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Political will needed to win fight against noncommunicable diseases

Dr Margaret Chan, WHO Director-General, and
Michael R. Bloomberg, WHO Global Ambassador for Noncommunicable Diseases (NCDs)

Commentary
30 September 2016

Our modern way of life is a major cause of many noncommunicable diseases (NCDs). Initially lifestyle diseases of industrialized countries, they have long since reached developing countries and lead to serious consequences and tremendous costs for health care systems worldwide. Above all, the implementation of sustainable solutions calls for political action.

The biggest health threats worldwide do not always attract headlines, but confronting them is an urgent challenge. Chronic, lifestyle-related diseases – such as heart disease, stroke, cancer, and diabetes, known collectively as noncommunicable diseases – are the deadliest diseases of our time: these diseases kill 16 million people each year before their 70th birthdays. Too often, these diseases are accepted as inevitable. They are not.

Dr Margaret Chan
Dr Margaret Chan, the Director-General of WHO
WHO

Problem has long since reached developing countries

For a long time, noncommunicable diseases (NCDs) were thought to be the close companions of affluent societies. Not anymore. Today, NCDs overwhelmingly affect poor nations, with 80% of the burden falling on the developing world. In these places, people fall ill sooner, get sicker, and die earlier than their wealthy counterparts.

The status of NCDs as the world’s biggest killers is fueled largely by air pollution, tobacco and alcohol use, and unhealthy diets that are heavy on highly processed foods rich in fat, sugar and salt. As these products have become more widely available, and as marketing budgets have grown exponentially, the prevalence of NCDs has exploded.

Our modern sedentary lifestyles also play a big role, and they especially contribute to obesity. One the one hand, this world has 800 million chronically hungry people, but on the other hand it also has countries where more than 70% of the adult population is obese or overweight.

Resulting costs are tremendous

These diseases are both deadly and costly. For example, the average cost of newly approved cancer treatments is US$ 120 000 per person per year, which can be unaffordable even in the world’s richest nations. Some countries spend up to 15% of their entire health budget on the treatment of diabetes alone and its costly complications.

As Director-General of WHO and its newly appointed Global Ambassador for NCDs, we are deeply concerned about this slow-motion disaster, which has the power to devour the steady economic gains recorded in much of the developing world. Ironically, economic growth and modernization, which traditionally lead to healthier and longer lives, have opened wide the entry point for unhealthy lifestyles and all their related ills.

Prevention and interventions are effective means

Michael R. Bloomberg, WHO Global Ambassador for Noncommunicable Diseases (NCDs)
Michael R. Bloomberg, WHO Global Ambassador for Noncommunicable Diseases (NCDs)

The good news is that many of these diseases can be prevented, and for those already suffering ill health, early disease detection and affordable treatments are available. For example, inexpensive medicines, like statins and aspirin, can reduce the risk of heart attacks and stroke. Countries that have experienced declines in smoking and alcohol consumption have been rewarded with fewer deaths, especially from cancer, heart disease, and stroke. However, not one single country in the world has managed to turn its obesity epidemic around in all age groups. Unfortunately, the unhealthiest foods are often also the cheapest and most convenient, making them a logical choice for the poor.

This month, heads of state and government have been gathering at the United Nations General Assembly in New York. We are urging these leaders to tackle the escalating NCD crisis by introducing population-wide measures that make healthy lifestyle choices the easy choices. Examples include excise taxes on alcohol and tobacco, easy-to-understand food labels and calorie counts in restaurants, and measures at the workplace and in schools that encourage physical activity.

Particular focus on food and children

"For a long time, noncommunicable diseases (NCDs) were thought to be the close companions of affluent societies. Not anymore."

Dr Margaret Chan, WHO Director-General, and
Michael R. Bloomberg WHO Global Ambassador for Noncommunicable Diseases (NCDs)

Governments also need to address features in the food environment that contribute to diabetes and diet-related cancers and increase the risk of heart attacks and stroke. In Europe, for example, up to three-quarters of salt consumed is added by the food industry; the sugar content of baby foods can reach 30%.

WHO has issued recommendations for protecting children from unhealthy foods and beverages, including removing sugar-sweetened beverages from schools and implementing restrictions on the marketing of these products. The traditional description of type 2 diabetes as “adult onset” diabetes no longer holds, as so many adolescents and children are now affected.

Global challenges require local solutions

On a local level, city mayors are well-positioned to play a preventive role: they can make all public areas and workplaces smoke-free, ensure that children have safe places to play, encourage people to cycle and walk, and address urban “food deserts” that offer abundant junk food but little fresh fruits and vegetables.

Finally, when crafting preventive strategies, government officials must recognize that the wide-scale occurrence of NCDs throughout a population is not primarily a failure of individual willpower. It is a failure of political will to take on powerful industries. If governments understand this – and their resulting duty to act on it – the fight against NCDs can be won.

Noncommunicable diseases (NCDs)

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