February 19, 2013
We have enough problems within Europe, haven’t we? The financial markets and the euro is in trouble and the deep dept crisis together with political division between key EU countries threatens the EU in a time when euroscepticism started to triumph again. Why do need we then another ‘new’ problem? Why should we take Non communicable diseases (NCDs) seriously?
Because NCDs are the silent killers: they are not visible, they are not in the news on TV but I do not exaggerate when I say that NCDs put a higher burden on Europe than the aforementioned ‘problems’ alltogether.
What are NCDs? Non-communicable disease, or NCD, is a medical condition or disease which by definition is non-infectious and non-transmissible among people. NCDs may be chronic diseases of long duration and slow progression, or they may result in more rapid death such as some types of sudden stroke. They include autoimmune diseases, heart disease, stroke, many cancers, asthma, diabetes, chronic kidney disease, osteoporosis, Alzheimer’s disease, cataracts, and more.
NCDs are the leading global cause of death worldwide, accounting for 60% of global deaths. Of these, 80% occur in developing countries. [WHO (2010) Global status report on noncommunicable diseases 2010. Geneva: WHO]
Why are NCDs unjustified and simply not fair?
Because a large proportion of NCDs are preventable through tackling the risk factors leading to NCDs. Which are they? We can identify 5 key risk factors, as follows:
– ultra-processed high fat,
– sugar food.
The tobacco is the only one where a strong and legally binding international treaty exists to help the legislators, and this is the the WHO Framework Convention on Tobacco Control (FCTC)
It is important to point out that this instrument is legally binding and widely accepted by 176 signing parties. The FCTC provides a multi-sectoral and comprehensive global strategy based on evidences; there is a strong focus on preventive measures and on population wide impacts. It is useless to say that either the EU or all Member States are signing parties to that treaty.
How can we fight against NCDs in an effective way?
By tackling the above mentioned risk factors.
Take the example of food to present some counter arguments and to explain why is it difficult to tackle food products as risk factors of NCDs.
We often hear the arguments that food is essential, food is not problem, and only the diet is a problem since in a certain quantity everything is harmful to the health. Well, the truth is that these arguments are valid for real food but not for food/drink products. Unfortunately, the formulation of these product makes very unlikely the low quantity of their consumption. Nowadays, the human body is simply not able to deal with so much calories these products contain.
In addition to that, we should always bear in mind that food/drink products are highly profitable products and cheap instead of healthy vegetables and fruits which are not profitable and expensive. As long as we can not reverse this tendency, the burden of NCDs remains on the European society.
How can we decide upon which are the effective measures against NCDs and which are the not effective ones?
Countries would have never reduced smoking prevalence through voluntary agreements with the tobacco industry and self regulation.
The answer is quite simple: we have to examine the arguments put forward by the industry representatives: they prefer put accent on individual behaviour, the importance of physical activity, the value of voluntary agreements, the efficiency of self regulation and public-private programs.
What can we say from a public health perspective? We agree, they are useful tools but they are simple not enough.
However, if legislators raise the usefulness of tax policies, regulating advertising and promotion restriction, control on labelling policies (traffic light and others) they immediately face strong opposition – which is a good sign.
We therefore identified with these the truly effective measures to fight NCDs.
NCDs make poor and rich countries equal in Europe in a way that they are estimated to cost the world economy $47 trillion over the next 20 years, representing 75% of global GDP and surpassing the cost of the global financial crisis.
I firmly believe that people are good. They could and would make the right, the healthy choice – if they were provided with the opportunity to do so. Thus, changing the environment concerning the aforementioned risk factors of NCDs is the most effective way (ex. taxation, reducing the harmful effect of advertising) to allow people to make the right, the healthy choices.
I remain at your disposal.
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Related earlier updates:Zoltán Massay-Kosubek