I went to Moscow last week to attend two meetings: The U.S.-Russia Scientific Forum on April 25-27, sponsored by the Russian Academy of Sciences (RAS) and the Foundation for the NIH; and with HHS Secretary Kathleen Sebelius for the First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control on April 28-29, in preparation for the United Nations General Assembly (UNGA) September 2011 meeting on the Prevention and Control of Noncommunicable Diseases. That meeting will focus on four noncommunicable diseases – cardiovascular, pulmonary, diabetes and cancer – that are all heavily impacted by risk factors dependent upon lifestyle: nutrition, physical activity, smoking, and abuse of alcohol.
I traveled on Saturday, April 23, with some members of the U.S. delegation, including Roger Glass, director of the Fogarty International Center; Harvey Feinberg, president of the U.S. Institute of Medicine (one of the National Academies); Gail Cassell, who was chair of microbiology at University of Alabama at Birmingham and more recently a VP at Eli Lilly; Van Hubbard, director of the NIH Division of Nutrition Research Coordination; and Marya Levintova, Fogarty International Center program officer for Russia/Eurasia/Arctic Affairs. We arrived midday Sunday, April 24, which was Easter in both the Eastern Orthodox and Western church calendars. We stayed at the Hotel National, which is right on Red Square, across from the Kremlin. We had fantastic weather the whole time and were fortunate to have some downtime on Sunday to enjoy the amazing history around Red Square. We visited the Kremlin, which houses the seat of government, the Cathedrals of the Assumption, the Annunciation and the Archangel; the Terem Palace, the residence of the Tsars; the Great Bell Tower; and the Armory, a museum which contains a staggering collection of Tsarist artifacts.
Kremlin from the Moscow River
On Monday, with sponsorship from the Foundation for the NIH and hosted by the RAS, the U.S.-Russian Scientific forum met at the main building of the RAS. Multiple presentations were given by representatives of both nations on cardiology, cancer, nutrition, and epidemiology. I spoke for the NHLBI. Dr. Vsevolov Tsachuk, dean of the University of Moscow School of Medicine, spoke for the Russian Federation. Representatives of industry were also present (J&J, Genetech, Genzyme, Amway, PepsiCo, Coca Cola, others). This meeting was held to prepare for a forum in November 2011 for discussions of scientific collaborations between the two nations. An agreement was signed in October 2010 by Presidents Obama and Medvedev that established 18 working groups, including one on health. Industry relationships and commercialization were prominent topics. Harvey Feinberg and Gail Cassell, representing IOM, have been active in creating this dialogue.
On Tuesday, we broke up into several groups, and visited different Institutes. Derek Yach of PepsiCo, Van Hubbard of NIH and I visited Cardiology, Nutrition, and Endocrinology. The first visit was to Yevgeny Chazov, now 82 years old. Dr. Chazov and Bernie Lown were the founders of the International Physicians for the Prevention of Nuclear War, for which they shared the Nobel Peace Prize in 1985. Dr. Chazov has many U.S. friends and colleagues and expressed his excitement about reestablishing relationships. The Nutrition Institute provided very impressive data about the predominance of smoking (55 percent of men, 5 percent of women), alcohol and drug abuse, and the impact on cardiovascular mortality – approximately threefold that in the U.S., with major health disparities.
The cardiology community credits Michael DeBakey with not only keeping contact in his field, but also transforming Russian medical education 20 years ago when, on several visits – among the few allowed to U.S. scientists and physicians – he encouraged them to move medical education into universities (the recommendations made by the Flexner Report, now a century ago).
In the evening, we attended a spectacular performance of Donizetti’s L’elisir d’amore, and watched the Army’s tanks preparing for May Day celebrations in Red Square four days hence. Both were truly phenomenal.
Van Hubbard, Susan Shurin, Yevgeny Chazov, and Derek Yach in Professor Chazov’s office, Cardiology Institute
Red Square at night -- tanks, soldiers
On Wednesday afternoon, we went to the elegant headquarters of the RAS for the formal signing of the MOU between NIH and the RAS. The building has portraits of Metchnikov, Peter the Great (a great proponent of science), and others, and some spectacular furnishings and artwork.
Later in the afternoon, the senior official members of the Working Group on Health met to go over their progress. Secretary Sebelius led the U.S. delegation with Nils Daulaire, director of the HHS Office of Global Health Affairs. The Russian delegation was led by the Deputy Director for Health Dr. Veronica Skvortsova. Plans for November were discussed.
Formal senior meeting of the Working Group on Health: Nils Daulaire, Secretary Sebelius, Veronica Skvortsova, Yevgeny Chazov, and others.
Susan Shurin, Yevgeny Chazov, Roger Glass, and Van Hubbard
Roger Glass (NIH/HHS) and Anatoly Grigoriev (RAS)
In the evening of April 27, the U.S. ambassador hosted a reception for those attending this meeting and many who had arrived for the Global Ministerial Conference. Both Secretary Sebelius and the Minister of Health, Tatyana Golikova, spoke at the reception.
We moved from the Hotel National to the Radisson Royal, across the Moscow River from the World Trade Center, where the next two days of meetings took place. The Radisson used to be the Ukrainian Hotel and is one of the original “Seven Sisters” wedding cake buildings which Stalin erected, very evident in Moscow. It was renovated in 2010 and is quite lovely.
Roger Glass, Secretary Sebelius, Nils Daulaire, HHS and U.S. Embassy Staff in front of Spaso House, official residence of the U.S. ambassador in Moscow, Russian Federation.
Secretary Sebelius speaks at Spaso House
Health Minister Tatyana Golikova at Spaso House.
Radisson Royal, formerly Ukrainian Hotel
Moscow World Trade Center
On Thursday, April 28, the First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control opened at the Moscow World Trade Center. The health ministers of many countries were in attendance, and many who spoke emphasized the rising importance of noncommunicable diseases. Many professional and advocacy groups were represented (World Hypertension, World Heart, World Diabetes, International Agency for Research on Cancer, International Obesity Task Force) as well as the CDC (Tom Frieden) and many familiar academics (among them Srinith Reddy, Chris Murray, Julio Frenk, Abdallah Daar, Bob Beaglehole, and Sid Smith, and Richard Smith from UnitedHealthGroup).
All the materials and the final report are available on the WHO website: http://www.who.int/nmh/events/moscow_ncds_2011/en/
The opening plenary session was led by WHO Director General Margaret Chan, who also presented words from UN Secretary-General Ban Ki-moon. Secretary Sebelius and Minister Golikova spoke. A high-level panel discussion on multisectoral action emphasized the importance of non-health sectors in combating noncommunicable diseases and the close relationship between the health of citizens and the health of national economies.
Prime Minister Vladimir Putin was the meeting’s keynote speaker, which precipitated a notable increase in security. He gave an impassioned tribute to the medical profession.
The afternoon sessions were breakouts, focusing on priorities for action: tobacco control; food and nutrition; harmful use of alcohol; and physical activity, sports, and transport. On Friday, a second plenary discussed international cooperation and coordination. This was followed by breakout sessions on monitoring noncommunicable diseases and their determinants, socio-economic development, innovative options for health financing, and bridging the implementation gap. The afternoon breakout groups focused on primary care; essential medicines and technology, civil society, and social mobilization; and what is needed at the UN General Assembly meeting.
Ministers of Ghana, India, WHO, Russian Federation, Saudi Arabia, U.S., and China
Veronica Skvortsova (RF), Roger Glass (U.S.), Abdallah Daar (Canada)
Vladimir Putin addressing the Ministerial Conference on April 28
Margaret Chan and Vladimir Putin (source: WHO)
Age-standardized deaths per 100,000 population worldwide, 2004
An excellent reference is Dying Too Young, put out by the World Bank in December 2005.
The global epidemic of cardiovascular and pulmonary diseases places the NHLBI in a position to have a major impact on the development of new solutions. The opportunities to collaborate with colleagues in other countries extend existing opportunities in basic and clinical sciences. The NHLBI must play an important role in advancing both biomedical science and public health.