In general, the report suggests that priority should be given to controlling those risks that are well known, common, substantial and widespread, and for which effective and acceptable risk reduction strategies are available. These criteria apply to many of the risks in the report. The increasing level of tobacco consumption, particularly in Asia, is one clear example. The report says a substantial increase in government tobacco taxes would produce significant health benefits at very low cost.
Government action, in partnership with multiple stakeholders, to reduce the salt content of processed foods would also achieve substantial health benefits in all settings. The report suggests that this should be one component of a comprehensive strategy for the control of cardiovascular disease risks. The overall strategy would be based on a mix of community-wide interventions, such as salt reduction, and treatment-based interventions focusing on individuals whose risk of a cardiovascular event in the next ten years is assessed to be high.
For many of the main risk factors there is likely to be good agreement between the general public and public health experts on what needs to be done. In some countries, risk understanding may need to be strengthened among the general public, politicians and public health practitioners.
Recommended actions that governments can take in risk reduction have been tailored to suit high, middle and low income countries. More generally, the report makes the following recommendations.
- Governments, especially health ministries, should play a stronger role in formulating risk prevention policies, including more support for scientific research, improved surveillance systems and better access to global information.
- Countries should give top priority to developing effective, committed policies for the prevention of globally increasing high risks to health, such as tobacco consumption, unsafe sex in connection with HIV/AIDS, and, in some populations, unhealthy diet and obesity.
- Cost-effectiveness analyses should be used to identify high, medium and low priority interventions to prevent or reduce risks, with highest priority given to those interventions that are cost-effective and affordable.
- Intersectoral and international collaboration to reduce major extraneous risk to health, such as unsafe water and sanitation or a lack of education, is likely to have large health benefits and should be increased, especially in poorer countries.
- Similarly, international and interesectoral collaboration should be strengthened to improve risk management and increase public awareness and understanding of risks to health.
- A balance between government, community and individual action is necessary. For example, community action should be supported by nongovernmental organizations, local groups, the media and others. At the same time, individuals should be empowered and encouraged to make positive, life-enhancing health decisions for themselves on matters such as tobacco use, excessive alcohol consumption, unhealthy diet and unsafe sex.