Policies & Campaigns

One of the primary aims of ISN’s advocacy strategy is to integrate kidney diseases into the ongoing global debate and drive toward Universal Health Coverage (UHC).

In this context, the ISN seeks to propose the advancement of kidney disease care as a model for monitoring progress, achieving UHC, and improving global health.

ISN is actively engaged in the current World Health Organization (WHO) and United Nations (UN) discussions around UHC and in global efforts to meet the UN’s Sustainable Development Goals (SDGs).

In December 2015, ISN signed up to the Global Coalition for Universal Health Coverage. The coalition includes the WHO, the World Bank Group, the Rockefeller Foundation, and hundreds of leading non-governmental organizations (NGOs), healthcare organizations, and academic institutions.

In December 2015, ISN responded to a UN consultation on the tracer indicators used to track UHC, one of the key health-related targets of the SDGs.

ISN outlined several key positions:

  • ISN supports the use of tracer indicators as an appropriate and effective way of monitoring progress toward the UHC target.
  • To provide a reliable indication of the state of the healthcare system, tracking should cover the full spectrum of health services available to the population, including those targeting disease prevention, diagnosis, treatment, and rehabilitation.
  • Kidney disease, a noncommunicable disease (NCD) with a growing global burden, especially in low and middle-income countries (LMICs), is a good example of how such a framework of interventions might develop. While the most significant impact is made by carrying out all baseline techniques, limited resources may require prioritization of interventions and a phased approach to implementation.

The ISN continues to actively demonstrate the impact and relevance of kidney disease in achieving UHC.

The ISN actively welcomes the inclusion of NCDs in the UN Agenda 2030 for Sustainable Development as well as its 17 SDGs. Nevertheless, the ISN continues to call for increased awareness of the often underestimated clinical, economic, and social burden of kidney diseases.

The ISN recognizes that structural factors, including poverty, education, nutrition, gender inequality, substance abuse, lack of access to primary care, and overall health  directly increase the risk of kidney disease. The ISN therefore commends the holistic approach of the Agenda 2030 and SDGs, which provide strategies to positively impact kidney disease globally.

Read the ISN’s statement at the 66th Session of the WHO Regional Committee for Europe in September 2016.

Read Dr. Valerie Luyckx’s article, “The Sustainable Development Goals: hope for kidney disease” in The Lancet Kidney Campaign.

The ISN anticipates that the international community and member states will successfully implement the UN Agenda 2030 framework to inspire other regions of the world.

The Global Coalition for Circulatory Health (GCCH) was launched in 2017 at the World Health Organisation’s Global Conference on Noncommunicable Diseases in Montevideo, Uruguay. The GCCH brings together international, regional and national stakeholders in circulatory health to drive the urgent action needed to combat kidney disease and other circulatory conditions. 

Objectives of the GCCH 

  • Advocate for and support the achievement of the Sustainable Development Goal (SDG) 3.4 of a one-third reduction in premature NCD deaths by 2030, by building on the work done to date to meet the global target of a 25 percent reduction by 2025 in premature mortality from from kidney disease and other circulatory conditions, and on the World Health Organization’s Global Hearts Initiative. 
  • Promote common messaging by partner organizations and leverage their extensive networks to cascade messages at regional and national levels in order to influence relevant local policy- and decision-makers.
  • Strengthen the voice of people living with kidney disease and other circulatory conditions by including patients, their families and communities in decision-making processes and in national, regional and global advocacy. 

The ISN, a member of the Global Coalition for Circulatory Health (GCCH) Leadership Group, has  jointly published the position paper “Preventing the next pandemic: The case for investing in circulatory health”,which presents a clear rationale and actionable proposals for Member States to address circulatory health in their emergency preparedness plans.

Having witnessed the devastating physical, mental and fiscal impact that the COVID-19 pandemic has had on the millions of people living with noncommunicable diseases (NCDs), and the greater risk for severe forms of COVID-19 experienced by people living with Cardiovascular disease, kidney disease stroke, obesity, diabetes, and hypertension, in May 2021, on the occasion of the 74th World Health Assembly (WHA), members of the GCCH presented a joint statement on circulatory health and emergency preparedness and response in the context of the COVID-19 pandemic. Following WHA’s decision to reconvene later in the year to discuss a formal instrument for improving global pandemic preparedness, the GCCH decided to expand on the joint statement and develop a position paper. The resulting Position Paper aims to advocate for the development and inclusion of effective and concrete strategies to address circulatory health in emergency preparedness plans, and includes a set of recommendations to support WHO Member States to take concrete steps towards a pandemic-free future.

A high-level GCCH webinar marked the launch of the position paper on 12 October 2021.

Download the Executive Summary

Aimed at policymakers in national and international bodies, the White Paper is a solution-oriented paper which draws on success stories and testimonies of people living with circulatory diseases to present feasible actions in education and training, universal health coverage, financing, infrastructure, and access to medicines and technologies to advance circulatory health.

Download the White Paper Download the Executive Summary

The Global Coalition will leverage the expertise and reach of its international partners to advocate for increased prevention, control and treatment of all circulatory diseases. The following are the current members of the Global Coalition:

  • Cuban Society of Cardiology
  • European Heart Network
  • European Primary Care Cardiovascular Society
  • FemSansCancer
  • Health Related Information Dissemination Amongst Youth (HRIDAY)
  • Heart Friends Around the World
  • Heart & Stroke Foundation of Canada
  • Instituto Nacional Cardiovascular Incor EsSalud
  • InterAmerican Heart Foundation
  • International Alliance of Patients’ Organizations
  • International Atherosclerosis Society
  • International Society of Hypertension
  • International Council of Cardiovascular Prevention and Rehabilitation
  • International Council of Nurses
  • International Diabetes Federation
  • International Primary Care Cardiovascular Society
  • International Society of Behavioral Medicine (ISBM)
  • International Society of Nephrology
  • Iranian Heart Foundation
  • Nepal Development Society
  • Polish Lipid Association
  • Preventive Cardiovascular Nurses Association
  • Rural Clinical School, University of New South Wales
  • Shenyang First People’s Hospital
  • South African Heart Association
  • Stroke Association Support Network-Ghana
  • Ukrainian Association of Cardiology
  • World Federation of Public Health Associations
  • World Hypertension League
  • World Organization of Family Doctors
  • World Stroke Organization
  • World Heart Federation

The Global Coalition Leadership Group sets the strategy and workplan for the Coalition. It comprises partner organizations with an interest in heart disease and stroke which also hold Official Relations Status with the World Health Organization. The Leadership Group is currently made up of the following organizations:

  • Framework Convention Alliance for Tobacco Control
  • International Alliance of Patients’ Organizations
  • International Council of Nurses
  • International Diabetes Federation
  • International Society of Nephrology
  • World Federation of Public Health Associations
  • World Heart Federation
  • World Hypertension League
  • World Organization of Family Doctors
  • World Stroke Organization

Organ transplantation is one of the life-saving medical breakthroughs of the 20th century.

Over the years, growing renal transplant waiting lists and a discrepancy in organ supply and demand have marred this accomplishment and given rise to a network of illegal traffickers who exploit the vulnerability of patients desperately waiting for a life-saving transplant.

While illegal transplantation may seem like a “win-win” for the recipient in need of a kidney and a donor in need of money, the long-term effects are devastating to both parties and negatively impacts healthcare systems.

The Declaration of Istanbul (DoI) calls on the medical community, especially transplant surgeons and nephrologists, to join the World Health Organization (WHO) in putting pressure on Health Ministries with a transplantation program to eliminate organ trafficking and transplant tourism. The DoI is promoted, implemented, and upheld by the Declaration of Istanbul Custodian Group (DICG). Read more about ISN’s work on the Declaration of Istanbul here.

Read more about our advocacy activities related to Declaration of Istanbul here

World Kidney Day (WKD), a joint initiative of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations (IFKF), is a global campaign that aims to raise awareness of the importance of our kidneys to overall health and to reduce the frequency and impact of kidney disease and its associated health problems.

Each year, hundreds of organizations and individuals launch initiatives and events on WKD to help raise awareness of kidney disease.

Read more about our advocacy activities related to World Kidney Day here

During the first Global Kidney Policy Forum: Focus on Latin America took place in Mexico, in April 2017, stakeholders invested in addressing the growing burden of kidney diseases gathered to describe, discuss, and develop a set of 12 Recommendations to Global Kidney Health to guide future efforts to reduce the burden of kidney diseases worldwide.

  1. Work within current frameworks promoted by the World Health Organization and the United Nations such the Sustainable Development Goals of Agenda 2030 for Sustainable Development, Universal Health Coverage, and Life Course approach in the context of Health 2020 to develop and implement policies to ensure integration and synergies for kidney disease prevention and treatment within existing initiatives.
  2. Develop and implement public health policies to prevent or reduce risk factors for chronic kidney disease in adults and children, including strategies to promote maternal and child health and nutrition, to reduce the burdens of diabetes, hypertension, obesity and tobacco consumption, to promote safe work environments and prevent infectious diseases.
  3. Implement and support ongoing surveillance mechanisms to better understand and quantitate the burdens of acute and chronic kidney disease within and outside the context of non-communicable diseases, specifically by developing robust national and regional registries for AKI, CKD and ESKD.
  4. Educate the public and people at risk about kidney disease within non-communicable disease education campaigns.
  5. Improve awareness of kidney disease among health care workers at all levels and ensure appropriate access to essential tools and medications required for diagnosis and treatment.
  6. Work towards universal health coverage to permit sustainable access to effective and affordable medication (for hypertension, diabetes, cardiovascular disease) to treat risk factors for kidney disease and delay kidney disease progression.
  7. Support education for a skilled nephrology workforce to implement prevention and treatment of kidney disease at all stages.
  8. Implement early detection, preventive and treatment strategies for AKI.
  9. Integrate early evidence-based treatment for CKD acknowledging the important synergies with diabetes, hypertension and cardiovascular disease.
  10. Develop and implement transparent policies governing just and equitable access to kidney disease care including dialysis and transplantation, according to international standards, and to support, safe, ethical, affordable and sustainable programs.
  11. Promote and expand kidney transplantation programs within countries and across the region.
  12. Support local, regional and transnational research on kidney disease to further understanding of prevention and treatment strategies.

You can pledge your support to the 12 Recommendations to Global Kidney Health here.

The Sharing Expertise to Support the set-up of Renal Registries (SharE-RR) initiative develops resources to help establish or develop renal registries in emerging countries; among the tools available is an open-access global inventory of renal registries and how they operate, a list of experts to provide advice, and workshops covering a range of topics.

The availability of these resources is important, as many countries currently lack or possess incomplete renal registry data. Such data provides critical information to support the planning, delivery, and evaluation of renal services and highlights discrepancies in available kidney care to allocate resources where the need is greatest. Registry data identifies the highest causes of kidney disease in a region to inform the prevention, detection, and early treatment of chronic kidney disease (CKD), which in parallel can be used as fundamental instruments to carry out evidence-based advocacy activities. Learn more about the SharE-RR initiative here.

Read more about our advocacy activities related to Share-RR here

In collaboration with the Dialysis Outcomes and Practice Patterns Study (DOPPS) Program team at Arbor Research Collaborative for Health, Michigan, USA; the ISN has conducted a ‘practice patterns’ survey of the impact of COVID-19 on hemodialysis and peritoneal dialysis programs around the world. The surveys have been offered to random samples of ~20 dialysis facilities in all countries via the ten ISN regional boards. Countries currently active in DOPPS will not need to repeat the survey as their data will be combined with the other countries to produce a global picture.

Read more about our advocacy activities related to Dialysis Outcomes and Practive Pattern Study (DOPPS) here

The ISN launched a public awareness campaign in 2021 highlighting chronic kidney disease (CKD) and its risk factors and promoting early detection in at-risk categories.

“Are your kidneys healthy?” is a quick online quiz, available in 11 languages, which helps people gauge their risk of kidney disease and indicates when they should see a doctor.

This quiz was inspired by the ‘Are you the 33%?’ campaign launched by the National Kidney Foundation in the United States. This public awareness campaign was launched with support from an unrestricted educational grant from AstraZeneca. 

Take the Quiz here.

COVID-19 has had a devasting impact on the over three million kidney patients undergoing dialysis. Dialysis patients have specific circumstances that lead to an increased risk of SARS-CoV-2 infection. Most patients need to receive in-center hemodialysis (ICHD), which forces them to travel to a dialysis center three times a week and attend dialysis sessions for at least 3-4 hours surrounded by 20 (or more) other patients, as well as staff members. Consequently, dialysis patients are up to 20 times more at risk of contracting the SARS CoV2 infection than the general population.

In addition to being exceptionally vulnerable to infection because they cannot self-isolate, people receiving ICHD who develop COVID-19 have a much greater risk of dying. The higher risk of death from COVID-19 is also observed in non-elderly patients on dialysis, with exceptionally high mortality rates exceeding rates observed in the elderly population. A 40-59-year-old dialysis patient, who contracts COVID-19, has a 94-fold increased risk of dying than patients who are not on dialysis (after adjusting for age).

The ISN has been advocating to prioritize the vaccination of patients with advanced chronic kidney disease undergoing dialysis. The ISN has published The urgent need to vaccinate dialysis patients against severe acute respiratory syndrome coronavirus 2: a call to action and has written to the WHO requesting its support in convincing policymakers worldwide to do so.

As part of this global campaign, the ISN has held the webinar, “Prioritization of Dialysis Patients in National Covid-19 Vaccination Programs – Lessons Learned from Successful Campaigns,” on March 9, 2021, highlighting the methods and results from campaigns carried out in Italy, Lebanon, Romania, the United Kingdom, and Uruguay, which led to government policies prioritizing the vaccination of dialysis patients in those countries. You can watch the webinar here.

Read more about our advocacy activities related Covid19 here