Conference agenda

Wednesday, March 2

Welcome: Gene Bukhman and Elizabeth Nabel

Keynote address
Paul Farmer, Partners In Health

Session I: Endemic NCDs: Advocacy for the Long Tail

Among those living on less than $1 per day, endemic NCDs are most often linked to infectious, hereditary, and environmental risk factors. None of these conditions alone accounts for a significant fraction of disease burden. This session aims to highlight this long tail of conditions, such as rheumatic heart disease, cardiomyopathies, cervical cancer, Burkitt’s lymphoma, sickle-cell anemia, mental illness, and cooking fuel-associated lung disease. Collectively, one quarter of death and disability in low-income settings is attributable to these entities. The session aims to touch on how the passion and clinical excellence that comes with a focus on specific diseases can be harnessed to promote health system strengthening in the poorest countries.

Jeffrey L. Sturchio, Global Health Council, Facilitator

“Lessons from the neglected tropical disease movement”
Peter Hotez, George Washington University Medical Center

“Endemic cardiovascular disease in Africa”
Ana Mocumbi, Maputo Heart Institute, Mozambique

“Inherited Non-Communicable Diseases: The Burden of Sickle Cell Anemia in Africa”
Stella Rwezaula and Julie Makani, Muhimbili University, Tanzania

“A historical perspective on infection and cancer in Africa”
John Ziegler, University of California, San Francisco

Stretch - coffee break

Session  I resumes

“Diabetes in low-income populations”
Jean Claude Mbanya, International Diabetes Federation, Cameroon

“Chronic respiratory disease in nonsmokers”
Sundeep Salvi, Chest Research Foundation, Pune, India

“Mental health in chronic and acute disasters”
Giuseppe Raviola, Harvard Medical School

Session II: Global Solidarity 1: Survivorship Communities and Endemic NCDs 

This is one of two sessions that brings together people from around the world whose lives have been directly affected by endemic NCDs, either as patients or as care-givers, both rich and poor. In each case, access to care for these conditions has made them citizens of a larger community dedicated to health as a human right.

Arthur Kleinman, Harvard Medical School, Facilitator

Conversations with Claudine Manizabayo and Gedeon Ngoga, Rwanda, and Celia Reddick, USA, about rheumatic and congenital heart disease, and with Diones Austin, Haiti; Phil Southerland, USA, about diabetes.

Session III: Links Between Middle and Low-income countries for the Bottom Billion

Middle-income countries with large urban and aging populations have been the dominant voices in global non-communicable disease advocacy. At the same time, many of these middle-income countries have large populations living on less than $1 per day in rural areas. Low-income countries also have growing urban and middle-income communities. This session explores differences in bottom-billion populations in low and middle-income countries, as well as increasing collaborations between leaders in these settings.

K. Srinath Reddy, Public Health Foundation of India, Facilitator

Bongani Mayosi, University of Cape Town, South Africa (call-in)

Jaime Miranda, Universidad Cayetano Heredia, Peru

Q&A

Keynote address: Framing the Diagonal Approach
Julio Frenk, Dean, Harvard School of Public Health

Session IV: Strategy for the Long Tail: Identifying the right units for policy and planning for endemic NCDs

Some countries have been able to translate investments in vertical global health initiatives for conditions such as HIV into broad improvements in their health systems. Unlike other diseases targeted explicitly by the millennium development goals, the endemic NCDs of the Bottom Billion are individually low prevalence. This long tail phenomenon creates a strategic planning challenge for governments with limited capacity in their Ministries of Health. This panel aims to highlight some very low-income countries who have begun to identify integrated platforms to tackle their endemic NCD burden strategically. These provider platforms include integrated chronic care delivery at health centers and in the community, gynecologic and advanced NCD services at the district hospital level, family and community medicine, and referral level platforms such as histopathology, cancer centers, general surgery, and cardiac surgery.

Lawrence Shulman, Dana-Farber Cancer Institute, Facilitator

“Chronic care integration”
Gene Bukhman, Harvard Medical School; Ministry of Health, Rwanda

“Moving beyond cervical cancer to integrated gyn care”
Frank Taulo, College of Medicine, Malawi

“Family and Community Medicine – Acute care at the district hospital”
Corrado Cancedda, Harvard Medical School

“Safe Surgery for the Long Tail”
Atul Gawande, Harvard School of Public Health

“Referral center platforms – Pathology, surgery, cancer center”
David Walton, Harvard Medical School, Partners In Health, Haiti

Conference reception – Joseph B. Martin Conference Center

Thursday, March 3

Check-in and continental breakfast

Keynote address
Dean Jamison, University of Washington, USA

Session V: What is unique about prevention of endemic NCDs?

Risk factors for the endemic NCDs of the Bottom Billion are largely hereditary, infectious, and environmental. In this sense, existing initiatives to address HIV, tuberculosis, malaria, and neglected tropical diseases are already a major part of the prevention agenda for endemic NCDs. Endemic NCDs are also driven by less prevalent streptococcal and viral infections that may require specific control strategies. At the same time, there are opportunities for prevention of emerging NCDs through tobacco policy and managed urbanization. This session looks at what is unique about prevention strategies for NCDs in the poorest populations. The session also highlights countries that are making prevention integral to their health system strengthening strategies.

Johanna Ralston, World Heart Federation, Facilitator

“Biomass fuels”
Kirk Smith, University of California, Berkeley

“Impact of Streptococcal disease on the global poor”
Jonathan Carapetis, Menzies School of Health Research, Australia

“Splenomegaly and more – the legacy of malaria”
Imelda Bates, Liverpool School of Tropical Medicine, UK

“Infectious risk factors for epilepsy”
Amadou Gallo Diop, Université Cheikh Anta Diop, Senegal

“Prevention for emerging NCDs”
Thomas A. Gaziano, Brigham and Women’s Hospital

Stretch - Coffee break

Session VI: Global Solidarity 2

This session extends the discussion on global solidarity and endemic NCDs to include care-givers.

Felicia Knaul, Global Task Force on Expanded Access to Cancer Care and Control, Harvard Medical School,  Facilitator

Conversations about cancer and sickle cell anemia with Claudine Humure and Sara Stulac, Rwanda and Arafa Salim Said, Tanzania

Lunch

Working Group meetings (invitation-only)

Session VII: Global Health Governance and Financing For Endemic NCDs

In 2001, the attention given HIV during the United Nations general assembly was followed by the establishment of the Global Fund to Fight AIDS, TB, and Malaria. The attention given to NCDs in 2011 has led to expectations of new global financing mechanisms for NCDs as well. At the same time, there are still large gaps in financing to achieve the existing Millenium Development Goals. This panel will examine the outlook for supporting low-income countries who want to tackle the long tail of endemic NCDs as part of their national health sector strategic plans. The panel includes experts in global health governance and financing, as well as corporate social responsibility.

Kyle Peterson, FSG Consulting, Facilitator

Felicia Knaul, Global Task Force on Expanded Access to Cancer Care & Control

Rachel Nugent, Center for Global Development

Gail Cassell, Eli Lilly and Company (retired)

Ann Keeling, NCD Alliance

Closing address:
Paul Farmer, Partners In Health

Working Group reports and audience discussion
Elizabeth Nabel, Facilitator 

Declaration and closing
Gene Bukhman, Felicia Knaul, and Elizabeth Nabel