WHO Technical Report Series No. 894. Geneva: World Health Organization.

Pan American Health Organization

PAHO. 2007. Regional Strategy and Plan of Action on an Integrated Approach to the Prevention and Control of Chronic Diseases. - Opens in a new window (5,939 KB – 63 pages) Washington, D.C.: Pan American Health Organization.

PAHO. 2006. Regional Strategy and plan of action on an integrated approach to the prevention and control of chronic diseases, including diet, physical activity and health. Washington, D.C.: Pan American Health Organization.

Pan American Journal of Public Health.

PAHO CNCD Newsletter

PAHO/WHO Collaborating Centers Database

PAHO/PHAC CARMEN Policy Observatory

CARMEN Pilot Canadian Case Study Final Report. 2006.

Member States

Australia. 2001. Preventing Chronic Disease: A Strategic Framework Background Paper. - Opens in a new window (228 KB – 56 pages) Melbourne, Australia: National Public Health Partnership.

Canada. 2010. Mobilizing Intersectoral Action to Promote Health: The Case of ActNowBC. Ottawa: Public Health Agency of Canada WHO Collaborating Centre on chronic noncommunicable disease policy.

Canada. 2009. Tracking Heart Disease and Stroke in Canada. Ottawa: Public Health Agency of Canada.

Canada. 2007. The Public Health Agency of Canada - Strategic Plan: 2007 – 2012, Information, Knowledge, Action. Ottawa: Public Health Agency of Canada.

Canada. Canadian Chronic Disease Infobase. Ottawa: Public Health Agency of Canada.

Ireland. 2008. Tackling Chronic Disease: A Policy Framework for the Management of Chronic Diseases. - Opens in a new window (1,777 KB – 26 pages) Dublin: Department of Health and Children.

Research Community

Brownson, Ross C. and Frank S. Bright. 2004. “Chronic disease control in public health practice: looking back and moving forward” - Opens in a new window (86 KB – 9 pages) in Public Health Reports (Vol. 119, No. 3) May – June 2004: 230-238.

Chronic Disease Prevention Alliance of Canada. 2008. Collaborative Knowledge Exchange: Enhancing CDPAC’s Capacity.

Chronic Disease Prevention Alliance of Canada. 2007. Knowledge Exchange in Health Promotion: Theoretical Models and Examples. (Lynne Moffatt, author).

Chronic Diseases in Canada (CDIC)

Ham, Chris. 2010. “The ten characteristics of the high-performing chronic care system” in Health Economics, Policy and Law (5): 71-90.

Lavis, John N., Jennifer A. Boyko, Andrew D. Oxman, Simon Lewin and Atle Fretheim. ”Support Tools for evidence-informed health policymaking (STP) 14: Organising and using policy dialogues to support evidence-informed policymaking” in Health Research Policy and Systems 2009, 7 (Suppl I):S14.

Schneiderman, Neil. 2004. “Psychosocial, behavioural, and biological aspects of chronic diseases” - Opens in a new window (65 KB – 5 pages) in Current Directions in Psychological Science (Vol. 13, No. 6) December 2004: 247-251.

World Bank. 2007. Public Policy and the Challenge of Chronic Noncommunicable Diseases. - Opens in a new window (2,255 KB – 218 pages)

Frequently Asked Questions

1. What are chronic diseases?
   
   

   Noncommunicable diseases (NCDs), sometimes referred to as chronic diseases, account for the highest cause of death in Canada and the world. NCDs include a variety of chronic diseases such as arthritis, diabetes, cancer, cardiovascular diseases, respiratory diseases, and mental illness. NCDs are largely preventable and are linked through modifiable behavioural risk factors such as tobacco and alcohol use, blood pressure, physical inactivity, cholesterol, overweight, stress and unhealthy diet.

2. What are WHO Collaborating Centres?
   
   

   WHO Collaborating Centres are centres of excellence.

   There are over 900 WHO Collaborating Centres in 99 Member States (nations) directing a variety of health-related programs at the regional, national, interregional and international levels.

   WHO Collaborating Centres form part of a collaborative network that can include research institutes, laboratories, universities and academies.

   To be designated as a WHO Collaborating Centre, an institution must be recognized internationally for work of high scientific and technical standing in its respective field. Once designated, these “centres of excellence” work together to fulfill WHO’s mandated activities.

   WHO Collaborating Centres are led by experts.

   To ensure the scientific validity of their work, WHO Collaborating Centres are led by experts in their respective fields: doctors and nurses, health professionals, public health experts, scientists, epidemiologists, and health economists work together to promote a spectrum of global health issues.

   WHO Collaborating Centres participate as technical leaders.

   By supporting national health development and sharing information and expertise with local institutions, WHO Collaborating Centres help to strengthen a country’s public health through information, research and training.

   WHO Collaborating Centres create global networks.

   The WHO selects and designates collaborative centres to create global networks that shape the international health agenda. The designation of an institution as a WHO CC provides it with enhanced visibility and recognition by national authorities, calling public attention to the health issues on which it works. It opens up improved opportunities for the exchange of information and development of technical cooperation with other institutions at a regional and international level, and helps to mobilize additional resources from funding partners.

   For more information, visit the WHO Collaborating Centres website.