Non-communicable diseases (NCDs) are responsible for 40 million deaths annually, accounting for more than two-thirds of global mortality. Perhaps even more alarming, 15 million people under the age of 70 lose their lives due to NCDs each year. WHO has described this group of chronic illnesses as a ‘slow-motion disaster,’ and the status of NCDs as an urgent and pressing global health issue is undeniable.
Importantly, these conditions share four main risk factors: poor diet, physical inactivity, tobacco smoking, and inappropriate use of alcohol. The fact that these risk factors are common to all NCDs presents a unique opportunity for coordinated action to limit the threat NCDs pose to human health. Further, rather than individual choice alone driving poor health behaviors, systemic factors play a significant role. Socioeconomic status, educational attainment, access to fresh food, health literacy, urban layout and proximity of services all contribute to NCD risk, and must be integral to any mitigation strategy.
The prominence of these system-level factors means that there is a large scope for policy and public health initiatives to combat NCDs. Our response to the rising burden of NCDs will necessarily involve forces from both within and outside of the health sector. Health systems, doctors, and medical students all have an important role to play, but we will fall short of the ambitious target set out within the third Sustainable Development Goal (SDG) of reducing premature mortality from NCDs by one-third if we do not adopt a multi-sectorial, global, coordinated approach.
International health bodies such as IFMSA and WHO are therefore optimally placed to deliver health outcomes in this space. Accordingly, NCDs formed the basis of a thematic stream at this year’s IFMSA youth pre-World Health Assembly workshop. The WHA is an ideal forum for advocacy on NCD control, cancer prevention and treatment, and tobacco control. IFMSA delegates came together on these issues, with a variety of capacity-building and advocacy workshops and sessions. Ending childhood obesity, in particular, is key to ensuring a healthy future, and through a WHA-specific policy brief, we recommended a host of interventions including a tax on sugar-sweetened beverages, subsidies for healthy foods, and restrictions on the advertising of unhealthy food and drink to children. Further, we were privileged with the opportunity to write statements on cancer prevention and control, the importance of strengthened tobacco control, and the 2018 UN High-Level Meeting on NCD prevention and control, to be read to WHA delegates from around the world. Together with an acute sense of urgency and motivation for change, this preparation equipped us with the knowledge and skills to take us into the pre-WHA workshop and the WHA itself.
Several sessions of the youth pre-WHA were dedicated to NCDs. Additionally, there was time available for participants in the NCD stream to prepare their advocacy strategy for the WHA.
One of the keynote speakers present was Dr. Bente Mikkelsen, head of the Secretariat for the WHO Global Coordination Mechanism, who explained why NCDs are a public health disaster in slow motion. According to Dr. Mikkelsen, there is a need for additional resources, advocacy and social mobilization regarding this issue.
We also heard from Dr. Cherian Verghese, who taught us more about resources allocated towards cancer control, fiscal food policies such as sugar taxing and the need for a stronger international treaty for tobacco control. Finally, he gave us the advice to always make sure public health policies relate to practice and emphasized the need to go into the field, talk to the people working on the ground, and find out the best way to empower them to create change.
During a fascinating panel discussion on NCDs, Her Royal Highness Princess Dina Mired of Jordan, Dr. Mychelle Farmer from NCD Child and Dr. Ishu Kataria from Young Professionals Chronic Disease Network discussed how rapid distribution of unhealthy food in rural areas and increased urbanization cause the prevalence of obesity to grow rapidly. Several ways to reverse this trend, such as banning unhealthy products from school zones and promoting physical activity were mentioned. Additionally, Princess Mired spoke about the need to find creative ways to communicate with youth in order to prevent NCDs and explain to people how they are currently victims of commercial determinants of health. We were advised to participate in intergenerational collaboration and help think of new and fun ways to engage young people in NCD prevention.
This year, WHO has undertaken the “25 by 25” action plan for 25% reduction in premature deaths due to NCDs. WHO plans to assist countries in setting national targets, developing national action plans, and closely monitoring the results. Implementing the Global NCD Action Plan 2013-2020 will cost the WHO a staggering US $11 billion and hence needs to be undertaken efficiently with proper guidelines and a structural framework. Member states will come together and discuss various relevant policies including a sugar tax, fat tax (tax on junk food), reduction in tobacco usage, surge in prices of cancer medicines, more equitable distribution of resources, and promoting high-quality NCD research. The involvement of IFMSA as a healthcare students organisation in the decision-making process will provide a fresh take on these demanding issues as we represent 1.3 million medical students worldwide. The WHA will involve participation from member states, intergovernmental organizations, NGOs, private sector industries, and the media. Hence, it is very important for WHO and member states to focus on the issue of NCDs, keeping in mind the current threat it poses to the healthcare of billions of people worldwide. NCDs are an integral part of this year’s WHA agenda which was decided by the WHO Executive Board and more than 20 side events are being entirely dedicated to NCDs.
NCDs remain the biggest cause of death worldwide but continue to suffer from chronic underfunding and a relative lack of attention. The prominence of NCDs in this year’s WHA is a promising start, but tangible action is required if we are to reverse the increase in premature death that these illnesses cause. The time for action is now, and IFMSA is well placed to play an important role in this next big public health challenge of our generation.
Policy Brief on Ending Childhood Obesity.
Patrick Walker (AMSA-Australia)
Laura Kalkman (IFMSA The-Netherlands)
Adit Desai (MSAI-India)