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Table 3 Prevention and control of NCDs at different levels of the GHD Pyramid

From: Global Health diplomacy for noncommunicable diseases prevention and control: a systematic review

 ActorTool (Process)ContentContext
Core Diplomacy- UN
- WHO
- the Food and Agricultural Organisation (FAO)
- the World Bank
- the World Trade Organisation (WTO)
- the Codex Alimentarius Commission
- Independent High-level Commission on NCDs
- Heads of government
- International professional associations
- International Diabetes Federation
- World Heart Federation
- Asia-Pacific Economic Cooperation (APEC)
- The Caribbean Community (CARICOM)
- Policy brief
- Technical support
- Exchange of experiences at the international level
- Knowledge generation
International legal obligations and laws
- non-binding recommendations and policy advice
- advocacy
- UN High-Level Meeting on Prevention and Control of NCDs
- WHO Global NCD Action Plan
- WHO Global Monitoring Framework for NCDs
- Recognition of NCDs as a major challenge to sustainable development
- Alliances, treaties, and other agreements
- FCTC
- Regional Action Plan for Prevention and Control of NCDs
- Port of Spain Summit Declaration “Uniting to Stop the Epidemic of Chronic NCDs”
- WHO Global Strategy on Diet, Physical Activity and Health
- Global Code of Practice on the Marketing of Unhealthy Food and Beverages to Children
- Resolutions WHA63.14: Marketing of Foods and Non-alcoholic Beverages to Children
- MPOWER Package
- Best Buys
- 2017 WHO Cancer Resolution
- WHO Mental Health Action Plan
- Montevideo Roadmap 2018–2030 on NCDs as a Sustainable Development Priority
- The Paris Declaration on Aid Effectiveness
- Need for network formation at regional and international levels
- Lack of resources at national and international levels
- Effect of the political will of politicians
- The instrumental use of GHD to achieve other foreign policy and diplomatic goals
- Differences in wealth, incidence and prevalence of NCDs, and method of disease control
Multi-stakeholder diplomacy- Ministry of Health
- Ministry of Industry
- Ministry of Agriculture
- Ministry of Education
- Ministry of Urban Development
- Ministry of Sports
- Environmental organizations
- Media
- The academia
- Commercial actors
- Civil society organizations and coalition
- Healthcare regulatory agencies
- Nutrition Foundation
- National Center for Chronic Disease Prevention, National Cancer Institute
- Parliamentary Committee for Prevention and Control of NCDs
- National Inter-ministerial Tobacco Control Committee
- Advocacy
- Scientific research
- Health in All Policies
- Clear guidelines to strengthen coordination mechanisms
- Whole-of-government approach
- Publication of a newsletter, shaming, and symbolism
- Media advocacy to influence policy positions of countries during negotiations
- Holding scientific conferences
- National Document on Prevention and Control of NCDs
- Agreements between ministries
- National Plan for Tobacco Control
- Development plans
- Advocacy varies across different governments and ministries (different cultures)
- Programs developed to change systems and cultures (e.g. lifestyle changes) require sustainable medical and political leadership
- A single plan is not responsive for all countries and different contexts
- Significant difference between low-income countries and the global context
- Political obstacles, including sanctions
- Geographical location, communication, and health infrastructure
- Language barriers and the need to translate tools to native languages
- Health-related socioeconomic factors are not limited to the public health sector alone and exist in other sectors of the health system, highlighting the need for multi-sectoral action
- Poverty and social factors affecting health
- Implementing changes for cancer control that are tailored to a specific context, society, and culture
- NCDs threaten economic and human development
Informal Diplomacy- NCD Alliance
- Research centers and academic associations
- The medical community
- The private sector
- Patients and their families
- International donors
- NGOs
- Health advocacy groups, NGOs, and humanitarian organizations
- National Cancer Institute
- Media
- Campaigns against alcohol and tobacco use
- National Campaign for Tobacco Control and Smoking Cessation
- Specific activities such as games for the elderly
- World No Tobacco Day
- NCD Advocacy Document- Understanding the historical context of negotiations
- Any country is several markets rather than one, with a wide variety of marketing types