With lifestyle and diet risk factors for noncommunicable diseases (NCDs) exacerbated by climate change and air pollution, a group of national and global health leaders called for more intensive action on NCD prevention and control on the sidelines of the 78th UN General Assembly.
“NCDs continue to be a public health threat that requires concerted efforts, great investments and prioritization to put countries back on course towards achieving global targets as we inch towards 2030,” said Kwaku Agyemang-Manu, Minister of Health of Ghana, who co-chaired the second annual gathering of the Global Group of Heads of State and Government for the prevention and control of NCDs.
The gathering on September 21, coinciding with the UN High-Level Meeting on Universal Health Coverage, builds on the first such meeting in Accra, Ghana in 2022, which coincided with the launch of the Global NCD Compact 2020–2030. The Compact aims to align countries around scaled-up commitments and action on the prevention and control of NCDs essential to achieving both UHC and other health-related Sustainable Development Goals (SDGs).
The meeting was convened and led by the Global Group of Heads of State and Government for the Prevention and Control of NCDs – an informal, voluntary collaboration of countries that signed onto the Global NCD Compact, and committed to developing specific national responses on NCDs, with the aim of reducing related mortality one-third by 2030 in line with SDG target 3.4.
“You [The Global Group] are on the front line to accelerate and scale up efforts to prevent and control NCDs and mental health conditions and achieve universal health coverage in your countries. Your leadership and the public health effort taken by your countries can save tens of millions of lives in years to come,” said WHO Director-General Tedros Adhnanom Ghebreyesus in opening remarks at Thursday’s gathering.
Speakers highlighted the progress seen and barriers faced in low- and middle-income countries and regions, with countries such as Barbados, Timor Leste, and Ghana relating stories of the national experiences in the fight against NCDs.
Alarming Levels of NCD Risk Factors
The latest edition of the World Health Statistics reflects alarmingly high levels of risks related to many of the key factors that contribute to NCDs, such as heart disease, hypertension, chronic respiratory disease, cancer and diabetes – which together represent some 74% of premature mortality worldwide. Those risks include tobacco and alcohol use, physical inactivity, unhealthy diets laden with sugar, salt and fats, as well as air pollution.
Nearly one in four people (22.3%) globally still use tobacco. Obesity, driven by unhealthy diets and lifestyles, has been on the rise since the 1970s, with the greatest increases in obesity levels now being seen in WHO’s Southeast Asia Region, up from 1.9% to 4.7% (an almost 150% increase) and the Western Pacific Region, up from 2.7% to 6.4% (an almost 140% increase). Hypertension is also on the rise globally, and one of the biggest drivers of deaths from cardiovascular disease.
Every year, NCDs cause 41 million deaths worldwide, which corresponds to 74% of total deaths, including 17 million ‘premature deaths’ before the age of 70 years. Of the premature deaths, 86% occur in low- and middle-income countries (LMICs).
This burden is notably felt in the African region, where between 50% and 88% of deaths in at least seven African countries are due to NCDs, according to the 2022 World Health Organization (WHO) Noncommunicable Disease Progress Monitor. Around two-thirds of Africans with non-communicable diseases (NCDs) die prematurely – before the age of 70. And yet, despite this burden, there remains a large research gap on the continent.
Climate and Air Linkage
Additionally, climate change and air pollution add to NCD risks and burden and may worsen mental health conditions. People living with NCDs are especially vulnerable to climate- and pollution-related risks.
In their comments at the meeting, Both Norway and Barbados highlighted the need to bring the linkage between climate and health to the forefront of NCD policies.
“The question of the effects of climate change in this context is very timely, we have to raise awareness to the threat of climate change on health, not at least on NCDs. Climate change and NCDs are interlinked in many ways,” said Ingvild Kjerkol, Minister of Health of Norway.
She used the example of extreme heat exposure, extreme weather events, and related to that, the physical and mental stress of displacement and trauma as events that worsen NCDs.
“The weakest are, as always, at most risk. Climate change will also produce shocks to the health system and to deal with that you need the resilience that comes from universal health coverage.”
In 98% of African countries, the future health, development and safety of children are severely threatened by the effects of climate change, said Mia Mottley, Prime Minister of Barbados, in remarks to the group.
Mottley’s “Bridgetown Initiative” has been advocating for creative forms of debt relief to heavily indebted developing nations in Africa and elsewhere, so as to free up funds for more investments in both health and climate.
“Africa spends more money on debt service than it is now spending on health care. That is a completely unacceptable set of circumstances,” Mottley told the group.
“In the context of the consequences that we expect to flow from the climate crisis, it becomes even more acute, because there has to be the capacity to respond in ways that we might not otherwise have had to do in the past because of the extreme heat, the extreme cold, extreme droughts, etc. and its impact on households and individuals.”
Milestones of progress
Mottley and other national leaders at the meeting provided snapshots of the recent initiatives their countries had undertaken in the fight against NCDs.
Barbados, for instance, has committed to eliminating trans fats and partially hydrogenated oils by December 2024. They’ve also been working with the Caribbean Community (CARICOM) and the NCD Commission to address front-of-package labelling, which has challenges that Mottley acknowledges.
“[Front-of-package labelling] is one of the areas for small states that is going to be very difficult because we are not producers of goods. We are takers of goods and we therefore would wish to see a hemispheric approach or global approach to this to ensure that those goods which we import, comply with [regulations] and not simply to put regulations in place that cannot be met,” Mottley said.
Tobacco control and physical activity in Timor Leste
In regards to tobacco control, Timor Leste’s first tobacco cessation center, opened last year, has now expanded to six more municipalities. Warning size labels on cigarette packaging have increased, as well as the tax on tobacco, which has increased five-fold, from $19/kg to $100/kg in January 2023.
In recognition of these achievements, the Minister of Health, Dr. Odete Maria Freitas Belo, was awarded the WHO Director General’s World No Tobacco Day award back in May.
“If we are sincere about improving the health of our people, the prevention and control of NCDs must remain a top priority,” said President of Timor Leste, José Ramos-Horta.
He also pointed to Timor Leste’s efforts to promote more physical activity. WHO has supported the Ministry of Health in establishing open-air gymnasiums in various communities, encouraging citizens to embrace an active lifestyle.
“Our health is decided outside the health sector on where we are born, live, work and play. The cost effective way to battle the scourge of NCDs is to move upstream on the prevention agenda. It is easier to close the tap than to mop the floor,” said Ramos-Horta.
Vice President of Tanzania Philip Mpango pointed to rapid urbanization and changing lifestyles in Tanzania as among the reasons for the rise in NCDs in the country. While awareness-raising initiatives and early detection programs can make a difference, the fight against NCDs must be a systemic, global effort, he emphasized.
“As we navigate these challenges, we must acknowledge that the battle against NCDs is not one that Tanzania can fight alone. It is a global issue that requires global solidarity and cooperation,” said Mpango.
“As leaders, we are duty-bound to confront this crisis head-on. Through the measures we have implemented and the support of our international community, we can turn the tide on NCDs in Tanzania and ensure a healthier future for people.”
Source: The Health Policy Watch
